d. Avoid percussing over a female patient's breasts.
e. Place a towel over the bare skin or percuss over the patient's clothing. Do not
percuss over buttons, snaps, or zippers.
f. Remove rings or any other jewelry that might scratch or bruise the patient.
2-16. PERCUSSION PROCEDURE
a. Prior to the start of the treatment, auscultate the patient's lungs to locate the
areas of congestion. Position the patient in the posture that best facilitates drainage of
the areas to be percussed. Instruct the patient to breathe slowly and deeply to promote
b. Hold your hands in a cupped shape with the fingers flexed and the thumbs
pressed tightly against the index fingers.
c. Using a tapping or clapping movement of your cupped hands against the
torso, percuss the selected area in a rhythmic manner. A hollow sound indicates
correct performance of the technique. Percuss each area one to two minutes.
d. After completion of percussion, instruct the patient to breathe deeply and
cough to remove loosened secretions.
e. Auscultate the patient's lungs to evaluate the effectiveness of the treatment.
2-17. INCENTIVE SPIROMETRY
a. An incentive spirometer is a device that stimulates the patient to achieve
maximum voluntary lung expansion. The purpose of the device is to help the patient
achieve deeper inspirations.
b. In performing the exercise, the patient places his lips securely over the
mouthpiece of the spirometer and inhales as deeply as possible. At maximum inflation
there should be a slight pause, and the patient then relaxes and exhales.
c. The spirometer is normally equipped with a visual reinforcement device for
patient encouragement. For example, a light may come on at maximum inspiration or
the patient may watch a plastic ball rise to the top of a chamber during inspiration.
d. The patient should be encouraged to cough and expectorate any secretions
loosened by the deep breathing.
2-18. OXYGEN THERAPY
a. Oxygen is a colorless, tasteless, odorless gas that is slightly heavier than air.
Oxygen may be delivered by various administrative devices. The method of delivery