This document provides information about flutter, an oscillatory positive pressure device used to decrease mucus viscosity and mobilize secretions. It has a mouthpiece at one end and a ball within a cone structure at the other end. During expiration, the ball moves within the cone, creating positive pressure and vibrations. The technique involves slow deep breathing through the flutter, holding the breath, then forcing expiration through the flutter faster than normal to loosen and mobilize mucus over multiple repetitions. Further stages include deep breathing, coughing, and gentle expiration to eliminate mucus. Studies found flutter more effective than other techniques at producing sputum.

1. Flutter
Dr. Blessy Joel (PT)
MPT (Cardio- Resp.)

3. Introduction
 Oscillatory positive pressure device
 Will create the positive pressure in
expiratory phase.

4. Purpose of flutter
 Decrease the viscosity of mucus.
 Mobilize the secretions
 Prevention or for treatment of atelectasis.
 Facilitate the collateral ventilation.

7. Flutter
 It is a small portable device
 Shape- pipe shape
 Single opening at mouth piece and multiple
opening at top end( bowl shape)
 Bowl contain a ball within a cone

8.  During expiration
there will be
movement of ball
within the cone -that
result into creation of
positive pressure and
vibratory motion.

9. Technique
 Position of patient: sitting or upright position
 Flutter should be paced in to mouth
↓
Inspiration through nose or from mouth
( around mouth piece)
↓
A slow deep ( slight) breath
Hold 2-3 seconds
↓
Breath out thro’ flutter at faster rate than normal rate of expiration
This phase is for mucus loosening and mobilization
Repeat 4-8 times

10. Second phase
 Deep breathing with breath hold
 Forced expiration
 This stage for mucus elimination

11. Third stage
 Breath control
 Coughing / huffing
 Gentle exhalation( 10 min) followed by
forced expiratory technique

13. Recent studies
1) Comparative study between
 Flutter, voluntary coughing, postural
drainage
 Flutter was more effective in amount of
production of sputum
2) Comparative study between flutter and
AD
 Compare to AD, flutter is easy to teach

14. Thank You