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Writer's pictureChristina Hunt

Acapellas, Peak Flow Meters, Incentive Spirometers…OH MY!


Welcome back to BreatheLiveFit! If you are a first-time visitor to my site, you will find the information that I post each week to be helpful in managing your lung condition and should inspire you to live each day to its fullest. Today I am discussing some popular respiratory care devices. Many of you have heard of (or use) one or more of these devices at some point during your journey with your lung condition. Some of you are asking yourself what these little devices actually are. To be honest, I was inspired to write this blog because I have seen many of you post questions about them to various support groups on Facebook. I am going to try my best to explain each one in layman’s terms, why they are used, and how you may be so inclined to want to use them to manage your own lung condition. So, let’s get into it!


Acapella®


What is it?


The Acapella® is a PEP device. (In layman’s terms: a device that you blow into that provides a back pressure) This type of PEP device is used to mobilize secretions like mucus by combining the effects of the back pressure and airway vibrations. Inside this little marvel is a counterweighted plug and a magnet which creates the vibrations or “oscillations” when you blow into it. (I know… so cool. Wish I had invented it!) Another cool thing about it is that it can also be used in virtually any position so if you need to combine it with postural drainage (positioning yourself to drain a lung that has a lot of mucus) that you don’t have to sit up to use it. I have to be honest in the fact that I REALLY love that benefit. Typically, the Acapella® is easy to tolerate because you can adjust the frequency and flow resistance by turning a dial located at one end of the device.



Who can benefit from using the Acapella®?


People with lung conditions who produce a large amount of mucus like chronic bronchitis, emphysema, mycobacterial diseases, cystic fibrosis, and bronchiectasis.

How do you use the Acapella®?


I would recommend that you use a short-acting bronchodilator (i.e. Albuterol) about 15 minutes prior to using the device. This medication will do its best to help open your airways making it easier for you to mobilize mucous in your lungs.

1. Make sure the dial on the end of the Acapella® is set properly (ask your physician or therapist for their recommendation)

2. Take a deep breath in and hold it for 2-3 seconds.

3. Place the mouthpiece of the Acapella in your mouth and seal your lips tightly around it

4. Exhale through the mouthpiece (but not forcefully) until end exhalation.

5. Repeat that maneuver approximately 10 times.

6. After blowing approximately 10 times through the Acapella®, take a deep breath in nice and slow and try to cough. (Make sure the device is away from your mouth when you cough as you want to prevent coughing into the Acapella®)


**As with any new therapy, ask your physician about whether they think you would benefit from using an Acapella®


Peak Flow Meter


What is it?


The peak flow meter is a monitoring device that measures how well air moves out of your lungs. The measurement that it collects is called a peak expiratory flow rate or PEFR. (Sometimes notated as PEF) Back in the early nineteenth-century doctors would instruct patients to blow out a candle in order to assess their peak flows. There have been several “upgrades” to this method of collecting information for someone’s peak flow and these days we have a fairly inexpensive, portable option for collecting this data. Peak flow meters are small, plastic devices that have a stainless-steel vane inside that measures the flow of air coming out of a patient’s lungs.



Who can benefit from using a peak flow meter?


In one word…asthmatics. Using a peak flow meter consistently every day will allow people who have asthma to notice small changes in their lung condition. Make a note of your “personal best.” (This is the highest peak flow measurement you have over a 2-3 week period when your asthma is under control.) The Asthma and Allergy Foundation recommends that asthmatics measure their peak flows once a day, usually in the morning before you take your asthma medications. (You may want to check it more often if you are seeing lower numbers than usual) Most physicians would recommend that you keep a log of your peak flows daily.


How do you use a peak flow meter?


1. Move the cursor or indicator to zero

2. Stand up and take a deep breath

3. Place the meter to your mouth and make a tight seal with your lips. (Don’t let your tongue block the opening to your meter.)

4. Blow out as hard and fast as you can.

5. Write that number down and repeat steps 1-4 two more times.

6. Write the highest of the three numbers in your personal log.


The Asthma and Allergy Foundation of America has lots of great information in more detail on their website when it comes to peak flow meters. Visit their site if you want more information on how to know what peak flow zone you are in, when to call the doctor, and how to make an Asthma Action Plan.


Incentive Spirometers


What is it?


Most likely if you have had any sort of surgery that has had you “laid up” for a few days in the hospital, odds are you were probably given one of these little beauties. I absolutely LOVE the incentive spirometer for people with chronic lung conditions, so if you have one of these stuck under your bathroom sink or in your linen closet… pull it out. The incentive spirometer was designed to prevent alveolar collapse (or in layman’s terms… prevent a patient from getting pneumonia and encourage them to take deep breaths). However, I really love it for monitoring purposes and for people with lung conditions that just aren’t moving around a lot. So much of how a person with a lung condition feels is subjective. This device allows you to make an objective measurement of how deeply you can inhale. This device is fairly inexpensive and easy to obtain. The incentive spirometer is made up of a breathing tube, an air chamber, and an speed of flow indicator. It encourages a patient to take long, slow, deep breaths promoting lung expansion and better gas exchange.



Who should use it?


People living with chronic lung diseases like COPD, emphysema, and pulmonary fibrosis. Really anyone with a chronic lung disease! (Also, it is a gold standard for most post-surgery patients)


How do you use an incentive spirometer?


When using your incentive spirometer, make sure you breathe through your mouth. If you feel dizzy at any time, stop and rest.

1. Sit up in a chair or bed. Put the mouthpiece in your mouth with your lips sealed around it. (Make sure your tongue does not block the mouthpiece opening.)

2. Exhale all of your air

3. Slowly (slowly is the key) breathe in through your mouth as deeply as you can. You will see the piston rise as you are doing so. Attempt to hold your breath for 3-5 seconds.

4. Try to get the piston as high as you can, while keeping the speed indicator in the window.

5. Make a note of how much volume you were able to pull in.

6. Rest a few seconds and repeat.

7. You should perform this maneuver with the incentive spirometer about 10 times. Be sure to rest as needed.

8. Keep a log of your average volume.

You can always take deep breaths on your own however, the incentive spirometer gives you feedback on how much volume you are taking in, helps you to control your flow, and provides motivation to improve with each attempt!


Thanks for Reading!


If you enjoyed this blog, I invite you to check out some of the topics I have covered in the past


Remember: We are in this TOGETHER!


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:) Christina


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