The client should sit in a comfortable position with their back straight or leaning slightly forwards onto a table with elbows supported.

They should take a slightly bigger than usual resting breath in and out through the PEP device.

The breath out should be a slightly active (forced, but not too forced) breath out against the mouthpiece.

10-15 breaths in a row maintaining sealed lips (with all the breathing occurring in and out of the mouthpiece). To ensure good mouthpiece PEP technique the child may be encouraged to use a nose clip.

The correct resistance will be set by the physiotherapist and the client should be able to use the device with the least amount of effort.

When secretions have reached the upper airways encourage huffing and controlled coughing to remove any secretions.

If your client experiences increased shortness of breath, severe chest pain, or coughs up any blood (haemoptysis) during treatment, stop the session, contact CFWA and encourage your client to contact their care team for further advice. 


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