How does Bubble PEP work?
Bubble PEP is fun way of using positive expiratory pressure to help splint the airways open, allowing air to get behind the sputum, making it easier to clear.
Reasons for using Bubble PEP
- To make treatment sessions more interesting and fun
- To give added incentive i.e. being able to blow bubbles out of a bottle.
- Helps sputum movement by splinting airways open
- Helps sputum removal
- Reduces small airway collapse.
Equipment
- Bottle (eg. two-pint plastic milk/juice or water bottle, cleaned out thoroughly. Opening of bottle to be least 2cm wide)
- Liquid soap or washing up liquid (3-5 squirts)
- Piece of wide tubing (given to you by your Physiotherapist)
- A tray or bowl to catch the bubbles as they come out.
Preparation
- Fill the bottle until the water in it is 10cm deep, this will achieve the required pressure
- Put the liquid soap/washing up liquid in the water Place the bottle in the tray
- Place the tubing to the bottom of the bottle
- Take any inhalers/nebulisers as prescribed before Bubble PEP to help prepare the airways.
Method
- Ask your child to seal their lips around the tubing, breath in through their nose and then blow out into the tube, using a slightly bigger breath than normal. Try to ensure your child is not puffing out their cheeks. Bubbles should start coming out of the top of the bottle into the tray.
- Aim to take a big breath in and achieve a long breath out
NB. Children who may attempt to suck rather than blow down the tube must be closely supervised by an adult when doing Bubble PEP.
Take any inhalers/nebulisers after your airway clearance as prescribed

Cleaning
Wash the bottle in hot soapy water and rinse in clean water.
Shake any excess water from the tubing and leave to air dry in a clean dry area.
ALWAYS ensure that the tubing and bottle are dried out as thoroughly as possible after each use. Leave the plastic bottle upside down to air dry.
You will be given spare tubing by your physiotherapist.
REPLACE the bottle every week and the tubing every month (you can get replacement tubing from your physiotherapist at clinic visits).
If you have any problems or questions about the above please do not hesitate to contact your physiotherapist on 0113 392 7125