Chest physical therapy is the preferred treatment in the MIEMSS for both preventing and treating pulmonary complications caused by retained secretions. The beneficial results of chest physical therapy in our facility, including improvement in chest roentgenogram appearance, arterial blood gases,8 and lung compliance,9 have been documented. The cases presented illustrate the successful use of chest physical therapy despite the presence of severe trauma and possible contraindications. The potential benefits of chest physical therapy may outweigh the existing possible contraindications. 204 PHYSICAL TH