The Vest − Minnesota Protocol

The standard protocol can be used with the following vest machines, Hill-Rom model 104 and newer, inCourage by RespirTech, and the Smart Vest.

Setting a Starting Pressure for the Vest

  • If this is your child's first time using the vest, you will need to set up a Starting Pressure.
  • Set the Frequency to 8 Hz and the Pressure* to 6.
  • Press the ON button (or foot pedal).
  • After a minute or two of being on the vest, increase the Pressure to 7.
    • Give your child another minute or so to get used to this setting.
  • Keep increasing the pressure in this fashion until you reach the point where your child no longer feels comfortable, at which time you can back the pressure setting down by one.
    • The maximum pressure setting is 10.
  • Based on your child's comfort level you have now established the Starting Pressure, and are ready to being treatment.

*Some vest machines will display pressures as a single number, double number, or a percentage (6, 60, or 60 percent).

There will be six cycles of treatment. Each cycle uses a different frequency setting. Follow the steps below to complete your child's treatment.

Setting the Machine for the First Cycle of Treatment  

1. Make the following setting on the machine:

  • Frequency = 8 Hz
  • Pressure = your Starting Pressure 
  • Time = 5 minutes 

2. Press the ON button to begin treatment

3. After five minutes of treatment, pause the vest generator to deflate the vest (if the vest does not deflate, disconnect one end of one of the hoses.)

4. Perform two or three sets of Huff Coughs to remove mucus from your child's lungs.

Note: During vest treatments, you will want to keep your child's airways moist by taking a nebulizer treatment during the entire time your child is on the vest. One way to do this is by filling your child's nebulizer cup with about 6-8 mL of sterile normal saline.

Repeat steps 2 to 4 for remaining cycles.

Setting the Machine for the Second to Sixth Cycle of Treatment

You will do five more treatment cycles.

  • Each 5-minute cycle will have a different frequency setting and starting pressure
    • Cycle 2: 
      • Frequency setting = 9 Hz 
      • Starting pressure = Same as 1st treatment 
      • Time = 5 minutes 
    • Cycle 3: 
      • Frequency setting = 10 Hz 
      • Starting pressure = decrease setting by one 
      • Time = 5 minutes 
    • Cycle 4: 
      • Frequency setting = 18 Hz 
      • Starting pressure = decrease setting by 2/3 (see chart below) 
      • Time = 5 minutes 
    • Cycle 5: 
      • Frequency setting = 19 Hz 
      • Starting pressure = same as Cycle 4 
      • Time = 5 minutes 
    • Cycle 6: 
      • Frequency setting = 20 Hz 
      • Starting pressure = Same as Cycle 4 and Cycle 5 
      • Time = 5 minutes

Frequency Setting Pressure Setting
If your starting pressure is:
6 7 8 9 10
8 and 9 Hz678910
10 Hz56789
18, 19, 20 Hz45567


(Pressure settings are read from the Starting Pressure down)


*Note: Some vest companies will display their pressure as a single number, double number or a percentage (6, 60, or 60 percent).


Last Updated 05/2013