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People with lung conditions often produce more sputum than usual. It is important to regularly clear your chest to reduce coughing spells, breathe easier and prevent recurrent chest infections.

Active Cycle of Breathing Technique (ACBT)

Chest_Clearance_A4_Trifold_Page_2_Image_0001.jpgThis technique uses a combination of breathing exercises to help move the sputum from the lungs making it easier to clear. It is best performed whilst upright, sitting or in combination with postural drain positions.

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Breathing control

Slow and controlled diaphragmatic breathing. As you breath in you should feel your diaphragm rise and as you breath out it should fall.

Deep breath (thoracic expansion)

Big breath in through your nose (if possible) and out through your mouth.

Huff

Big deep breath in through your nose and fast sharp breath out through an open mouth (imagine fogging up a mirror).

Cough

Big cough (only if sputum needs clearing). Limit coughing as too much coughing can make you more breathless

  • Complete one to three cycles per session
  • If feeling well and not productive complete one session daily
  • If feeling unwell and productive you may need to complete three to four times daily.

Postural drainage

There are multiple different body positions that can help clear sputum from your lungs. This is called postural drainage. This method uses gravity to help remove mucus from the bottom parts of our lungs making it easier to cough and clear. This technique is beneficial if you produce a moderate to large amount of sputum. Your physiotherapist or GP can advise you on positions that would suit you best.

You should not complete postural drainage if you have any of the following:

  • Acid reflux
  • Significant increase in breathlessness
  • Wheeze (bronchospasm)
  • Fresh red blood in sputum
  • Gastro-oesophageal reflux
  • Recent spine or rib fracture
  • Recent muscle injury to spine or ribs
  • Nausea.

Techniques to use with postural drainage

  • Stay in the positions for around five minutes as tolerated
  • Complete ACBT whilst in the position
  • Try percussion (the vibrations help to loosen the secretions off the chest well).

Devices to help clear your chest

If ACBT is not working effectively to clear your chest, there are a few devices that can be used to help. The Acapella and Flutter devices can help with clearing the secretions from your chest and can vary in price from £50 to £90. They can be bought online or sometimes available on prescription from your doctor.

Small green plastic device - the acapellaThe Acapella

It uses vibrations and resistance (adjustable dial on back of device) to help clear sputum.

Small white plastic device - the flutterThe Flutter

A device that you breath against that provides a vibration of your airways making it easier to cough up the sputum.

Hydrate

It is important that you drink enough fluids to help with removing secretions otherwise they can become thick and sticky making it harder to clear. It is recommended that you drink eight glasses of fluid per day. Try to avoid drinking too many caffeinated drinks (coffee, tea) as it can make you dehydrated.

Humidification

If your sputum is extra thick, inhaling steam can help loosen the secretions helping to clear your chest. However, if you are still struggling, contact your GP as there is other medication that can help.

Sputum

It is important to understand and be able to describe sputum in relation to what’s normal for you and your condition.

Colour

  • Clear
  • White
  • Cream
  • Brown
  • Yellow
  • Green
  • Blood stained.

Amount

  • Some = up to a teaspoon
  • A little = up to a tablespoon
  • Moderate = up to three tablespoon
  • A lot = an egg cup full or more.

General tips to improve sputum clearance

  • Maintain regular exercise
  • Have an annual flu and pneumonia vaccine (if applicable)
  • Early treatment when symptoms are worsening
  • Maintain a regular chest clearance regime
  • Recognise symptoms of infection to allow prompt treatment
  • Correct use of medication.

Contact us

If you have any questions related to the content within this leaflet, please contact your physiotherapist for further guidance or the team at:

Netherton Health Centre
Magdalen Square
Bootle
L30 5SP

Or call Telephone: 0151 247 6417.

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 Liaison Service (PALS) and Complaints Team.

Phone: 01514712377 or 0800 328 2941

Email: palsandcomplaints@merseycare.nhs.uk

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