Using the Acapella DM or DH®

People with some lung conditions, such as chronic bronchitis, emphysema, mycobacterial disease and bronchiectasis often produce a large amount of mucus. If the mucus is allowed to collect in the airways, breathing may become difficult and infection may occur. The Acapella^® airway clearance device is a technique to help mobilize mucus from the airways. The Acapella DM® is blue. The Acapella DH^® is green.

How to Use the Acapella^®
How to Clean and Care for the Acapella (green or blue)
How to Replace the Acapella^®

How to Use the Acapella^®

1. Assure proper setting of the dial on the end of the Acapella. This is the end opposite the mouthpiece. Your health care provider will set the dial when you get your Acapella. Rotate the end toward the + (plus) to increase resistance. Rotate the end toward –  (minus) to decrease resistance.
2. Sit up with good posture to use the Acapella. Sometimes we may have you lie in a postural drainage position to use the Acapella. Postural drainage positions include lying flat on your back, flat on your side and alternating sides. Your health care provider will show you postural drainage positions to use if these are recommended.
3. Take in a fairly deep breath and hold it for about 3 seconds.
4. Place the Acapella mouthpiece in your mouth. Seal your lips tightly around the mouthpiece.
5. Exhale as much as possible (but not to forcefully) through the mouthpiece. Keep your cheeks as firm as possible when you exhale. Try not to inhale through the device.
6. Repeat this maneuver for 10 breaths. Try to resist coughing during this phase.
7. After these 10 blows, perform 3 huffs, then a big cough to bring the sputum up and out. Try not to swallow the mucus.
8. Huff coughing is a type of coughing if you have trouble clearing your mucus. Take a breath that is slightly deeper than normal. Use your stomach muscles to make a series of 3 rapid exhalations with the airway open, making a “ha, ha, ha” sound. Follow this by normal breathing and a deep cough if you feel mucus moving.
9. Repeat steps 1 through 7 for 15 minutes 2 to 4 times a day (or as prescribed by your health care provider).
10. Your health care provider will tell you how many times a day to use the Acapella. If you use a short-acting inhaled bronchodilator, use the Acapella 15 minutes after you inhale the medicine.

How to Clean and Care for the Acapella (green or blue)

1. Wash your hands.
2. Clean the Acapella every day.
3. Take the mouthpiece off the Acapella body. The mouthpiece and body need to be washed.
   Daily –
   Clean the mouthpiece and body of the Acapella daily with liquid dish detergent – Rinse with water.
   Disinfect Weekly –
   Clean the mouthpiece and body with alcohol – soak both parts in 70 percent isopropyl alcohol for 5 minutes. OR Clean mouthpiece and body with hydrogen peroxide – soak both parts in 3 percent hydrogen peroxide for 30 minutes.
   Note: The Acapella should not be placed in the automatic dishwasher, boiled or bleached.
4. Rinse in clean water.
5. Shake off excess water.
6. Drain dry the device. Place each piece downward or rest the unit on its side.
7. Replace the mouthpiece when the unit is completely dry and ready for use.

How to Replace the Acapella

To replace the Acapella DM (blue) or DH (green) you need a prescription from your local health care provider. Take the prescription to a local home care company. 

This information has been approved by Leslie Schamaun, RRT and Ann Mullen, RN, MSN, AE-C (January 2013).