How to coach peak flow and the incentive spirometer
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
Both devices only work if the patient uses them correctly, so the skill is coaching.
Step by step
Prepare
Introduce yourself, explain the device and have the patient sit up or stand. [1]
Peak flow: set up
Slide the marker to zero. Patient stands, takes the deepest breath possible. [1]
Peak flow: blow
Lips sealed around the mouthpiece, blow as hard and fast as possible. Repeat three times and record the best. [1]
Peak flow: compare
Compare with the patient's personal best: 80% or more is the green zone, 50 to 79% yellow, under 50% red. [1]
Incentive spirometer: breathe in
Breathe out normally, seal the lips, then breathe in slowly and deeply to raise the piston to the goal. [1]
Incentive spirometer: hold and repeat
Hold the breath 3 to 5 seconds, rest, and repeat about 10 times every hour while awake. Cough after, hugging a pillow over any incision. [1]
Record
Write the values and the volume reached. [1]
Common errors
- Breathing out into the incentive spirometer.
- Taking one peak flow instead of the best of three.
- Comparing with a population value instead of the personal best.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Sickle cell pain crisis
- Pain after abdominal surgery
- Post-operative atelectasis
- Acute asthma attack
- Botulism
- Rib fracture
8 Making Synapses cases train this skill: open the case library
Sources
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.