Anterior Chest Percussion

[Jo Dirt]

I started anew case yesterday with a 14 yr old boy who is immobile with a tracheostomy. He was terribly congested with thick phlegm that was hard for him to get up. After I gave him a breathing tx another nurse stopped by and said we should do some chest percussions on him. I don't doubt this is a seasoned nurse who knows her stuff, but I am wondering about doing chest percussion on the anterior wall of the chest. She squirted some saline down his trach and proceeded to beat the tar out of him with the mask off an ambu bag.

I thoght it could be dangerous to hit the chest this way?

BTW, it sure got the job done, though, he coughed up copious amounts of phlegm for two hours afterward.

[Antikigirl, ASN, RN]

I do posterior, the bones there help like a drum! And you don't have to THUMP hard...just rhythmic from bottom to top like a massage.

Phlem production is the goal...remember..lungs are a one way street....things go in, have to come out that way. The thing is..have suction nearby to help out!

Squirting NS down? Ummmmmm not what I would choose! Aspiration big time....