Incentive Spirometry: Difference between revisions

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<h2> Guideline on appropriate use  </h2>
== Guideline on appropriate use  ==
<p>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.<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Hough">Hough A, Physiotherapy in Respiratory and Cardiac Care: an evidence based approach. 4th Edition. Cengage Learning, 2014. p186-189.</span>  
 
</p><p><br />  
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>  
</p><p><br />  
 
</p><p><span class="fck_mw_template">{{#ev:youtube|-O-Zawtb32o|300}}</span>
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</p><p><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 />  
 
</p><p>-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.  
<br>  
</p><p>-The device is not suitable for people with severe dyspnoea.<br />  
 
</p>
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<h2> <br />Indications<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="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.</span>  </h2>
 
<p>- 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 />  
<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>  
</p>
 
<h2> Contraindications or Precautions<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Restrepo et al." /> </h2>
-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.  
<p>- 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 />  
 
</p>
-The device is not suitable for people with severe dyspnoea.<br>  
<h2> References  </h2>
 
<p><span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" />
== <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>  ==
</p>
 
- 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&lt;span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Restrepo et al." /&gt; ==
 
- 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  ==
 
&lt;span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" /&gt;

Revision as of 12:52, 23 February 2016

Original Editors -[[User:]] Top Contributors-Kudzanayi Ronald Muzenda, Alex Palmer, Kim Jackson, Rucha Gadgil, Uchechukwu Chukwuemeka, Joao Costa, Rachael Lowe, WikiSysop, Adam Vallely Farrell, Karen Wilson, Candace Goh and Evan Thomas

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]



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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" />

  1. ↑ Hough A, Physiotherapy in Respiratory and Cardiac Care: an evidence based approach. 4th Edition. Cengage Learning, 2014. p186-189.
  2. ↑ Restrepo RD, Wettstein R, Wittnebel L, Tracy M. Incentive Spirometry: 2011, AARC Clinical Practice Guideline. Respiratory Care 2011; 56:10 p1600-1604.
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