What are the indications for PEP therapy?
1. To reduce air trapping in asthma and COPD
2. To aid in mobilization of retained secretions (in cystic fibrosis and chronic bronchitis)
3. To prevent or reverse atlectasis
4. To optimize delivery of bronchodilators in patients receiving bronchial hygiene therapy
What are the contraindications for PEP therapy?
No absolute contraindication
1. Inability to tolerate increased work of breathing
2. Intracranial pressure (ICP) > 20 mmHg
3. Hemodynamic instability
4. Recent facial, oral, or skull surgery or trauma
5. Acute sinusitis
6. Epistaxis (Nose bleed)
7. Esophageal surgery
8. Active hemoptysis
10. Known or suspected tympanic membrane rupture or other middle ear
What are the possible adverse reactions associated with PEP therapy?
1. Increased work of breathing that may lead to hypoventilation and hypercarbnia
2. Increased intracranial pressure
3. Cardivascular compromise
4. Myocardinal ischemia (reduced blood flow to part of the body)
5. Decreased venous return
6. Air swallowing with increased likelihood of vomiting and aspiration
8. Skin breaks and discomfort from mask
9. Pulmonary barotraumas (tear due to back pressure)
What are the three devices used for PEP therapy?
1. DHD TherapPEP Device
What device(s) are able to deliver medication to the lungs with PEP therapy?
SVN w/ adapter, SVN w/o adapter, MDI Spacer/holding chamber
What are the pressure range commonly used with PEP therapy?
How many breaths should a patient be instructed to take during one attempt during PEP therapy?
Which device is used for Vibrational Therapy?
Acapella (Green, Blue, or Teal)
What liter flow should EZPAP Therapy be started at?
When should the pressure measuring port on the EzPAP device be closed or opened?
Closed with cap if no pressure motoring is being done; if measuring then should be open/exposed to ambient air while in use
What rates should be used when delivering an EzPAP treatment?
10-20 breaths 4-6 times