Respiratory - Sputum Clearance Device - Using your Acapella

Your physiotherapist has provided you with an Acapella to help mobilise the sputum you produce so it is easier to cough up.

How does it work?

The device causes vibration and resistance to the airflow which is then transmitted to your lungs.

• The resistance to the airflow will help keep your airways open to get air behind the sputum and move it upwards
• The vibration dislodges the secretions from the walls of the airways and moves them upwards to the larger airways, where it can be coughed out

The Acapella contains a rocker, counterweighted by a magnet, which moves in a see-saw action, creating the vibrations and resistance.

How to use the Acapella Choice?

Before you start:

• Make sure you gather supplies together (water, tissues)
• Relax and assume correct posture and position (depends on device being used)
• You may find taking your nebuliser or blue inhaler before you start will help

You can use the Acapella in sitting, lying down or postural drainage positions.

1. Slowly breathe in, slightly more than a normal breath but do not fill the lungs completely.
2. Hold breathe for 2-3 seconds.
3. Place the acapella in your mouth with a good seal around the mouthpiece.
4. Breathe out through the acapella at a fast rate but not too forceful for at least 3-5 seconds. You should be able to feel the vibrations on your chest.
5. Do not empty your lungs completely.
6. Try to keep your cheeks held in to maximise the vibration in your lungs.
7. Adjust the dial at the end to give you the most optimal vibration on your chest – your physiotherapist will help you with setting this up initially.
8. Try to suppress your cough.
9. Repeat for 5-10 breaths.
10. Try cough/huff to clear secretions.
11. Repeat the huff once or twice more to clear secretions.
12. Repeat whole cycle again from 1 - 11 if needed.

Cleaning the Acapella Choice

As your Acapella Choice will be exposed to saliva during use, we recommend that you clean it after each use.

Your physiotherapist will show you how to dismantle and reassemble the device.

After each use, take apart your acapella into 4 pieces. Wash it is warm soapy water and rinse thoroughly. Allow parts to dry and reassemble.

One a week it is recommended that you sterilise your Acapella. See manufactures guidance.

How often should I use the device?

Use the device twice daily or as directed by your physiotherapist.

If you are unwell, you may need to use it more often but may need to reduce the number of breaths you do, so you don’t get too tired.

Precautions

If you start coughing up fresh blood or are diagnosed with a pneumothorax, STOP using your device, seek medical advice and contact your physiotherapist for ongoing secretion management advice.

If you become lightheaded using the device, stop the exercise and breathe calmly until the feeling stops.

To reduce the feeling of light-headedness, have a short rest between each breath and try not to breathe out as hard. If it continues, speak to your physiotherapist for advice.

Other things that may help sputum clearance

• Drink plenty of clear water (unless you have been told you are on a fluid restriction)
• Always clear your chest in a morning. A hot drink may help you if you wake feeling dry
• Do not clear your chest immediately after eating a meal
• If your phlegm changes colour, take a sample to your GP
• If you have questions about your condition, contact your doctor, nurse or physiotherapist

Contact Details

Email: respiratoryphysio@nca.nhs.uk
Telephone: 0161 206 5321