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Positive Expiratory Pressure (PEP)

What is Positive Expiratory Pressure (PEP)?

Positive Expiratory Pressure, or PEP, is a small device that a patient exhales into, using a mask. PEP is also called PEP Therapy, PEP Mask or TheraPEP.

Description of PEP

The PEP device creates pressure in the lungs and keeps your airways from closing. The air flowing through the PEP device helps move the mucus into the larger airway. A Huff cough will help move the mucus out of the airways.

Instructions to Use PEP

  1. Have your child sit up straight with elbows resting on a table.
  2. Have your child take slightly deeper breaths than normal for one to two minutes.
  3. Have him / her take a large, steady breath (just slightly more then a normal breath) through the mask attached to PEP device.
  4. Have your child hold their breath for two to three seconds.
  5. Have your child breathe out through the mask into the PEP device to create pressure 10-20 cm H2O. Have him / her breathe out for four to six seconds until just beyond a normal breath.
  6. Repeat 15 times (one cycle). Keep the mask sealed around your child's mouth and nose throughout the cycle.
  7. At end of a cycle, remove the mask and perform two to three Huff coughs.
  8. Follow this with one (or more) regular cough to clear the mucus from the large airways.
  9. Have your child rest for one to two minutes while doing the controlled breathing technique.
  10. Repeat the entire process for six cycles or a maximum of 30 minutes.

A mouthpiece with nose clips can be used instead of a mask.

Cleaning the PEP Device

After each treatment:

  • Store on a clean paper towel to air dry

After last treatment of the day:

  • Clean with mild soap and rinse with sterile water
  • Air dry on a clean paper towel

You should not rinse or disinfect the white tubing or the white / blue pressure manometer cone.

The outside of the manometer can be wiped down, but should not be taken apart or placed in water.

Last Updated 11/2021

Reviewed By Jen Gronauer, RT

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