DEFINITION/DESCRIPTION:
The application to the thorax of a rhythmical compression force in the direction of airflow. Movement occurs throughout the expiratory phase of respiration. The minimum effective compression force is applied, normally for a period of 3-5 respirations, interspersed with adequate periods of breathing control.
Vibrations are a smaller grade of the same movement carried out is a similar way.
CONTRAINDICATIONS:
- prolonged history of use of steroids
- metabolic bone disease e.g. osteoporosis, rib metastases
- predisposition to paroxysms of coughing
- presence of wheeze
- predisposition to bronchial hypersensitivity
- subject intolerance
- thoracic burns
- application directly over rib fractures
- frank haemoptysis
- low platelet count
HAZARDS/COMPLICATIONS/PRECAUTIONS:
- a rigid & non-compliant thorax
- increased bronchial constriction
- precipitated paroxysm of coughing
- breathlessness
- pulmonary carcinoma (unless specifically indicated)
INFECTION CONTROL:
- management of expectorated products
- hand hygiene
- appropriate disposal of clinical waste
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