Incentive Spirometry: Difference between revisions
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# 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). | # 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). | ||
#. 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. | #. 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. | ||
# Patient relaxes seal around mouthpiece and exhales; normal breathing is resumed with relaxed shoulder girdle. | # Patient relaxes seal around mouthpiece and exhales; normal breathing is resumed with relaxed shoulder girdle. | ||
Further pointers: | Further pointers: | ||
*Advise patient to take approximately ten incentive spirometry breaths per waking hour (use clinical reasoning to prescribe using Frequency, Intensity, Time and Type principles). | *Advise patient to take approximately ten incentive spirometry breaths per waking hour (use clinical reasoning to prescribe using Frequency, Intensity, Time and Type principles). | ||
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== 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> == | == 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 | *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 | *Presence of pulmonary atelectasis or conditions predisposing to atelectasis | ||
*Abdominal or thoracic surgery | *Abdominal or thoracic surgery | ||
*Prolonged bed rest | *Prolonged bed rest | ||
*Surgery in patients with COPD | *Surgery in patients with COPD | ||
*Lack of pain control | *Lack of pain control | ||
*Restrictive lung disease associated with a dysfunctional diaphragm or involving respiratory musculature | *Restrictive lung disease associated with a dysfunctional diaphragm or involving respiratory musculature | ||
*Patients with inspiratory capacity less than 2.5 litres | *Patients with inspiratory capacity less than 2.5 litres | ||
*Patients with neuromuscular disease or spinal cord injury<br> | *Patients with neuromuscular disease or spinal cord injury<br> | ||
== Contraindications or Precautions == | == Contraindications or Precautions == | ||
*Patients who cannot use the device appropriately or require supervision at all times | *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 | *Patients who are non-compliant or do not understand or demonstrate proper use of the device | ||
*Very young patients or paediatrics with developmental delay | *Very young patients or paediatrics with developmental delay | ||
*Hyperventilation | *Hyperventilation | ||
*Hypoxaemia secondary to interruption of oxygen therapy | *Hypoxaemia secondary to interruption of oxygen therapy | ||
*Fatigue | *Fatigue | ||
*Pain<br> | *Pain<br> | ||
== Recent Related Research (from Pubmed) == | |||
<div class="researchbox"><rss>Feed goes here!!|charset=UTF-8|short|max=10</rss></div> | |||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 14:33, 23 February 2016
Original EditorAlex Palmer
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]
- Therapist demonstrates using a separate device and provides information sheet regarding technique, prescription of use and cleaning advice based on manufacturers instructions.
- 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).
- . 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.
- Patient relaxes seal around mouthpiece and exhales; normal breathing is resumed with relaxed shoulder girdle.
Further pointers:
- 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.
The video below explains more on the use of the incentive spirometer
Indications[3][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[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
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
- ↑ Hough A, Physiotherapy in Respiratory and Cardiac Care: an evidence based approach. 4th Edition. Cengage Learning, 2014. p186-189.
- ↑ My Doctor - Kaiser Permanente. Learn to Use an Incentive Spiromete. Available from: https://www.youtube.com/watch?v=-O-Zawtb32o [last accessed 2/23/2016]
- ↑ Restrepo RD, Wettstein R, Wittnebel L, Tracy M. Incentive Spirometry: 2011, AARC Clinical Practice Guideline. Respiratory Care 2011; 56:10 p1600-1604.
