An overview of your Lungs

Let's start from the basics – we all have two lungs, the right and the left one. Each is divided into lobes – the right lung has 3 lobes, namely upper, middle and lower, and the left lung has 2 lobes – upper and lower. Further segmentation of these lobes is comprised of 3 sections – topical (upper), anterior (front) and posterior (back) chamber. The ‘air sacs’ that you must have heard about while undergoing treatment or even from your schoolbooks, lie within these chambers. They’re not alone! They are fitted with a network of airways as well as blood vessels.

These sacs are the warehouses for the exchange of oxygen and carbon dioxide. So, they are crucial – to the extent that they are the center from where purified blood is carried away to other parts of your body!

An introduction with ‘Chest Percussion’

It commonly performed across households, especially on young children – the clapping on the chest and/or back that we do to loosen up the mucus such that one can cough out is technically termed as ‘percussion’. Hence, the purpose is clear – it is the act of unclogging the airways to keep the air sacs clear and your lungs healthy.

Respiratory therapy is medically termed as CPT (Chest Physical Therapy). CPT involves postural drainage and percussion (aka PD & P). Performing postural drainage and percussion involves techniques, positions, time duration, etc. This article ventures into a detailed elucidation of this airway clearance technique - postural drainage and percussion.

Postural drainage depends upon the following:

POSITION – The process takes the aid of gravity. The patient is made to lie down, bend downwards or sit in a position such that along with percussion, gravity aids in helping the mucus to shoot up.

The clap, on the other hand, should be on the right part. It could be over the breastbone, back, spine, stomach, lower ribs but not on the spleen in your left, liver on the right and kidneys at your back!

DURATION – Clapping on the chest wall of the person is done for 3 to 5 minutes. This could be followed by vibrations in that region for about 15 seconds (during exhalation). Gravity combines with these acts and helps in draining your lungs! The whole procedure can, however, last till 15 to 20 minutes. To avoid instances of vomiting, it is recommended before meals, early morning or at bedtime.

The positioning of your palm is important for PD & P

While giving percussion, your palm needs to be cupped (as if it were to hold some amount of water). This is done so that while clapping on the chest wall, some amount of air gets trapped within and the act does not hurt! Since cushioning is already applied, the clapping needs to be done a little forcefully and in a steady beat. The hollow sound lets you know that the procedure is okay, and the cup formation is right.

If vibration is required, your palm needs to be flattened. A light pressure (of the palm) on the area that is being given vibration, works well in shaking the mucus out into the larger airways.

The use of percussors and other equipment

The cupped palm method discussed above is essentially the traditional one. Nowadays, different percussor devices are in the market. Palm percussors come in both the electrical and non-electrical variant. There are also vibrators and drainage tables that aid in the process and also make self PD & P easier!

Percussions can be made more fun...

The best thing to do when one needs percussions is to make it a fun activity. You could ask one of your friends to do it for you. Turn on your favorite show while doing PD & P. For kids you need to first train them using coughing games like coughing the deepest cough and pinwheels. One thing needs to be assured, however – you need to minimize interruptions. Else, the percussion therapy does not turn out to be effective.