Incentive Spirometry: Difference between revisions
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== Guideline on appropriate use == | |||
The purpose of incentive spirometry is to facilitate a sustained slow deep breath. The device gives the individual visual feedback regarding flow and volume. The device can prevent and reverse atelectasis when used appropriately and regularly.<ref>Hough A, Physiotherapy in Respiratory and Cardiac Care: an evidence based approach. 4th Edition. Cengage Learning, 2014. p186-189.</ref> | |||
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<br>1. Therapist demonstrates using a separate device and provides information sheet regarding technique, prescription of use and cleaning advice based on manufacturers instructions.<br>2. Patient should be in a relaxed position suitable for deep breathing (e.g. sitting upright in a chair or side lying if extra volume is required in one lung due to ventilation perfusion matching).<br>3. Patient creates a tight seal around the mouthpiece and inhales deeply and slowly. The patient watches the flow meter for visual feedback. If possible the patient sustains the inhalation to create an end-inspiratory hold. Ideally the inhalation is sustained for 4-5 seconds.<br>4. Patient relaxes seal around mouthpiece and exhales; normal breathing is resumed with relaxed shoulder girdle. <br><br> | |||
-Advise patient to take approximately ten incentive spirometry breaths per waking hour (use clinical reasoning to prescribe using Frequency, Intensity, Time and Type principles).<br>-Patients with an oxygen requirement can use device with a nasal cannulae or a device, which entrains oxygen. <br>-Deep breathing offers a similar effect. However, using an incentive device as feedback may create greater inhaled volumes, greater control of flow and more motivation to participate in therapy. <br>-The device can be used with paediatrics and individuals with learning difficulties. | |||
-The device is not suitable for people with severe dyspnoea.<br> | |||
== <br>Indications<ref>Restrepo RD, Wettstein R, Wittnebel L, Tracy M. Incentive Spirometry: 2011, AARC Clinical Practice Guideline. Respiratory Care 2011; 56:10 p1600-1604.</ref> == | |||
- Pre-operative screening of patients at risk of post-operative complications to obtain a baseline of their inspiratory flow and volume<br>- Presence of pulmonary atelectasis or conditions predisposing to atelectasis<br>- Abdominal or thoracic surgery<br>- Prolonged bed rest<br>- Surgery in patients with COPD<br>- Lack of pain control<br>- Restrictive lung disease associated with a dysfunctional diaphragm or involving respiratory musculature<br>- Patients with inspiratory capacity less than 2.5 litres<br>- Patients with neuromuscular disease or spinal cord injury<br> | |||
== Contraindications or Precautions<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Restrepo et al." /> == | |||
- Patients who cannot use the device appropriately or require supervision at all times<br>- Patients who are non-compliant or do not understand or demonstrate proper use of the device<br>- Very young patients or paediatrics with developmental delay<br>- Hyperventilation <br>- Hypoxaemia secondary to interruption of oxygen therapy<br>- Fatigue<br>- Pain<br> | |||
== References == | |||
<span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" /> |
Revision as of 12:52, 23 February 2016
Original Editors -[[User:]] Top Contributors-Kudzanayi Ronald Muzenda, Alex Palmer, Kim Jackson, Rucha Gadgil, Uchechukwu Chukwuemeka, Rachael Lowe, Joao Costa, Evan Thomas, WikiSysop, Adam Vallely Farrell, Karen Wilson and Candace Goh
Guideline on appropriate use[edit | edit source]
The purpose of incentive spirometry is to facilitate a sustained slow deep breath. The device gives the individual visual feedback regarding flow and volume. The device can prevent and reverse atelectasis when used appropriately and regularly.[1]
<img _fck_mw_template="true" _fckrealelement="1" _fckfakelement="true" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" class="FCK__MWTemplate">
1. Therapist demonstrates using a separate device and provides information sheet regarding technique, prescription of use and cleaning advice based on manufacturers instructions.
2. Patient should be in a relaxed position suitable for deep breathing (e.g. sitting upright in a chair or side lying if extra volume is required in one lung due to ventilation perfusion matching).
3. Patient creates a tight seal around the mouthpiece and inhales deeply and slowly. The patient watches the flow meter for visual feedback. If possible the patient sustains the inhalation to create an end-inspiratory hold. Ideally the inhalation is sustained for 4-5 seconds.
4. Patient relaxes seal around mouthpiece and exhales; normal breathing is resumed with relaxed shoulder girdle.
-Advise patient to take approximately ten incentive spirometry breaths per waking hour (use clinical reasoning to prescribe using Frequency, Intensity, Time and Type principles).
-Patients with an oxygen requirement can use device with a nasal cannulae or a device, which entrains oxygen.
-Deep breathing offers a similar effect. However, using an incentive device as feedback may create greater inhaled volumes, greater control of flow and more motivation to participate in therapy.
-The device can be used with paediatrics and individuals with learning difficulties.
-The device is not suitable for people with severe dyspnoea.
Indications[2][edit | edit source]
- Pre-operative screening of patients at risk of post-operative complications to obtain a baseline of their inspiratory flow and volume
- Presence of pulmonary atelectasis or conditions predisposing to atelectasis
- Abdominal or thoracic surgery
- Prolonged bed rest
- Surgery in patients with COPD
- Lack of pain control
- Restrictive lung disease associated with a dysfunctional diaphragm or involving respiratory musculature
- Patients with inspiratory capacity less than 2.5 litres
- Patients with neuromuscular disease or spinal cord injury
Contraindications or Precautions<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Restrepo et al." />[edit | edit source]
- Patients who cannot use the device appropriately or require supervision at all times
- Patients who are non-compliant or do not understand or demonstrate proper use of the device
- Very young patients or paediatrics with developmental delay
- Hyperventilation
- Hypoxaemia secondary to interruption of oxygen therapy
- Fatigue
- Pain
References[edit | edit source]
<span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" />