Breath Stacking
A Guide for Patients
What is breath stacking?
Breath stacking is a technique you can use regularly for keeping lungs clear of
secretions. It is used for people with weakness of the muscles used for
breathing. A piece of equipment called a modified ambu bag is used to help
push more air into the lungs as you breathe in.
Benefits of breath stacking
      Keeps the lungs clear of secretions
      Helps prevent chest infections from developing
      Keeps lungs and chest wall flexible
      Makes it easier to cough effectively
      Improves voice strength
What equipment is needed?
      Modified ambu bag
      Face mask or mouth piece
      One way valve
      Two green connectors
This will be assembled for use by your physiotherapist
                                      Correct assembly of equipment before use
Caution                                    Cleaning Equipment
Only to be used under advice of            The face mask or mouth piece
your physiotherapist as it is not          should be washed in mild soapy
suitable for some respiratory              water, rinsed in warm water and
conditions. Do not share breath            then allowed to dry naturally once a
stacking equipment with anyone as          week.
this could spread infection.
How is breath stacking done?
(You might need assistance handling the bag)
   1. Sit up straight with your back and head supported.
   2. Put the mouth piece in your mouth or hold the face mask firmly to your
      face.
   3. If using an assistant, it is
      important to coordinate the
      breath with them. Your
      assistant may be in front of
      you or if necessary behind
      you to aid head control
      during the technique (see
      picture).
   4. Take a deep breath IN while your assistant squeezes the bag.
   5. Hold the breath (the one way valve will help this).
   6. Then immediately take another breath IN on top of the first breath while
      your assistant squeezes the bag again (stacking one breath on top of the
      other).
   7. Take up to 3-4 breaths IN one after the other in this way.
   8. Remove the mask and breathe OUT.
   9. This technique may also be followed by a cough instead of a breath out.
How often should breath stacking be done?
One set     =            _________          breath stacking cycles
A breath stacking cycle is 3- 4 breaths IN followed by a breath OUT or a cough
Number of coughs =       _________          per set
You should do            _________          sets
                         _________          times a day.