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ORIGIN
Traditional CPT with manual percussion, postural drainage & vibration was
first introduced in 1901 to assist airway clearance in children with
bronchiectasis.
In the 1970’s PEP device were developed in Denmark, as means to aid the px
airway clearance with an effective, self-administered low-pressure device
Since 1991 PEP devices have been modified & improved upon which have
produced devices such as the TheraPEP & Acapella
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What does PEP do?
Enhances secretion mobilization & removal
Helps prevent infections
Improved pulmonary mechanisms & gas exchange
Asthma
Emphysema
Chronic Bronchitis
Cystic Fibrosis
Explain that flutter therapy is used to reexpand lung tissue and help
mobilize secretions. Px should be taught to huff cough.
The patient is instructed to inhale deeply and hold his breath for 2
to 3 sec. Expiration should be slow through the Flutter valve,
causing oscillations of the steel ball inside the cone of the Flutter.
The patient selects the position that results in the best transmission of
vibration to chest wall, optimizing the mobilization of mucus.
SOURCE:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2580042/
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Indications: Contraindications:
Bronchiectasis
Right-sided heart failure
Cystic Fibrosis
COPD Pneumothorax
The high and low flow models have a dial to set expiratory resistance while
the Choice model has a numeric dial to adjust frequency. All models can be
used with a mask or mouthpiece and can be used in line with a nebulizer.
While these attributes may offer the Acapella some advantage over the
Flutter, no long–term studies have been done in CF patients. A bench study
of the performance characteristics of the two devices showed a slight
advantage for the Acapella, with more stable wave form and a wider range
of PEP at low air flow.
Acapella
Consist of two barrels with matching slots that fit snugly over each
other.
When these slots are aligned, the patient can inhale and exhale
freely through the device.
When the slots are not aligned, back pressure is created because
the px continuous breath is prevented from escaping.
The faster a px rotates the handle, the greater the frequency and
lower the pressure; the slower the handle rotation, the lower the
frequency
SOURCE: Mosby’s Respiratory Care Equipment
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QUAKE
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High –
frequency
chest wall
oscillation
devices
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High-Frequency Compression/
Oscillation
As applied to airway clearance, oscillation refers to the rapid
vibratory movement of small volumes of air back and forth in
the respiratory tract.
The pressure differential bet. The negative and positive pressure settings
used for normal respiratory rates influences the VT delivered.
The frequency of oscillations, the I:E ratio & inspiratory & expiratory
pressures are controlled by a microprocessor which can be programmed
by the respiratory therapist according to the px’s need.
+ Lung Flute
It is a device used to help loosen, mobilize, and eliminate secretions from
your airways.
Features:
Simple hand held device
Low pressure operation
Replaceable reeds
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Therapeutic Advantages
Features:
Simple hand held disposable device
Low pressure operation
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Diagnostic Advantages
The lung flute for hospitals and clinics is indicated for the
collection of sputum samples for laboratory analysis and
pathologic examinations
Chronic Bronchitis
Asthma
Emphysema
Cystic Fibrosis
Lung Cancer
Tuberculosis
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Secretion Loosening and Mobilization
(Stage 1)
The patient should hold the lung flute pointing down.
Inhale a little deeper than normal, place his/her lips completely around
the mouthpiece, and gently blow out through the lung flute as if trying to
blow out a candle.
As the patient blows, he/she will hear the reed inside the lung flute make
a fluttering noise as it moves.
Next, the patient should remove the mouthpiece from his/her mouth,
quickly inhale again, put the mouthpiece back in his/her mouth and blow
gently through the lung flute
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The patient should wait five minutes after the session for secretions
to collect at the back of the throat.