Chest physiotherapy CPT positioning for larger children age 2 and older (1033)

Positioning for larger children - age 2 and older

What is CPT?   

CPT is a treatment to help loosen mucous in your child's lungs.  CPT is sometimes called chest clapping. 

When should I do CPT?

Your doctor will tell you how many times to do CPT each day. 

CPT should be done either:

• Before your child eats.
  OR
• 1 hour after eating.  

How do I prepare to do CPT?

• Wash your hands.
• Remove rings, bracelets, or watches from your hands
• Remove tight clothes from your child

How is CPT done? 

Your doctor or nurse will show you

how to clap over each area.  

Usually each spot is clapped for 2 to 5 minutes.  Your doctor or nurse will tell you how long to clap each spot.  
Using your cupped hand or a “clapper” begin clapping your child’s chest. Your healthcare provider will show you how strong to clap.

Do not clap:

• On bare skin
• Over the spine
• Over the breastbone
• Over the stomach 

During CPT, ask your child to cough and spit into a tissue or basin.  

What positions should I use for CPT?

Your doctor or nurse will tell you which positions should be used.  Look at the following pictures. 

Upper Areas: 

1. Front  upper area, both sides

• Your child should lie flat on their back.  
• Place a pillow under the knees.
• Clap between your child's nipple and collarbone. 

2.Top upper area, both sides

• Your child should sit in a reclining position, about halfway to upright.  
• Clap over the right and left collarbones.    

3. Back upper area, both sides 

• Your child should sit bending forward.  
• Your child might want to lean on a table or rest against a stack of pillows.
• Clap your child's back on the shoulder blade.  
• Do not clap on the backbone (spine). 

Middle areas:

1. Left middle area

• Your child should lie on their right side.  
• Place a pillow behind your child’s back from shoulder to hip.  
• Roll your child back part way onto the pillow. 
• Do not turn your child all the way onto their back.
• Clap above your child’s left nipple, toward the armpit.
• Clapping the left side is shown in the picture below.  Have your child turn over to do the right side.

2. Right middle area

• Your child should lie on their left side.  
• Place a pillow behind your child’s back from shoulder to hip.  
• Roll your child back part way onto the pillow. 
• Do not turn your child all the way onto their back.
• Clap above your child’s right nipple, toward the armpit. 

Lower areas:

Important note:  
Some children should not have their head or the bed “tipped down” like the picture below.  Check with your doctor before tipping the bed.
If your doctor tells you not to tip the bed, position the bed flat and clap the spot shown.

1. Right and Left Side, Lower Area

• Have your child lie on their side.  
• Your child's arm should be placed out of the way. Put the arm either above the head or in front of their body.
• Clap over the side of your child’s chest, above the bottom edge of the ribs.  
• Clapping the right side is shown in the picture below.  Have your child turn over to do the left side.   

2. Lower Front Areas 

• Have your child lie on their back.  
• Clap between the nipples and the stomach on each side. 
• Do not clap on your child’s breastbone or stomach.