Active cycle of breathing technique (ACBT)
There are 3 parts of this which have fancy names, try not to get bogged down by the names rather focus on what you need to do.
1) Thoracic expansion exercises (TEE) - Deep breath in. this is a steady breath in through your nose until you cannot breathe any more air in and hold it for 3 seconds if you can. This gets air behind the sputum.
2) Forced expiratory technique (FET) – Huff out. this is a forced breath out through an open mouth also called a huff like steaming up a mirror or glasses. It can be a long huff if you think the sputum is deep in your lungs or a shorter huff if it feels higher or in the middle of your chest. This moves sputum along your airways. (If you find your chest gets tight doing this you may find AD more suitable).
3) Breathing control (BC) – Relaxed breathing. This should be in and out through your nose. You should see your tummy gently be pushed out as your lungs fill but don’t force it out. Keep your shoulders relaxed as you do this. This stops you from feeling lightheaded or over tired.
Start with 20 seconds of relaxed breathing, take 2-3 deep breaths followed by relaxed breathing then do 2 huffs – if your sputum is moved high enough to cough it up do so, if not do some relaxed breathing for 20 seconds or so. Then repeat.
How many deep breaths versus huffs is up to the individual. Some people stick rigidly to 3 deep breaths then 2 huffs and 20 seconds relaxed breathing. Others may do several cycles of deep breaths with relaxed breathing then a couple of huffs at the end. Its good to experiment to see what works for you best. At the end of chest clearance I usually encourage people to finish on a couple of deep breaths.
*Avoid huffing if you have coughed up blood within the last 48hours.*
