Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent
CPT4 code
Name of the Procedure:
Manipulation Chest Wall (Commonly known as Chest Physiotherapy) — including techniques such as cupping, percussing, and vibration.
Summary
Chest wall manipulation involves physical techniques, such as cupping, percussing, and vibration, to help clear mucus from the lungs and improve lung function.
Purpose
Chest wall manipulation is used to treat respiratory conditions where mucus buildup occurs, such as chronic bronchitis, cystic fibrosis, and pneumonia. The goal is to enhance lung function and breathing efficiency by facilitating the removal of mucus.
Indications
- Chronic obstructive pulmonary disease (COPD)
- Cystic fibrosis
- Bronchitis
- Pneumonia
- Respiratory infections with high mucus production
Suitable for patients experiencing difficulty in clearing mucus or impaired lung function.
Preparation
- No specific preparation like fasting required.
- Ensure the patient is hydrated.
- A thorough respiratory assessment will be performed prior to the procedure.
Procedure Description
- Cupping: The therapist forms a cup shape with their hands and rhythmically taps the chest to loosen mucus.
- Percussing: Similar to cupping but involves striking the chest wall vigorously to dislodge mucus.
- Vibration: The therapist vibrates the chest using their hands or a mechanical device to promote mucus movement towards the larger airways for easier expectoration.
Tools and Equipment:
- Hand-held mechanical percussors (if used)
- Vibratory devices (if used)
The procedure does not generally require anesthesia or sedation.
Duration
Each session typically lasts 15 to 30 minutes.
Setting
Usually performed in an outpatient clinic, hospital respiratory therapy department, or at home under instruction.
Personnel
- Respiratory therapists
- Physical therapists
- Trained nurses
Risks and Complications
- Discomfort or pain during the procedure
- Bruising of the chest wall
- Increased coughing immediately following treatment
- Rarely, broken ribs in patients with osteoporosis or other brittle bone conditions
Benefits
- Improved clearance of mucus from the lungs
- Enhanced lung function and breathing
- Relief from symptoms associated with mucus buildup
- Benefits typically felt within days of regular treatment
Recovery
- Patients may feel slight soreness in the chest muscles.
- Increased coughing to expel mucus is expected.
- Follow-up sessions may be scheduled based on the patient’s condition.
Alternatives
- Inhaled medications (bronchodilators, mucolytics)
- Postural drainage
- Positive Expiratory Pressure (PEP) therapy
- Mechanical insufflation-exsufflation devices
Alternatives may be less physically demanding but might not be as effective in certain cases.
Patient Experience
During the procedure, patients might feel tapping and vibrating sensations, which could be uncomfortable but generally not painful. Post-procedure, they may experience light soreness and increased coughing to clear mucus. Pain management typically includes over-the-counter pain relievers if necessary. Comfort measures like ensuring a warm and comfortable environment can also help.