Postural drainage to clear secretions from the left lower lobe in a patient who had a lumbar fusion is MOST effectively achieved with which position?

• A. Left sidelying with the head lower than the feet
• B. Left sidelying with the head lower than the feet, with percussion
• C. Right sidelying with the head lower than the feet
• D. Right sidelying with the head lower than the feet, with percussion

Answer: (C)

Postural drainage relies on gravity to move secretions from the target lung region toward the central airways so they can be coughed out. To maximize drainage from a specific lobe, you place the patient so that that lobe is the most dependent part of the chest, while also considering any medical precautions.

In this scenario, after a lumbar fusion, maintaining spinal precautions is important and the position chosen keeps the spine neutral while still using gravity to favor drainage from the left lower lobe. Lying on the right side with the head lowered toward the feet (head-down) achieves this balance best, directing secretions from the left lower lobe toward the trachea without excessive lumbar flexion. Percussion can help loosen secretions, but it isn’t required in this case, so the option without percussion is considered most effective.