Incentive Spirometry: Difference between revisions
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== Guideline on appropriate use == | == Guideline on appropriate use == | ||
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== <br>Indications<ref name="Restrepo et al.">Restrepo RD, Wettstein R, Wittnebel L, Tracy M. Incentive Spirometry: 2011, AARC Clinical Practice Guideline. Respiratory Care 2011; 56:10 p1600-1604.</ref> == | == <br>Indications<ref name="Restrepo et al.">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> | - 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<ref name="Restrepo et al." /> == | == Contraindications or Precautions<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> | - 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 == | == References == | ||
<references /> | <references /> |
Revision as of 10:25, 23 February 2016
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]
Guideline on appropriate use[edit | edit source]
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[2][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