The standard protocol can be used with the following vest machines, Hill-Rom model 104 and newer, inCourage by RespirTech, and the Smart Vest.

If your child is prescribed to perform the Minnesota Protocol, follow the instructions below.

Setting a Starting Pressure for the Vest

• If this is your child's first time using the vest, you will need to set up a Starting Pressure.
• Set the Frequency to 8 Hz and the Pressure* to 6.
• Press the ON button (or foot pedal).
• After a minute or two of being on the vest, increase the Pressure to 7.
• Give your child another minute or so to get used to this setting.
• Keep increasing the pressure in this fashion until you reach the point where your child no longer feels comfortable, at which time you can back the pressure setting down by one.
• The maximum pressure setting is 10.
• Based on your child's comfort level you have now established the Starting Pressure, and are ready to begin treatment.

*Some vest machines will display pressures as a single number, double number, or a percentage (6, 60, or 60 percent).

Instructions to Perform Treatment

Minnesota Protocol:

There will be six cycles of treatment. Each five-minute cycle uses a different frequency and pressure setting.

• Cycle 1:
  • Frequency setting = 8 Hz
  • Pressure = Starting Pressure
  • Time = 5 minutes
• Cycle 2:
  • Frequency setting = 9 Hz
  • Starting pressure = Same as cycle 1
  • Time = 5 minutes
• Cycle 3:
  • Frequency setting = 10 Hz
  • Starting pressure = decrease Starting Pressure setting by one
  • Time = 5 minutes
• Cycle 4:
  • Frequency setting = 18 Hz
  • Starting pressure = decrease Starting Pressure setting by 2/3 (see chart below)
  • Time = 5 minutes
• Cycle 5:
  • Frequency setting = 19 Hz
  • Starting pressure = same as Cycle 4
  • Time = 5 minutes
• Cycle 6:
  • Frequency setting = 20 Hz
  • Starting pressure = Same as Cycle 4 and Cycle 5
  • Time = 5 minutes

(Pressure settings are read from the Starting Pressure down)

Treatment:

1. Confirm correct settings on machine for cycle
2. Press the ON button to begin treatment
3. After five minutes of treatment (one cycle), pause the vest generator to deflate the vest (if the vest does not deflate disconnect one end of one of the hoses)
4. Perform two or three sets of Huff Coughs to remove mucus from your child's lungs
5. Repeat Steps 1-4 for remaining cycles

Note: During vest treatments, you will want to keep your child's airways moist by taking a nebulizer treatment during the entire time your child is on the vest. One way to do this is by filling your child's nebulizer cup with about 6-8 mL of sterile normal saline.