Bubble PEP PDF

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Bubble PEP What is it? Low cost Positive Expiratory Pressure device What does it do? A level of water is blow in to through a straw to create bubbles. The amount of water provides a degree of Positive Expiratory Pressure to splint open the airways. This allows sputum to move from the distal airways towards the larger airways where it can be cleared How do you use it? Place between 5 and 10 cm of water in a bottle – a higher level of water will provide increased resistance to blow against (increased PEP) Cut a length of tubing that is long enough to sit at the bottom of the bottle, and the patient can reach without hunching over. The tubing should be reasonably wide (a piece of suction is ideal) The patient blows into the tubing, creating bubbles in the water. They repeat this 8 – 10 times, before utilising the huff technique, and cough, to clear any sputum

When would you choose to us use e it? When secretion clearance is impaired due to airway collapse Patients need to be cognitively able to understand instructions Might utilise in an acute setting, and provide an oscillatory PEP device for longer term use as required Are there any precautions or contr contraindications aindications to its use? Contraindications to PEP devices: 

Undrained pneumothorax

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Haemodynamic instability, or severe cardiovascular disease

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Active haemoptysis

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Inability to tolerate increased work of breathing

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Sinusitis

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Middle ear infection

Additional precautions for PEP devices: 

Following thoracic surgery...