Incentive Spirometry

Incentive Spirometry

I. S. Introduction
* Also called SMI (sustained maximal inspiration)
* Involves the use of a device that encourages a patient to make larger-than-normal inspiratory effort and establish a breathing incentive
* Involves pt. mentally and physically and is less expensive and usually as effective as IPPB
* I. S. devices let the patient see their own progress
* Results in the generation of increased negative transpulmonary pressures increased Vt for the primary purpose of opening and stabilizing atelectatic areas of the lung against recurrent atelectasis
* Prevention of postoperative complications
- primary purpose is to help open closed alveoli, facilitate the cough reflex, help mobilize secretions, and prevent hyperventilation.

* Preoperative “cleanup”, which strengthens pulmonary muscles, increases voluntary ventilation, improves “bronchial toilet”
* Psychological support


Contraindications for I. S.
* Uncooperative or physically disabled pt.
* Patient with mental or CNS disorders
* Patients that are physically unable to generate large enough Vt (10-15 ml/kg)

Hazards and Complications of I.S.
* Hyperventilation may occur if SMI is performed too rapidly, without rest periods between deep breaths, which may lead to dizziness, light-headedness, a tingling sensation in the extremities, and possible muscle tremors
* Barotrauma in pt. with emphysematous blebs
* Pulmonary embolism from decrease Ppl

Procedure for I. S.

* Determine baseline volume expectations
* If post-op, set realistic, achievable goals initially and increase level by 200 ml until pt. reaches desired Vt
* Make sure pt. understands proper use of device
* Stress importance of achieving goals and coughing to clear secretions
* Splint surgical incisions
* Noseclips can be used to better facilitate a deep breath
* Asses pt., incl. V.S. and chest auscultation
* Explain and demonstrate
* Proper technique includes having pt. inspire slowly and deeply from FRC
* At the end of max. inspir. have pt. do breath hold for 5 sec.
* Repeat 6 - 10 times or as prescribed
* Instruct proper cough
* Reassess pt.

Incentive Spirometry.ppt