Which is the most appropriate modification for a patient experiencing distress during postural drainage and percussion?

The most appropriate modification for a patient experiencing distress during postural drainage and percussion is the use of an external percussive device, such as a vest. This technology provides a more comfortable and less physically taxing alternative for the patient, especially when they are already experiencing distress from manual percussion methods.

External percussive devices generate chest wall vibrations that help loosen secretions without the need for manual percussion, which can sometimes be uncomfortable or distressing for patients. Additionally, these devices allow for a more controlled and consistent application of vibrations, which can be beneficial for patients with heightened sensitivity or anxiety related to the procedure.

In contrast, modifying the position of the bed or using manual percussion techniques may not effectively reduce the patient's discomfort. For instance, providing percussion with the bed flat or adjusting the head of bed may still require the patient to endure the physical sensations of manual therapy, which could exacerbate their distress.

Overall, using an external percussive device prioritizes the patient's comfort while still addressing the need for effective airway clearance.