The following topics are discussed on this page:
Ideally, patients receiving treatment with the Vibralung Acoustical Percussor should be seated upright to facilitate holding the Hand-held Transducer (HHT) and for coughing and subsequent expectoration of secretions.
Adults may hold the HHT in many different acceptable ways.
Children may be able to hold the HHT by themselves, or with a little assistance from a parent or caregiver.
Buttons and Settings on the Treatment Control Unit
The TCU has 7 user-selectable buttons that illuminate when activated. The buttons provide tactile feedback when they are pressed. These buttons enable the user to select from 5 control settings as shown in the legend below, as well as a “Start/Pause” function and Power On/Off. Additionally, two LED indicators (“Charging” and “Low Battery”) illuminate as needed to show the status of the internal battery.
Front panel of Treatment Control Unit, showing mode selection buttons on the top row, Pause and Power (on/off) buttons and indicators on the bottom row plus connector jacks on left side.
Simultaneous Aerosol Therapy
The Circulaire II Hybrid aerosol delivery device may be coupled with the Vibralung Acoustical Percussor if wetting agents or inhalation medications are prescribed. The Circulaire II Hybrid is the only nebulizer system approved by the FDA for use with the Vibralung Acoustical Percussor. The Vibralung includes an Aerosol Y-adapter that allows interfacing the Circulaire to the HHT, as shown in the bottom figure on page 17.
The Circulaire II Hybrid, when coupled with the Vibralung Acoustical Percussor via the Aerosol Y-adapter, provides a pathway for inhalation and exhalation with minimal mechanical dead space, while the Aerosol Y-adapter provides a straight and unimpeded waveguide for the sound waves to travel through. In this manner, the acoustical energy remains coupled to the patient’s airway during both inhalation and exhalation.
Further, PEP can also be administered by way of the Circulaire, which has a Variable Expiratory Resistor on the exhalation port.
Finally, because many of the patients who may benefit from ACT and simultaneous aerosol therapy via the Vibralung Acoustical Percussor also have pulmonary infections, an exhalation filter is included in the exhalation pathway of the Circulaire to prevent fugitive medications and patient droplets from being emitted into the room and possibly inhaled by caregivers, other patients, or family members.
Refer to a physician’s or caregiver’s prescription or instructions for appropriate settings for the Vibralung Acoustical Percussor, plus treatment frequency and treatment times.
Regardless of which Y-adapter is used, operation of the Vibralung Acoustic Percussor is the same. The patient should hold the device in one or both hands while inserting the mouthpiece into the mouth and breathe normally throughout the treatment.
Steps of Operation:
To power on the TCU, disconnect it from the charger, plug the HHT into it, then press the Power button
The LEDs embedded in the Power and Pause buttons flash 3 times and remain illuminated when the TCU passes its Power On Self Test (POST).
The Unit is in Pause mode upon powering on.
The Low Battery LED illuminates if the battery needs charging.
2) Mode Selection:
To select and activate a setting, press one of the 5 setting buttons in the top row (L, M, H, R2 or R5). The LED embedded in the selected setting button illuminates.
Press the Pause button to activate the device and emit sound at the selected setting. The LED embedded in the Pause button extinguishes.
Unless stopped or paused, the unit will operate at the selected setting for 10 minutes and then terminate.
Press the Pause button at any time while activated to pause the session. The LED embedded in the Pause button illuminates.
Press the Pause button while paused to resume the session. The LED embedded in the Pause button extinguishes.
If a paused session is not resumed within 2 minutes by pressing the Pause button again, the session automatically terminates.
Important: If a different treatment mode is desired before the currently selected mode has terminated, it is necessary to power the TCU off, then power it on again and select the desired mode.
3) Resume, Terminate, Repeat:
To resume an automatically terminated session, or repeat a session with the same settings, or start a different session with different settings, repeat steps 1 and 2 above and select the appropriate settings.
To initiate treatment, the patient should place the mouthpiece in his or her mouth and seal their lips around it just tightly enough to maintain a comfortable seal. The teeth may rest gently on the mouthpiece but the patient should be cautioned to not bite down or chew on the mouthpiece.
5) Patient Position:
Avoid recumbent positioning while using the Vibralung Acoustical Percussor. Patient should be sittign upright or at no less than a 30° recumbent angle to facilitate coughing and expectoration.
6) Breathing Pattern:
The patient should breathe normally during the treatment. As with any breathing treatment, alveolar hyperventilation may result in dizziness or light-headedness. The treatment may be paused at any time and resumed within 2 minutes if the patient needs to rest. If the pause period extends beyond 2 minutes, the TCU will automatically shut itself off.
7) Positive Expiratory Pressure (PEP) Therapy:
Adjust the Variable Expiratory Resistor to apply PEP during resting breathing. Minimal PEP is applied when the orifice is wide open (60°) and maximal PEP when the orifice is at the minimal position (10°). An optional PEP manometer is available so that PEP levels can be monitored. Minimal PEP levels will be observed during quiet tidal breathing due to relatively low respiratory flowrates. If desired, the patient may be instructed to perform an extended PEP maneuver by taking a deep breath and exhaling slowly while maintaining an expiratory flowrate sufficient to keep the PEP manometer in the 10 to 20 cm H2O pressure range for 3 to 5 seconds. This maneuver can be repeated as often as prescribed for the patient.
A selected treatment setting with the Vibralung Acoustical Percussor takes up to 10 minutes, depending upon the setting that has been selected, and provided the session has not been paused at any time.
Five settings, representing a designated sequence of frequency ranges, have been coded into the signal generator portion of the Treatment Control Unit as shown in the following table: