INCENTIVE SPIROMETER

is a medical device commonly used after surgery or with certain lung conditions such as COPD or asthma.

As it measures how well your lungs fill up with each breath, an incentive spirometer helps exercise your lungs to help keep your alveoli (air sacs where oxygen and carbon dioxide are exchanged) inflated.

When you lie in bed for a long time (while recovering from injuries or surgeries, for instance) you tend to take shallow breaths and not cough as often as needed

You might start taking shallow breaths in an attempt to decrease pain associated with chest surgery or abdominal surgery

Using an incentive spirometer will help you return to normal breathing rhythms

HOW TO USE AN INCENTIVE SPIROMETER?

Sit up as straight as possible.  If you’re in bed, sit up as far as you can or try to sit on the edge of your bed if possible.

Hold the incentive spirometer upright Put the mouthpiece in your mouth and

tightly seal your lips around it. 

Breathe in slowly and deeply.  This will raise the yellow piston to the top of the column.  The yellow indicator should be in the little blue box.

Hold your breath as long as possible (at least five seconds), allowing the piston to fall to the bottom of the column

Position the yellow indicator on the outside of the column to mark your best effort.  This should be your goal to reach with each repetition.

Rest for a few seconds and repeat steps 1-7 at least 10 times an hour.

After each set of 10 breaths, try to cough in order to clear your lungs.  If you have an incision, support your incision by placing a pillow against it.

Once you are able to get out of bed, walk in the hallway and cough heartily.  You may stop using the spirometer unless instructed otherwise.

AEROSOL THERAPY

Aerosol therapy is administered to deliver breathing medication directly to the surface of the breathing tubes and lungs.  This is accomplished by breaking down the medication into a very fine mist so that it can be easily and effectively inhaled.

HOW DOES THE AEROSOL MIST ENTER YOUR LUNGS?

As you inhale, the aerosol passes from your mouth through the windpipe (trachea) into a system of airways (bronchi) that divide into smaller and smaller airways (bronchioles). 

The smallest airways end in tiny air sacs (alveoli).  The most common type of medication used in aerosol therapy is called a bronchodilator (e.g. Albuterol).  This type of medication relaxes the breathing tubes so that they become larger which makes breathing easier and coughing up secretions more effective.  Most aerosol treatments are taken 3 to 4 times a day for approximately 10 minutes.

DRY POWDER INHALER

Drugs administered as dry powder use a Dry Powder Inhaler (DPI). While this type of device is portable and free of chlorofluorocarbons (CFCs), and the treatment time is minimal, there are disadvantages to this method.

Some DPI devices require high inspiratory flow rates for adequate delivery of the drug to the lungs. The required high inspiratory effort may prevent certain segments of the patient population from using this device (e.g., pediatric and geriatric patients).

METERED DOSE INHALER (MDI)

MDIs are hand held devices activated by the patient. The ability to apply pressure to the base of the canister while at the same time taking a deep inhalation is key to the effectiveness of this treatment.

Most patients requiring aerosol therapy use an MDI. While this device is portable, fast and easy to use, many patients have difficulty using an MDI properly.

INHALATION ACCESSORY DEVICES

Inhalation accessory devices (IADs) are used in conjunction with MDIs. IADs are often referred to as spacers and holding chambers and promote increased drug deposition when used with a MDI.

HOW DO I TAKE AN AEROSOL TREATMENT?

Select an area in your home that is comfortable, has good lighting and is near an electrical outlet.

Plug your nebulizer compressor unit into a 3-pronged outlet, or use a plug adapter if these are not available.

Wash your hands before assembling your hand-held nebulizer or handling your medication.

 Pour your medication into your nebulizer cup.

***If your medication is not packaged in a unit dose form, you must carefully measure the proper amount(s) with saline or water.

***Your respiratory therapist or pharmacist will give you specific instructions on mixing your medication.

Reattach the nebulizer cap/T assembly to the nebulizer cup.

Attach one end of the supply tube to the port on the bottomed of the nebulizer, and the other end to the outlet on the nebulizer compressor unit.

Position yourself comfortably in a sitting position and turn your nebulizer compressor unit on.  You should immediately see a fine mist coming from the mouthpiece on your nebulizer.  If not, check all connections and insure your compressor motor is running and you have adequate medication in your nebulizer cup.

Place the mouthpiece in between your teeth, seal your lips around it, and breathe normally through your mouth.  DO NOT BREATHE THROUGH YOUR NOSE!  You should see the mist disappear and appear out of the reservoir tube as you inhale and exhale.

  Breathe at a normal rate and depth.  DO NOT BREATHE FAST!  Approximately once every minute, or every 10-15 breaths, take a deep breath and hold it in for several seconds.  This allows the medication to be effectively and evenly distributed throughout your lungs.

  Continue your treatment for the specified time period or until the medication is completely gone.  If you become lightheaded or dizzy, pause between breaths for a few seconds.  If you need to stop for more than a few seconds, turn your nebulizer compressor off so you won't waste your medication.

When your treatment is over, turn off your nebulizer compressor.