A registered nurse (RN), licensed practical nurse (LPN), respiratory therapist, or healthcare prescriber initiates use of incentive spirometry (IS) to enhance voluntary deep breathing.
IS may be incorporated into routine postsurgical care in addition to deep breathing, directed coughing, turning, positioning, and early mobilization and ambulation.
IS encourages the child to take long, slow, deep breaths. Use of IS decreases pleural pressure, promotes increased lung expansion and promotes better gas exchange.
Low and high inspiratory capacity ranges for children are available and are based on the child’s height and weight. Respiratory therapists are responsible for communicating to the healthcare provider and the family the IC target that is physiologically realistic for the child.
Children (≥6 years) may perform the procedure while supervised by a trained staff member or other caregiver who has been trained on the procedure. Direct supervision of the child performing the procedure is not necessary once the child has demonstrated mastery of the technique.
The child should use the spirometer five to ten breaths per session at a minimum of every hour while awake.
Incentive spirometer—volume oriented or flow oriented
Pillows or folded bath blanket (if needed); can use stuffed animal instead of pillow
Obtain baseline respiratory assessment, including:
Previous IS measurements obtained to assist in determining current treatment goals
Arterial blood gas results, if available
Obtain child’s height and weight to assist in determining low/high inspiratory capacity.
Assess both child’s and family’s readiness to learn and determine whether any barriers to learning exist. Determine whether child and family can learn to perform the treatment independently.
If the child is a surgical candidate, provide preoperative instruction to the child and family to facilitate use of the incentive spirometer, directed coughing and deep breathing postoperatively.
Assisting With Incentive Spirometry