Health Library

Positive Expiratory Pressure (PEP)

Positive Expiratory Pressure, or PEP, is a small device that a patient exhales into, using a mask. PEP is also called PEP Therapy, PEP Mask, or TheraPEP.

Description of PEP

The PEP device creates pressure in the lungs and keeps the airways from closing. The air flowing through the PEP device helps move the mucus into the larger airway. A huff cough will help move the mucus out of the airways.

Instructions to Use PEP

1. Have your child sit up straight with their elbows resting on a table.
2. Have your child take slightly deeper breaths than normal for one to two minutes.
3. Have them take a large, steady breath (just slightly more than a normal breath) through the mask attached to PEP device.
4. Have your child hold their breath for two to three seconds.
5. Have your child breathe out through the mask into the PEP device to create pressure 10-20 cm H2O. Have them breathe out for four to six seconds or until just beyond a normal breath.
6. Repeat 15 times (1 cycle). Keep the mask sealed around your child's mouth and nose throughout the cycle.
7. At the end of a cycle, remove the mask and perform two to three huff coughs.
8. Follow this with one (or more) regular coughs to clear the mucus from the large airways.
9. Have your child rest for 30 seconds while they do the controlled breathing technique.
10. Repeat the entire process for six cycles or a maximum of 30 minutes.

Note: A mouthpiece with nose clips in place can be used instead of a mask.

Cleaning the PEP Device

After each treatment:

• Store on a clean paper towel to air dry

After the last treatment of the day:

• Clean per manufacturer instructions or with mild soap and rinse with sterile / distilled water
• Wipe down tubing and outside of pressure manometer, do not rinse / submerge in liquid
• Air dry on a clean paper towel