Intended Use:

The DHD Acapella Choice is indicated for use in conjunction with a medical need for Positive Expiratory Pressure (PEP) Therapy. It may also be used simultaneously with nebulized aerosol drug delivery.

The Acapella Choice Easy To Clean Vibratory PEP Device with one-way inspiratory valve and 22 mm male fitting consists of:

A. Detachable mouthpiece (device end adapts to mask)

B. Expiratory resistance/frequency adjustment dial

C. Detachable cover

D. Detachable rocker - DO NOT disassemble the rocker

Initial Settings:

• If this is the first use of Acapella Choice, ensure that frequency adjustment dial is set at the lowest frequency-resistance setting, indicated at ""1"" (see figure 1).
• Instruct the patient to relax while performing diaphragmatic breathing and inspiring a volume of air larger than normal tidal volume (but not to total lung capacity).
• Direct the patient to exhale to functional residual capacity (FRC) actively, but not forcefully, through the device.
• Adjust the dial to increase the resistance.
• The patient should be able to exhale for 3-4 seconds while the device vibrates. Clockwise adjustment increases the resistance of the vibrating orifice, which will allow the patient to exhale at a lower flow-rate. Counter-clockwise adjustment decreases the resistance.
• Once the proper range has been identified, the patient may be instructed to exhale harder or softer, or dial adjustments may be made to optimize the response the user ""feels"" from the vibratory pressure.

 For the user:

1. Ensure the adjustment dial is set to the correct range as identified by your clinician.

2. Sit with elbows resting comfortably on table.

3. Place mouthpiece lightly in mouth.

• Be sure to maintain a tight seal on the mouthpiece during exhalation.
• Your clinician may recommend the use of a nose clip, if necessary.
• If using a mask, apply mask tightly but comfortably over nose and mouth.

4. Breathe from the diaphragm, as directed by your clinician, taking in a larger than normal breath, but not filling your lungs to capacity.

5. Hold your breath for 2-3 seconds.

6. Exhale actively, but not forcefully, through the device. Exhalation should last approximately 3 to 4 times longer than inhalation.

7. Perform 10-20 PEP breaths as recommended by clinician. Remove mouthpiece or mask and perform 2-3 ""huff"" coughs to raise secretions as needed. Your clinician may direct you on proper cough technique.

8. Repeat steps 2 to 7 as prescribed.

Note: See nebulizer set-up section.

Cleaning Instructions:

There are four parts to clean the mouthpiece, the cover, the rocker, and the base unit. Detach mouthpiece or mask. Detach the cover by placing your forefinger and thumb on the (3) ribs located on the unit toward the mouthpiece. Gently press on the ribbed surface and lift the cover up. The cover should only be lifted to a 90 degree angle. Detach the rocker by placing your forefinger and thumb on either side of the grooved surface and gently lift the rocker up. Soak the four parts in warm soapy water and rinse. Drain the device by resting it on its side.

Autoclaving:

Acapella Choice will functionally withstand autoclaving at temperatures not to exceed 136º C (277º F). It is the responsibility of the user to ensure all sterility verification(s).

Note: Acapella Choice will maintain its integrity using cold sterilizing solutions such as Glutaraldehydes.

Note: Bleach is not recommended for use on Acapella Choice. It may deteriorate the nickel plated mechanism located on the interior of the Acapella Choice.

Note: Do not microwave.

Take advantage of exceptional low pricing for the Acapella Choice Vibratory Positive Expiratory Pressure (PEP) device online today, or speak with a courteous medical supply representative by phone at 1-888-687-4334.