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Patient Instructions

Postural drainage is an important way to treat bronchiolitis (swelling and too much mucus in the airways of the lungs). When you do postural drainage, you get into a position that helps drain fluid out of your lungs. Your doctor may recommend postural drainage for you. It may help:

• Treat or prevent an infection
• Make breathing easier
• Prevent more problems with your lungs

A respiratory therapist, nurse, or doctor should show you the best position for you.

The best time to do postural drainage is either before a meal or 1 ½ hours after a meal, when your stomach is emptiest.

Use one of the following positions:

• Sitting
• Lying on your back, stomach, or side
• Sitting or lying with your head, flat, up, or down

Stay in the position as long as your doctor has told you to (usually at least 5 minutes). Wear comfortable clothes, and use pillows to get as comfortable as possible. Repeat the position as often as your doctor has told you to.

Breathe in slowly through your nose, and then out through your mouth. Breathing out should take about twice as long as breathing in.

Your doctor may also recommend percussion or vibration to you.

Percussion can help break up thick fluids in your lungs. Either you or someone else claps a hand on your ribs while you are lying down. You can do this with or without clothing on your chest:

• Form a cup shape with your hand and wrist.
• Clap your hand and wrist against your chest (or have someone clap your back, if your doctor tells you to).
• You should hear a hollow or popping sound, NOT a slapping sound.
• Do not clap so hard that it hurts.

Vibration is like percussion, but with a flat hand that gently shakes your ribs.

• Take a deep breath and then blow out hard.
• With a flat hand, gently shake your ribs.

Ask your doctor, nurse, or respiratory therapist how to do this the right way.

Do percussion or vibration for 5 to 7 minutes in each area of the chest. Do this on all of the areas of your chest or back that your doctor tells you to. When you finish, take a deep breath and cough.

Call your doctor if you have:

• Indigestion
• Vomiting
• Pain
• Severe discomfort
• Difficulty breathing

Chest physical therapy; CPT

Vender JS, Szokol JW. Oxygen delivery systems, inhalation therapy, and respiratory therapy. In Hagberg, ed. Benumof’s Airway Management. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 13.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.