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The positive expiratory pressure (PEP) mask is a piece of equipment used to clear excessive phlegm from airways. It does this by forcing air into the lungs, which helps to make more space for the mucus to move and pushing air up beneath it so that it can be forced out of the body. A PEP mask consists of a breathing mask, which is connected via a tube to a pressure gauge known as the manometer. This pump is modulated by pieces called resistors which are made to provide various levels of pressure. The mask is commonly used by patients who have cystic fibrosis and other similar conditions which impede breathing.
Successful use of the PEP mask depends upon the patient, as this is an entirely self-administered technique. The process consists of strapping the mask over nose and mouth, inhaling, and then exhaling. Pressure from the pump will slightly increase the amount of effort needed to breathe.
The proper position in which to use the mask depends upon the needs of the patient. It can be used in an upright position, with the patient sitting with elbows resting on a hard surface in front of him or her. The patient may also use the mask lying down on his or her side. Each of these positions is meant to provide optimum conditions for drainage of fluid.
It can take a few tries to find the correct PEP mask resistor for a particular patient. A doctor will typically have a patient monitor the manometer for a certain pressure reading. The correct resistor will bring the monitor to the right level, the result of which will be sufficient pressure in the lungs to remove phlegm effectively, but without too much force.
Once the PEP mask has extracted the phlegm, the mucus is then expelled by the patient. After a rest period, the patient will typically continue to use the PEP mask until the airways are entirely free. This routine is usually practiced daily, either for life or until there is no further need to remove phlegm. The process usually takes about 15 to 20 minutes to complete.
Use of the PEP mask does not tend to be a high-risk activity. Usually the most important safety consideration is to keep the equipment clean and in good condition in order to avoid contamination and infection. Care typically consists of washing the mask and tubing by hand with a mild detergent and allowing it to air dry.