How to Do
Chest Physical Therapy
(CPT)
Children, Adolescents, and Adults
©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital




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©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital

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Name of Child: Date:____________________
How to Do
Chest Physical Therapy
(CPT)
Children, Adolescents, and Adults
Your child needs a treatment called Chest Physical Therapy or CPT. CPT is also
called Percussion and Postural Drainage (P & PD). Read this booklet to learn
what CPT is and how to use it to help your child.
What is CPT?
Chest Physical Therapy (CPT) is something you can do to help your child
breathe better. Sometimes there is too much mucus, or it is too thick. It blocks
the air from moving in and out of your child’s lungs. Mucus makes it hard for
your child to breathe. Mucus that sits too long in the lungs can also grow germs
that can make your child sick. CPT helps to loosen your child’s mucus, so your
child can cough it up.
Think about how you would take Jell-O out of a mold. You tilt the mold over,
then shake it and tap it to loosen the Jell-O . Mucus is like that Jell-O , and CPT
helps to get it out.
©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital




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Words to Learn
Airways Air moves through these and into your lungs. The airways of the nose
and throat lead to the big airways in the chest. The big airways branch off into
smaller airways in the lungs. The big airways are like a trunk of a tree, and the
small airways, like the branches.
Chest Physical Therapy (CPT) is something you can do to loosen your child’s
mucus. The three parts to CPT are postural drainage, percussion and deep
breathing and coughing.
Percussion is clapping
the chest. Percuss
means to tap sharply. A
drum is a percussion
instrument. Percussion
in CPT can be done with
either a cupped hand
or an electric percussor.
The clapping shakes the
cupped hand
inside of the chest and
loosens mucus, so it is easier to cough out.
Postural Drainage moves the mucus by changing the child’s position. Mucus,
like water, moves from high places to low places. Tilting the child helps move
the mucus from the small airways at the bottom of the lungs to the large airways
in the middle. The most mucus moves into the large airways when you do
percussion and postural drainage together.
Deep breathing and coughing helps to move the loosened mucus.
Lobe is a section of the lung. The left lung has two lobes, and the right lung
has three lobes.

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©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital

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Before Doing CPT
• It is best to do CPT before meals or at least one to two hours after eating.

This will make it less likely that the child will feel sick to the stomach or

throw up.
• The best times for CPT are early morning and at bed time. Early morning

CPT helps remove the mucus that built up over night. Bed time CPT

takes out the mucus of the day, and helps the child cough less at night.


Your doctor may want you to do CPT more often.
• Your doctor may prescribe medicine to open the airways. This may come as an

SVN (small volume nebulizer) or an MDI (metered dose inhaler). This

medicine should be taken before CPT. The medicine, positioning and

percussion all work together to clear the mucus from the lungs.
• The person doing the CPT should take off all rings and jewelry on the hands or

wrists.
• If the child’s clothing is tight or has thick seams, remove it.
• If the child is wearing clothes with buttons, remove it.
• Have the child wear a t-shirt or put a soft cloth over the spot that will be

percussed.
©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital




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You Need:
• A place to do CPT. You will need a bed, pillows, a couch, ?oor or a special

table (slant board).
• Your hand or a percussor.
• A clock or a timer, to know how long to percuss.
What to do:
• Always percuss over the ribs. Never percuss below the ribs or on the stomach.

The lungs are in the chest, protected by the ribs. Never percuss on the

backbone, breast bone, nipples or on any IV tubes or feeding tubes.
• Do CPT in each spot for

p 2 minutes p 3 minutes or p ____ minutes.


(Health Care Provider: check one)

Your doctor will tell you how long to percuss.

One session of CPT should take 20 to 40 minutes.
• Usually, CPT is done in all the positions and percussion in all the spots.

Your doctor may have you do more in some areas, where the chest x-ray


shows more mucus.
• If your child’s mucus has bright red blood in it, stop the CPT and call your

doctor.

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©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital

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Positions
p Top Upper Lobes
• Sit the child up. Tilt the child half way between sitting up and laying ?at.
• Percuss between the nipple and collarbone on the left side of the chest for

p 2 minutes p 3 minutes

or p ____ minutes.
• Percuss between the nipple and collarbone on the right side of the chest for

p 2 minutes p 3 minutes

or p ____ minutes.
©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital




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p Back Upper Lobes
• Sit the child up. Tilt the child half way between sitting up and laying ?at.
• Percuss over the shoulder blade on the left side of the back for

p 2 minutes p 3 minutes

or p ____ minutes.
• Percuss over the shoulder blade on the right side of the back for

p 2 minutes p 3 minutes

or p ____ minutes.


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©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital

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p Front Upper Lobes
• Lie child on his or her back.
• Percuss between the nipple and the collarbone on the left side for

p 2 minutes p 3 minutes

or p ____ minutes.
• Percuss between the nipple and the collarbone on the right side for


p 2 minutes p 3 minutes

or p ____ minutes.
©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital




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p Front Right Middle Lobe
• Lie child down on his or her left side, feet higher than head.
• Percuss below the right arm, but above the bottom edge of the ribs, for

p 2 minutes p 3 minutes

or p ____ minutes.

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©(2001, 2003, 2009) The Emily Center, Phoenix Children’s Hospital

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