Incentive Spirometry part 2

Incentive spirometry is most useful when there is a chance that the lung may collapse after surgery. The types of surgery that commonly cause atelectasis include incisions on the chest, upper abdomen, or on patients who smoke or have obstructive lung disease. There are some bed ridden patients or those who are paralyzed who also develop weakened respiratory muscles and are prone to the development of atelectasis.

While incentive spirometry is beneficial for most medical patients, there are some patients who may find no use of the device. It is necessary that the patient be cooperative and understand how to use the device. For those individuals who have a tracheostomy, the technique requires adaptation of the spirometer.

The majority of patients who are taught how to perform incentive spirometry benefit from it. However, without supervision most patients will have no benefit. In some cases, there may be pain associated with incentive spirometry, esp. after surgery. In rare cases incentive spirometry can exacerbate asthma and lead to fatigue.

Assessment of incentive spirometry can be done in several ways. At the bed side one can quickly check the Pulse Oximetry and listen to the chest. The fever may subside and the heart rate may return to normal. If there is doubt, a chest x ray can confirm the presence or absence of atelectasis. Other ways to assess the success of incentive spirometry is to observe the flows and volume before and after the use of the device.

Once the patient has acquired skill in the use of the device, direct nursing supervision is not required. Most experts recommend at least 5-10 breaths/ hour while awake. After each session one is encouraged to cough out the mucus from the lungs.