CHEST THERAPY (CPT)
CONTENT
Purpose of CPT
Anatomy
Clapping and vibration
Positions for CPT
When to do CPT
Signs of tiring or distress
Problems
Be careful!!!
After CPT
Purpose of CPT
1. CPT is used to thin and move mucus in the lungs so your baby can cough it up.
2. Certain body positions and percussion (clapping) are used to move mucus and help expand collapsed areas of your baby’s lung.
ANATOMY
1. Lungs are two balloon-like organs located in the chest.
2. The right lung has 3 lobes.
3. The left lung has 2 lobes.
CLAPPING AND VIBRATION
1. Clapping is done holding hand in a cupped manner with all the fingertips and thumbs together.
2. In a small baby, clapping may be done holding two or three fingers together and tapping the chest.
3. Clapping is done firmly at a fairly fast rate.
4. Baby should have blanket or shirt over his skin.
5. Clapping breaks loose plugs and mucus from lungs. It stimulates baby to cough and bring up secretions.
6. Vibration is done after clapping to stimulate the flow of secretions.
7. To vibrate, hand is kept flat and pressed firmly against same area of lung. Result is described as a controlled quiver. Fingers placed flat against chest wall of small baby may be sufficient to produce the same effect.
8. Approximately 1-2 minutes should be spent over one area.
9. Vibration with padded electric toothbrush or small hand vibrator may be used.
10. Coughing may occur shortly afterward. Suction your baby with a bulb syringe.
11. The treatment should last no longer than 10-15 minutes.
POSITIONS FOR CPT
Position baby in your lap or on the bed using pillows for support.
1. Upper lobe
· Lean the baby back on the pillow at a 30-degree angle.
· Clap with cupped hand over area of clavicle (collar bone) on both sides.
2. Upper lobe
· Place baby flat on back on pillow in lap.
· Clap with cupped hand just below the collar bone on each side.
3. Upper lobe
· Lean baby forward over pillow or hand at 30-degree angle.
· Clap with cupped hand over upper back on both sides.
4. Left upper lobe
· Place baby on his right side with his hips about 5 inches higher than his head.
· Roll him ¼ turn backwards.
· Clap with cupped hand over left nipple.
5. Right middle lobe
· Baby on his left side with his hips about 5 inches higher than his head.
· Roll him ¼ turn backwards.
· Clap with cupped hand over right nipple.
6. Lower lobe
· Place your baby flat on his stomach.
· Clap with cupped hand at the top of his shoulder blade on each side of his spine (backbone).
7. Lower lobe
· Place your baby on his left side with his hips about 8 inches higher than his head.
· Clap with cupped hand just beneath his armpit.
8. Lower lobes
· Place your baby on his right side with his hips 8 inches higher than his head.
· Clap with cupped hand just beneath his armpit.
9. Lower lobes
· Roll him forward ¼ turn.
· Clap with cupped hand over topmost lower ribs.
10. Lower lobes
· Place your baby on his left side with his hips about 8 inches higher than his head.
· Roll him forward ¼ turn.
· Clap with cupped hand over topmost lower ribs
11. Lower lobe
· Place your baby on his stomach with his hips 8 inches higher than his head.
· Clap with cupped hand over the lower ribs close to his spine (backbone) on each side.
WHEN TO DO CPT
1. As ordered by the doctor.
2. Primarily early morning or prior to bedtime.
3. The treatment should last no longer than 10-15 minutes,
4. Before meals or 1½ hours after feeding, to prevent vomiting.
5. Contact your baby’s doctor if he requires CPT more often than it is ordered.
6. Many babies “enjoy” CPT. They often fall asleep or become quiet during therapy.
SIGNS OF TIRING OR DISTRESS
1. Baby becomes blue or pale.
2. Baby becomes floppy or limp.
3. Baby’s breathing becomes difficult or increases in rate.
PROBLEMS
1. Breathing difficulties.
2. Aspiration (breathes mucus or formula into the lungs).
3. Vomiting.
4. Pauses in the baby’s breathing from a blocked airway.
5. Bruising.
6. Broken ribs.
7. Decreased oxygen.
8. Injury and/or bleeding of the liver or spleen.
BE CAREFUL!!!
1. Use only battery-operated, electrically safe vibrators.
2. Do not apply vibration or percussion (clapping) to broken skin area.
3. Avoid positions that will cause breathing problems. Examples of these positions are:
· Placing your baby flat or with his head down when his stomach is full.
· Sitting your baby up without head support and with his neck bent forward—blocking his breathing passage.
4. Avoid clapping over fractures, stomach, backbone, or recent chest surgery areas
AFTER CPT
1. Baby may cough up mucus. Suction his mouth and nose using a bulb syringe.
2. The baby’s doctor will determine how long your baby needs CPT.
Reviewed/Revised:
1/99, 2/01, 1/03, 8/05, 4/07, 1/10
Chest Therapy 6