Vibratory PEP OPEP Therapy

Key Points

• OPEP therapy uses handheld devices (for example flutter, Acapella, Aerobika) to mobilize retained mucus.
• Technique requires upright posture, deep inhalation, and controlled exhalation through the device.
• Device-generated oscillation and mild expiratory pressure help keep airways open and move secretions centrally.

Equipment

• Prescribed OPEP device (flutter valve, Acapella, or Aerobika)
• Seating support for upright posture
• Tissues/sputum container for expectoration
• Route for respiratory-therapy/provider communication if tolerance is poor

Procedure Steps

1. Verify prescription and patient suitability for vibratory PEP/OPEP therapy.
2. Position patient upright for optimal airway mechanics.
3. Explain the breathing sequence and expected need to cough/expectorate.
4. Instruct patient to inhale deeply.
5. Instruct patient to exhale through device with controlled flow.
6. Repeat cycles per ordered plan while monitoring comfort and effectiveness.
7. Encourage cough and sputum expectoration after mobilization cycles.
8. Reassess breath sounds, secretion output, and work of breathing.
9. Document treatment tolerance and airway-clearance response.

Common Errors

• Poor posture or shallow inhalation → reduced oscillatory clearance effect.
• Inadequate exhalation effort through device → insufficient mucus mobilization.
• Skipping post-cycle cough coaching → mobilized secretions remain uncleared.
• Continuing despite poor tolerance without reassessment → avoidable fatigue and distress.

Related

• bronchial-hygiene-techniques - Concept-level framework for choosing among airway-clearance modalities.
• postural-drainage-and-chest-physiotherapy - Alternative or complementary secretion-mobilization strategy.