Respiratory Cloud Clinical Skills Library

Clinical knowledge review

Contraindications

Use these educational prompts with current orders, protocols, patient assessment, facility policy, and supervising-clinician direction.

Skill

Positive Expiratory and Airway Pressure Therapy (PEP, PAP)

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Contraindications Conditions identified as reasons to avoid or defer the procedure pending authorized clinical review. View list Relative contraindications Factors requiring individualized risk-benefit assessment, added precautions, or a modified approach. View list

Contraindications

Review these conditions before proceeding and follow current orders, protocols, facility policy, and supervising-clinician direction.

  • Untreated pneumothorax
  • Hemoptysis of unknown origin
  • Recent facial/skull surgery or trauma

Relative contraindications

Use individualized risk-benefit assessment, added precautions, or a modified approach as authorized for the patient and setting.

  • Increased intracranial pressure (>20 mmHg)
  • Nausea/vomiting or aspiration risk
  • Severe bullous lung disease (barotrauma risk)

Sources

Supporting sources include peer-reviewed research, evidence-based clinical practice guidelines, professional standards, and foundational respiratory care references, as applicable to the skill.

  1. AARC CPG: Airway Clearance Therapies (2013)
  2. ATS/ERS Statement on Airway Clearance (2013)
  3. Egan's Fundamentals of Respiratory Care, 11e (2021)