INTRODUCTION

It is a technique in which different positions are assumed to facilate the drainage of secretions
from the bronchial airways. Gravity helps to move the secretions to the tracheae to be coughed
up easily.

PREPARATION OF POSTURAL DRAINAGE

 Loose and tight or bulky clothes.

 Sputum cup or tissue paper.
 Explain the treatment procedure to the patient.
 Teach the patient to deep breathe prior to postural drainage.
 Make any adjustment tube and wires such as test tubes, electrocardiography wire.

MANUAL TECHNIQUES

1. Percussion
2. Vibration
3. Shaking

Percussion: Percussion is an assessment technique which produces sounds by the examiner

tapping on the patient's chest wall. Just as lightly tapping on a container with your hands
produces various sounds, so tapping on the chest wall produces sounds based on the amount of
air in the lungs. Percussion sets the chest wall and underlying tissues into motion, producing
audible sounds and palpable vibrations. Percussion helps to determine whether the underlying
tissues are filled with air, fluid, or solid material.

Vibration:

 It is also used to mobilize secretion to larger airways.

 It is applied during the expiratory phase.
 Vibration is applied by placing both hands directly on the skin over the chest wall and
gently compressing and rapidly vibrating the chest wall as the patient breaths out.
Shaking:

 Shaking is a more vigorous form of vibration applied during exhalation.

 The therapist thumbs are locked together.
 Then the open hands are placed directly on the patient skin and fingers are wrapped on
the chest wall.

POSTURAL DRAINAGE SEQUENCE

 Check the patient vital signs and breathe signs.

 Correct positions should be given to the patient.
 Maintain its positions for 5-10 minutes. If the patient can tolerate it or as long as the
position is productive.
 Have the patient breathe deeply during postural drainage.
 Encourage the patient to take a deep, sharp double cough whenever necessary.

INDICATIONS

 Bed ridden patient

 Those who have received general anesthesia
 Painful incision causing restricted deep breathing and coughing
 Diseases with increased production or viscosity of mucous
 Pneumonia
 Acute lung disease
 Lung abscess

CONTRAINDICATIONS

 Over fracture
 Osteoporotic bone
 Over tremor area
 Trauma
 Post thoracic surgery
 Chest wall pain