› Incentive Spirometry

Incentive Spirometry Demonstration

The incentive spirometer is a nifty little tool to motivate your post-op patients to do some good breathing exercises. For most of us who like a visual on how well we are measuring up, it does that to a “T”.

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Some of the spirometers don’t have the gauge of "good, better, best" so just make sure you tell the patient that slow and steady is the way to go. If they try to rush through it they will hyperventilate and get all lightheaded on you.

Obviously this is a supply for each individual. They are “throw aways” (or maybe more appropriately “take aways” for when they go home.  So don’t go letting them share.

incentive spirometer

The concept is simple, when you have just come out of anesthesia, getting your lungs to fully inflate is important. You want to make sure that all those little alveoli open up fully and that there is no build-up of mucus in the lungs. Mucus in the lungs leads to pneumonia. 

While under normal circumstances we all generally breath adequately, if you really look at people, shallow breathing is pretty common. So this exercise just amps up the patient’s effort a tad.

How to Teach Incentive Spirometry

Want to get your patient to really fill those lungs with air? When they are using the machine, tell them to first inhale using their abdominal muscles, then their chest / rib muscles. That increase the length and quality of the inspiration. Most people just breathe using chest muscles. 

Remember: they breathe in, not out!

At the end of the exercise, see if they can cough up any sputum. We don’t want them busting a gut, but a good hearty cough or two at the end is a good thing.  

They should do it frequently. Ten repetitions at least every hour while awake, more often if they can.  If they can’t remember that, tie it into something else, like TV commercials. Every TV commercial they should pick up their incentive spirometry and give it a whirl.

There is a marker on the side of the machine. Most docs don’t actually give a required or recommended level to get to. They are just happy the patient does it at all. So you can use the marker for where they started and see how they progress. 

All this being a good post-op exercise, understand it is just a nice little gadget. Not necessary, just nice. You can accomplish the same thing as an incentive spirometry machine simply by teaching your patient to cough and deep breathe.

Here’s the old fashioned way of keeping your patient out of post-op trouble:

Cough and Deep Breathe

There really isn’t anything magical about the spirometry machine. It’s just a handy tool

Why Pursed Lips?

Why does the therapist ask the patient to breathe out using pursed lips? Because it forces the air out of a smaller opening. This increases the back pressure of air in the lungs and can help pop open any unopened alveolus. Opening all the alveoli allows better exchange of oxygen and CO2.

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