Percussion and Vibration

Percussion (Chest Clapping) Definition

Rhythmic striking of chest wall with cupped hands.

Percussion Mechanism

Air trapped between hand and chest creates vibrations.

Percussion Mechanism

Vibrations loosen thick secretions from bronchial walls.

Percussion Procedure

Cover area with towel/gown.

Percussion Procedure (Rationale)

Provides privacy.

Percussion Procedure (Rationale)

Provides comfort.

Percussion Procedure

Client breathes slowly and deeply.

Percussion Procedure

Use cupped hand with relaxed wrist.

Percussion Procedure

Strike rhythmically.

Percussion Procedure

Avoid flat hands.

Percussion Duration

1–2 minutes per segment.

Percussion Rate

3–5 claps/second.

Percussion Sound

Hollow/popping sound (not flat slapping).

Percussion Force

Firm, not painful.

Areas to Avoid When Percussing

Breasts.

Areas to Avoid When Percussing

Sternum.

Areas to Avoid When Percussing

Spinal column.

Areas to Avoid When Percussing

Kidneys.

Vibration (Definition)

Hands flat on chest, rapid gentle shaking during exhalation.

Vibration

Usually follows percussion.

Vibration Mechanism

Increases turbulence of air moving out.

Vibration Mechanism

Loosens thick secretions.

Vibration Mechanism

Moves mucus toward larger airways.

Vibration Procedure

Hands flat, fingers together (stacked or side by side).

Vibration Procedure

Client inhales deeply.

Vibration Procedure

Vibrate during exhalation only.

Vibration Procedure

Vibration stops during inhalation.

Vibration Procedure

Repeat over segment for about 5 exhalations.

Vibration Procedure

Encourage coughing/expectoration after vibration.

Vibration Procedure (Rationale)

Loosening secretions is not enough; they must be removed.