How to use your PEP device for a child with cystic fibrosis

PEP (positive expiratory pressure) in an airway clearance technique that creates positive pressure in the airways to loosen the mucus so that it can move out of the lungs. This video takes you through the different steps in performing PEP.
*These instructions are part of a teaching program for families of patients at The Hospital for Sick Children. They are provided in addition to detailed hands-on training. We urge you not to follow these instructions without training and advice from a healthcare professional who understands your child's unique needs. Please also review these instructions with your doctor to check if they are suitable for your situation.
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VIDEO TRANSCRIPT:
PEP works by creating positive pressure in the airways to loosen the mucus so that
it can move out of the lungs. The PEP device is usually connected to a manometer which measures pressure.
See the video of someone performing therapep with a mouthpiece.
Start with five belly breaths in through your nose and out through your mouth in
the shape of an O.
Place your hand over your belly and feel your stomach rise into your hand.
Remember to perform about five of these and keep them nice and relaxed.
Next, sitting up nice and tall, elbow supported on the table, take a breath in through your PEP and blow up for about three to four seconds, keeping the blue toggle between the two lines or at a
pressure of 10 to 20 centimeters of water pressure.
In one one thousand, two one thousand, three one thousand, four one thousand.
Down and in one one thousand, two one thousand, three one thousand, four one thousand.
Down. Allow yourself to finish your breath comfortably as you see the blue toggle go down.
Keep up the good work and keep the pressures within the desired range. Take
medium-sized relaxed breaths. In one one thousand, two one thousand,
three one thousand, four one thousand. Down. And in one one thousand, two one thousand, three one thousand, four one thousand.
Down. After performing 10 to 15 repetitions, take the PEP out of your mouth and pick up the cylinder piece and a tissue to perform some huffing.
After the huff, take the cylinder piece out of your mouth and do your coughing and spit your secretions into the tissue.
Remember to growl up your secretions after you cough to help you spit them out.
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