Respiratory: Chest physiotherapy (for nursing assistant training)

Chest physiotherapy, or simply CPT, is a technique that can be performed by certain healthcare workers for people suffering from diseases that impair mucus clearance, such as chronic obstructive pulmonary disease, bronchitis, and cystic fibrosis. The goal of CPT is to help the client clear excessive mucus secretions from the lungs in order to prevent complications, like mucus plugs, infections, and atelectasis. 

Before performing this procedure, be sure this is within your scope of practice and is allowed by your facility's policy. To start, first gather the supplies you’ll need, including gloves, face shield, and gown for you and pillows for the client’s comfort. In addition, keep suction machine equipment available to assist in clearing airway secretions in case the client’s ability to cough and clear their airway is ineffective. Make sure you know if the client is feeling weak, anxious, or in pain. CPT must be scheduled according to the client’s needs and daily routine and activities. Individuals in pain can take analgesics 20 minutes before beginning CPT. Each CPT session usually lasts between 20 and 40 minutes which can be very exhausting, so try to schedule it between rest periods. Avoid performing CPT around 1 to 2 hours before and after meals. The best times to perform CPT are in the morning to clear secretions that may have accumulated over night as well as at night to clear the lungs before bedtime. Frequency of CPT varies for each client from just once daily to as frequent as every 2 hours. This will depend on each client’s needs and capabilities as well as the healthcare professional orders, so make sure to check the nurse charts.

Now, CPT includes postural drainage, percussion, vibration, and shaking. It involves a lot of touching, so before you begin, make sure you always explain to the client where and how you’ll be touching. Postural drainage involves placing the individual in different positions for 10 to 15 minutes, using gravity to help clear lung secretions. Each position drains a corresponding lung section into the trachea, so before starting, you should know which lung segments require postural drainage to ensure the therapy is appropriate to the client's needs.