Airway clearance is very important as it removes mucus from the lungs, helping to prevent infections. You should do some type of airway clearance one to two times a day and at least three times a day when you’re feeling sick. The types of airway clearance you use will change throughout your lifespan. Choose a technique you want to do every day. Chest Physical Therapy (CPT)
There are three ways to do CPT:
• Postural Drainage
• Percussion
• VibrationPostural Drainage
This method relies on gravity and body positions to drain excess mucus from the lungs. Positions are limited for infants, keeping them upright or on their side because they tend to spit up. Older children can tolerate all of the positions that an adult performs. Patients with reflux disease should avoid any head-down positions. Percussion
By cupping their hands, caregivers create a hollow clapping sound to loosen mucus in the lungs. For infants, the percussion is made with 2-3 fingers, a bottle nipple, or a percussor cup. Each method takes about 2-5 minutes. For older children and adults, CPT is performed using the whole hand, and even doing both sides at the same time. Sessions last 25-30 minutes. Vibration
By using their hands or manual devices on the chest, caregivers can create vibrations that shake secretions from the walls of the lung, allowing the patient to clear them by coughing. In infants, this force can be created by using “Tickle Me” toys, a bouncy seat with vibration, or bouncing the baby on your knee. Using a trampoline, tumbling, performing wheel barrow races, and tickling are good ways to achieve this with older children. In adults, use one or two hands over a specific area of the lung to create vibrations. PEP Therapy
Positive Expiratory Pressure (PEP) therapy is done by breathing through a device that provides pressure while exhaling. This pressure keeps the small airways of the lungs open to improve the movement of secretions. There are many different forms of PEP therapy, including Acapella®, Flutter®, Therapep®, and Bubble PEP. Each treatment should be done twice a day for 15-20 minutes. Acapella®
The Acapella® helps shake mucus from the walls of your lungs. The blue Acapella® is for little kids, the green one for older kids and adults. It can be adjusted so that it is “easy” or “hard” to blow out. Also, it can be used in any position and with any postural drainage position. The Acapella® is great for kids starting PEP therapy. Flutter®
This oscillating device also creates pressure and vibration, but unlike the Acapella® it doesn’t come in different levels of PEP and is not adjustable. Because the settings on this device are fixed, it’s more difficult for younger children to use. Therapep®
This is a PEP device with no oscillation, but it has six different settings, making it easier for younger kids to use. Bubble PEP
Blowing bubbles is an easy and fun way to do your airway clearance every day. Fill an empty milk jug half way with water, then insert a rubber tube to blow through. It’s just like blowing bubbles in a glass of milk! Food coloring can be added to make it even more fun. Your friends and family will enjoy it, too. 
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