Positive Expiratory Pressure (PEP) Mask guide

What is the PEP mask?

The PEP (Positive Expiratory Pressure) mask is a device developed to help clear secretions and reduce or reverse lung collapse. 

The equipment consists of cushioned resistors. These can be used to increase the effort while breathing in training the respiratory muscles. They can also be used to increase the effort when breathing out. This opens up your lungs and mobilises secretions.

How does the PEP mask work?

The mask will be assembled by your therapist to increase resistance when breathing out. This creates back pressure within the lungs and encourages air to get behind any secretions, and airways re
expansion.

This effect combined with other physiotherapy techniques helps to move secretions to where they can easily be coughed and cleared. Air re-enters areas of lung tissue previously blocked by sputum, 
further re-opening your lungs.

Cystic Fibrosis, COPD, asthma, lung disease with secretory problems and patients with atelectasis (lung collapse) are some of the typical patients that would benefit from the PEP mask.

What does the technique involve?

Your physiotherapist will advise how to use the device. Please follow the advice as directed to gain best results and prevent harm.

1. Inspect the device and its attachments for cleanliness. Check it is set up correctly (see picture above). When completing without your therapist you will not be using the pressure manometer.
2. Check the resistor is the correct resistance (colour) as set by your therapist. It should be connected directly to the mask’s expiratory valve.
3. Sit with your elbows resting comfortably on the table.
4. Place the PEP mask firmly over your nose and mouth tapered end up.
5. Take a normal sized breath in then actively breathe out. Do not force it.
6. Repeat for up to 10 to 15 minutes.
7. Remove mask.
8. Perform two to three huffs and cough to clear secretions.
9. If advised by your therapist this can be combined with other treatments such postural or autogenic drainage.
10. Stop using the PEP Mask and seek advice from your physiotherapist if you notice blood in your sputum, chest pains or significant or prolonged shortness of breath when using it.
11. Seek advice from your physiotherapist if you are diagnosed with a pneumothorax, bullae or a cyst.

How often?

Use your PEP mask as directed by your physiotherapist. If you are unwell, have an active infection, excessive or difficult to clear secretions you may need to use it three to four times per day or even hourly.

When unwell, if treatment is making you excessively tired, reduce the treatment time. You must remember to increase the number of treatment sessions, though.

Cleaning

Do not bleach or put in the microwave. to clean.

1. Clean in warm soapy water - two teaspoons detergent to one gallon of water.
2. Rinse and dry before reassembling.
3. Do not leave in direct sunlight. This will crack you mask.

Breathing tasks required for the PEP mask

Test Your Breathing

Place one hand on your upper chest and one hand on your stomach, just below your ribs. You will probably feel your top hand move more than your bottom hand as you take a breath in. This is an ineffective way of breathing, when recovering from using the PEP Mask.

How to Tummy Breathe when recovering from use of the PEP

Breathe in slowly through your nose then out through the mouth. Aim to make your stomach rise as you breathe in and fall as you breathe out.

The aim is to relax your breathing. Try to slightly reduce the depth and rate of your breathing to reduce recovery time. It is very difficult to change your breathing pattern, however, if you practice daily it will
become more natural.

You can practice tummy breathing by itsself. When competent you can use it with the PEP mask to maximise its effect.

Huff

Take a slow half breath in through your nose. Feel your lower chest expand. Open your mouth wide to make a big O with your lips and blow the air out through your open mouth. Practice by steaming up the mirror.

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and LiaisonService (PALS) and Complaints Team.

Telephone: 0151 471 2377 Freephone: 0800 328 2941 Email: palsandcomplaints@merseycare.nhs.uk