Patients unable to take deep breathe effectively due to pain, diaphragmatic dysfunction, or opiate analgesia.Hypoxaemia secondary to interruption of oxygen therapy.Very young patients or paediatrics with developmental delay.Patients who are noncompliant or do not understand or demonstrate proper use of the device.Patients who cannot use the device appropriately or require supervision at all times.Patients with neuromuscular disease or spinal cord injury.Patients with inspiratory capacity less than 2.5 litres.Restrictive lung disease associated with a dysfunctional diaphragm or involving respiratory musculature.Presence thoracic or Abdominal binders.Conditions predisposing to atelectasis such as:.Pre-operative screening of patients at risk of postoperative complications to obtain a baseline of their inspiratory flow and volume.The video below explains more on the use of the incentive spirometer However, using an incentive device as feedback may create greater inhaled volumes, greater control of flow and more motivation to participate in therapy. Deep breathing offers a similar effect.Patients with an oxygen requirement can use the device with a nasal cannula or a device, which entrains oxygen.Advise patient to take approximately ten incentive spirometry breaths per waking hour (use clinical reasoning to prescribe using Frequency, Intensity, Time and Type principles).Patient relaxes seal around the mouthpiece and exhales normal breathing is resumed with relaxed shoulder girdle.Ideally, the inhalation is sustained for 4-5 seconds. If possible the patient sustains the inhalation to create an end-inspiratory hold.
The patient watches the flow meter for visual feedback.
Incentive spirometry is performed using devices which provide visual cues to the patients that the desired flow or volume has been achieved. The basis of incentive spirometry involves having the patient take a sustained, maximal inspiration (SMI). Incentive spirometry is designed to mimic natural sighing by encouraging patients to take slow, deep breaths. The purpose of incentive spirometry is to facilitate a sustained slow deep breath.