A very common question that I get quite often is: What is an acapella flutter valve and how does it work? That is what we are going to learn in this article.

People who are suffering from chronic bronchitis and COPD (chronic obstructive pulmonary disease), among other cardiopulmonary diseases, often produce a large amount of mucus in their airway.

types of flutter valvesThis, of course, is a problem that needs to be solved, as it can lead to other issues. Besides, having mucus in an individual’s lung is just not healthy. That’s where the little gadget known as an acapella flutter valve can come in handy.

There are several techniques available to help prevent such situations. One common technique is the use of bronchodilator medication to help open up the airways which can also help loosen up the secretions. Also, there are other various methods of airway clearance such as vest treatment, exercises like huff coughing, deep coughing, etc. However, although many of these methods work well, a common and much simpler approach is to use this little device that resembles a Christmas tree.

What is a flutter valve?

A flutter valve is a handheld device used as a type breathing therapy. It helps to clear mucus from the lungs as well as make the breathing easier and more comfortable. It is a triangularly shaped cylinder and sometimes green in color, which is often why it’s referred to as the “Christmas tree”.

This device loosens the secretions in your lungs and helps you to cough them up. The acapella causes both airway vibrations and positive expiratory pressure (PEP) therapy, so it essentially provides dual therapy.

The flutter valve is consists of:

  1. Removable mouthpiece
  2. Expiratory resistance dial, which allows the patient a customized therapy to meet his/her clinical needs.
  3. One-way inspiratory valve to enable inhalation by not removing the device from the patient’s mouth.
  4. Proximal 22mm O.D. connection
  5. Distal fitting to fit easily with 22mm I.D. connection

Types of Acapella Flutter Valves

There are 2 types of acapella flutter valves available to pick from:

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Green Flutter Valve The green flutter valve is advised for patients who are able to exhale minimum 15 liters per minute within 3 seconds or less. This is the most commonly used flutter valve in hospitals today.
Blue Flutter Valve The blue flutter valve is suggested for patients who are not able to exhale minimum 15 liters per minute within 3 seconds or less and have lower lung volume.

How does the Acapella Flutter Valve Work?

The acapella flutter valve directs exhaled air by using an opening that is systematically blocked by a pivoting cone. The pivoting cone helps to open and close the air flow path when the air moves through the opening. The final result of this process is a vibrating pressure waveform. From observations of the patients, the frequencies between 0 to 30 Hz are accomplished at the time of keeping positive pressure during the exhalation process. This is known as vibratory Positive Expiratory Pressure (PEP) therapy. By turning the adjustment dial, the acapella’s frequency, as well as the flow resistance of the opening, becomes changed.

How to use the flutter valve?

For someone using an acapella flutter valve for the first time, make sure the frequency adjustment dial is set counterclockwise to the lowest frequency-resistance setting. Now, sit in a chair by keeping your back straight. Keep your elbows resting comfortably on the table. Now, tilt your head slightly upward. This will help to keep the upper airway open wide. As a result, the air you exhale will be able to flow out smoothly.

Breathe deeply

Please keep in mind that your breathing needs to be deeper compared to the normal one. Put the mouthpiece of the flutter lightly in your mouth and then close the lips around its stem. Ensure that you are maintaining a strong seal on the mouthpiece at the time of exhalation. You can use a nose clip if needed. If you are applying a mask instead of the mouthpiece, make sure comfortably but tightly positioned over the nose and mouth.After placing the flutter at a proper angle, start the exhalation.

Note: You must need to be able to exhale for at least three to four seconds while using the device. If you fail to maintain your exhalation for this advised length of time, then you need to turn the adjustment dial clockwise. This adjustment will help the patient to exhale even at a lower flow-rate by raising the total resistance of the vibrating orifice.

Take a full, as well as deep, breath into the lungs and hold it for two to three seconds. After that, blow the air out forcefully as much as you can through the flutter valve mouthpiece. Please ensure that the ball with the valve starts to bounce and also rolling at the time of blowing out the air. Repeat this step for approximately ten repetitions. Now you can remove the mouthpiece and will be able to cough up much of the mucous that was in your airways.

After removing the mouthpiece or mask, you can also perform 2 to 3 “huff” coughs to increase secretion removal as needed. Taking instructions from a physician or trained respiratory therapist will be very beneficial.

(These instructions, of course, may need to be modified for patients in the hospital who are bedridden, as appropriate.)

When should you not use the flutter valve?

There are no absolute contraindications for use of an acapella flutter valve. However, the following points need to be carefully assessed before a decision is taken to initiate therapy:

Intracranial pressure more than 20 mm Hg
Esophageal surgery
Tympanic membrane rupture
Acute sinusitis
Nausea
Epistaxis
Not able to tolerate increased activity of the breathing
Any facial or oral trauma or surgery

Where can I get a flutter valve?

In order to purchase a flutter valve, it is possible that you may need a prescription from you doctor or medical care provider. However, you may also choose to purchase one for yourself online for recreational use. They can actually be found on Amazon.com for a reasonable price.

Final thoughts

Now you know what an acapella flutter valve is and how to use it. And, you even know where you can purchase one on your own. Whether you’re a patient yourself, a respiratory therapist, or anyone interested in flutter valves, you can now feel competent with the use of these excellent PEP therapy devices. So let’s put these Christmas trees to good use.