Republic of the Philippines

Isabela State University

Echague, Isabela

PERFORMANCE EVALUATION CHECKLIST

Name: Rating:
Course/Year/Group:

SKILL: Chest Physiotherapy

Note: this procedure includes groups of treatments that are done to improve respiratory by way of improving
lung expansion, strengthening respiratory muscles and promotion of the elimination of excess mucus from the
respiratory system.
PREPARATION: RATING
1. Explain the procedure to the patient (explanation of the procedure reduces anxiety
and enhance cooperation)
2. Perform hand-washing (to prevent that possible spread of infection)
3. Assess for baseline vital signs and general condition of the patient

PROCEDURE:
BREATHING EXERCISES:
1. Position the patient in upright, seated position at the edge of the bed
2. Ask the patient to take deep breath through the nose then exhale through a pursed
lip. The exhalation should take twice as long as the inhalation (i.e. the patient may
start inhaling for 2 seconds then exhale for 4 seconds)
COUGHING EXERCISES:
3. Before either technique, assist patient to sit uprights and glass of water.
4. For controlled cough technique
a. Instruct the patient to inhale through a pursed lip and hold his/her breath for a
few seconds; and
b. Make two brief gentle coughs
5. For huffing technique
a. Instruct the patient to inhale through a pursed lip and hold his/her breath for a
few seconds; and
b. Instruct patient to exhale by using abdominal muscle to push air out.
PERCUSSION
6. Place a lightweight towel over the patient’s chest or back
7. Cup the hands by bending then at the knuckles. Hold thumb against the index finger
while keeping the fingers closed together top form a cup.
8. Clap hands over the intended area in a rhythmic manner. Do it in a fairly fast but
comfortable fashion. It should be firm so as the mucus in the lungs will be moved.
9. Instruct the client to breathe normally during the entire duration of the therapy.
VIBRATION
10. Place hand flat over the intended area. Stiffen shoulder and arm so the whole
shoulder, arm and hand vibrate
11. Create vibration by quickly contracting and relaxing arm and shoulder muscles.
Vibration should be done with gentle, downward pressure on the area.
12. Perform vibration while the patient exhales. Have the patient “SSS” when he/she
breathed out if he/she can.
13. Start each vibration at the outside edge of the chest or back and move slowly
towards the center.
14. Repeat vibration for about 5 breathes per segment.
 Republic of the Philippines
Isabela State University
Echague, Isabela

PERFORMANCE EVALUATION CHECKLIST

Name: Rating:
Course/Year/Group:

POSTURAL DRAINAGE
15. Gather material that are needed: pillow, sputum cup or kidney basis, paper
tissues, suction machine as needed.
16. Auscultate for lung sounds to determine the areas that need postural drainage
17. Observed general guidelines in performing postural drainage:
a. This procedure is done 2 to 3 time a day BEFORE MEALS and BEDTIME.
Each position is done 3-15 minutes.
b. Bronchodilators, mucolytic agents, as well as nebulizer maybe administered
BEFORE THERAPY.
c. Encourage diaphragmatic breathing throughout the therapy.
18. Upper Lobes – Apical Segment
a. Assists patient in upright or fowler’s position
b. Percusses/vibrates just below the collar bones or just above the shoulders on
both sides.
19. Upper Lobes – Anterior Segments
a. Place patient in supine position with pillow under the knees
b. Percusses/vibrates just below the collar bone.
20. Lower Lobes – Superior Segments
a. Place patient in prone position with pillow under the abdomen and legs
b. Percusses/vibrates just below the shoulder blades
21. Left Upper Lobe – Posterior Segments
a. Place patient on a right side with a pillow under the right armpit and lean
forward at a 45 degrees angel against the pillow.
b. Percusses/vibrates on the top of the left shoulder blade
22. Lower Lobes – Anterior Segments
a. Place patient on supine position with the head lower than the chest and hips.
Place pillow under the knees.
b. Percusses/vibrates on both sides just below the nipple and above the lower ribs.
23. Right Lower Lobe – Lateral Segment
a. Place patient on left side with pillow under the left lower ribs and hip. Ensure
that the head is lower than the chest and hips.
b. Percusses/vibrates below the right armpit above the lower ribs
24. Lower Lobes – Basal Segments
a. Position patient on prone position with pillow under abdomen and legs. Ensure
that the head is lower than the chest and hips.
b. Percusses/vibrates below the shoulder blades and above the lower ribs.
 Republic of the Philippines
Isabela State University
Echague, Isabela

PERFORMANCE EVALUATION CHECKLIST

Name: Rating:
Course/Year/Group:

25. Left Lower Lobe – Lateral Segment

a. Position patient on right side with pillow under the right lower ribs and hip.
Ensure that the head is lower than the chest and hips.
b. Percusses/vibrates below the shoulder blades and above the lower ribs
26. Provide meticulous oral care
27. Document relevant data accordingly

Rating Scale:
0 – Not observed
1 – Needs improvement
2 – Satisfactory
3 – Very Satisfactory

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Name and Signature of Professor