RESPIRATORY MANAGEMENT IN SPINAL CORD INJURY:
BREATHING AND THE RESPIRATORY SYSTEM IN SCI: TREATMENTS FOR RESPIRATORY TRACT
Percussion can be used while you are in a postural drainage
position to dislodge and mobilize secretions from the air sacs into larger
airways so they can be coughed up or suctioned. This is accomplished by
forcefully tapping over the affected areas of the chest. Indications for
Presence of thick or excessive mucus
Inability to raise mucus with assisted cough.
Reasons to avoid percussion include:
Irregular pulse, or
Tendency to bleed (taking Heparin or Coumadin or if pulmonary embolus exists).
Following is the procedure for percussion:
Lie in a postural draining position, i.e. with your chest elevated above
your head, so affected area is elevated. Lie on the left side if the right
side is to be percussed, or, lie on the right side if the left side is to
Place towel over the area to be percussed.
Hand should be cupped, with the tip of the thumb at the side of the middle
joint of the index finger. Fingers should be straight and held closed. Assistant
should remove all jewelry.
With hand in this cupped position, forcefully tap the rib cage over the affected
area, using a smooth rhythm and keeping the arms and shoulders relaxed. (The
motion is similar to playing a bongo drum).
Percuss for 1-2 minutes. Always avoid percussing over the spinal column and
Use suction or assisted cough, following each position.
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