Pulmonary Hygiene for Easier Breathing (PHBE) is a method to improve your ability to breathe during emergencies. It involves breathing through one’s mouth or nose while holding the breath with the aid of a bag. A person can use it even if they are not allergic to any substances used in its preparation. PHBE is generally considered safer than other methods such as artificial respiration, mechanical ventilation, or cardiopulmonary resuscitation (CPR).
The main advantage of using a bag over conventional airways is that it allows for better control of the amount of oxygen inhaled into the lungs. Also, a bag does not require as much time to prepare before use since it takes less than five minutes to put on and take off.
Another benefit is that a bag can be worn continuously without needing to change out equipment because the user simply breathes through their mouth or nose when needed.
In addition to improving lung function, there are several other benefits of using a bag. First, the bag may prevent the formation of pockets in the lungs which could lead to pneumonia.
Second, it provides some protection against particles in the air that might cause irritation and inflammation of the lungs. Third, it prevents mucus from accumulating in the lungs which could result in asthma attacks. Furthermore, a bag does not require the time and effort needed to perform conventional airway management techniques such as bag-valve mask (BVM), endotracheal intubation, or cricothyrotomy.
The bag does have some disadvantages. For example, it is not suitable for the prevention of smoke inhalation injury since it does not prevent the entry of fine particles into the lungs.
It is also not suitable for patients with large facial burns, or who have sustained injury to the mouth and nose, since it involves breathing through the mouth. Lastly, it can cause dryness in the mouth and nose which may require the use of water mist.
Start of Procedure
The bag is made almost entirely of aluminum foil, with a small hole in the middle for one to two small straws to be placed into. A small opening on one side is left so that the straw can be put in and removed.
The material is non-toxic and bio-degradable, making it safe for long-term use. It is important to make sure that the bag is large enough to cover the patient’s mouth and reach their nostrils, but not so large that it would fall off when in use. It should be held tight around the patient’s face to avoid as much leakage as possible.
The bag can be made at home with household items such as aluminum foil, a small plastic bottle with a small amount of water (such as an empty contact lens solution bottle), and various sized straws.
First, cut or punch a hole in the bottom corner of the bottle. Then cut and roll up enough aluminum foil to cover the inside of the bottle.
Make sure to squeeze out any air bubbles while doing this. Once finished, place the straws into the bottle, one on top of the other, through the hole. The easiest way to do this is to heat up the tip of a pin and push it through the hole until the straws stay in place. Finally, fill the bottle with water and seal it with the cap.
To use, simply cover the patient’s nose and mouth with the bag, making sure to keep as little space as possible between the bag and the patient’s face. Then place the straws into the patient’s mouth and nostrils.
With your other hand, firmly squeeze the bottle to force air through the straws, inflating the bag around the patient’s face. The patient should be able to breath through the bag just like they were breathing through their nose and mouth. Inflate the bag slowly at first until you are sure there is no problem. If you are unable to force enough air through, try cutting a larger hole in the bottle or using a pin to create more holes in the top of the straws.
The bag can be reused indefinitely as long as it is not torn or punctured.
Advantages: It is very cheap, easy to make, and reusable. It can be used for a variety of patients.
Disadvantages: It is not suitable for use in patients with facial burns or extensive nasal or mouth trauma. It is also not effective in preventing smoke inhalation injury.
It is very important to monitor the patient while they are using the bag, as it can cause them to develop dryness in the mouth and nose, leading to a critical deficiency of oxygen.
Sources & references used in this article:
Patient preferences for dry powder inhaler attributes in asthma and chronic obstructive pulmonary disease in France: a discrete choice experiment by N Hawken, S Torvinen, ME Neine, I Amri… – BMC pulmonary …, 2017 – Springer
Helping your patient breathe easier after chest surgery by BC Mims – RN, 1984 – go.gale.com
Work of breathing in patients with chronic obstructive pulmonary disease in acute respiratory failure by B Fleury, D Murciano, C Talamo, M Aubier… – American Review of …, 1985 – atsjournals.org
Chlorofluorocarbon-free aerosol therapy in patients with pulmonary airflow obstruction by H Matthys – Respiration, 1996 – karger.com
Comparison of two teaching methods for self-care training for patients with chronic obstructive pulmonary disease by FK Brough, CDW Schmidt, T Rasmussen… – Patient Counselling and …, 1982 – Elsevier
How to Train yourself to be Healthier by Best Breathing! by SA Nigro – Journal of Medical Care Research and Review, 2019 – jmcrr.in
Benefits of standardizing additional airway clearance in the trauma patient population by VD Hanlon, F White, AE Hustosky… – Journal of Trauma …, 2014 – journals.lww.com
Apparatus for artificial pulmonary ventilation during anaesthesia and resuscitation by GS Rodari – US Patent 4,508,117, 1985 – Google Patents
Chronic Obstructive Pulmonary by E Child, A Blaylock, K Wilkinson, H Price – pdfs.semanticscholar.org