The flutter is a small hand held device that is used to remove mucus from the lungs. When
exhaling through the mouthpiece, the steel ball inside the flutter moves up and down causing a
vibration inside the lungs. This vibration loosens mucus in the airways and lung walls. The
airflow when you breathe out helps move mucus up the bronchial tubes and maintains open
How to do a Flutter Treatment
1. Before beginning the treatment, wash your hands with soap and warm water, or use anti-
bacterial hand gel, to reduce the risk of infection.
2. Relax and sit upright with your head slightly tilted back, so your airway is open.
3. Take a deep breath in and hold for 2-3 seconds. This allows the air to distribute equally
throughout the lungs.
4. Exhale as long as you can through the flutter while keeping your cheeks hard and flat.
5. The angle of your flutter is critical. Start with the stem of the flutter horizontal to the
floor. The bowl of the flutter is at a slight tilt. This tilt insures that the ball bounces and
rolls while you exhale making the vibrations that loosen the mucus. Place your hand on
your chest while you exhale to decide the best vibration or “fluttering”. Tilt your flutter
to give you the best vibration.
6. Keep taking slow deep breaths while breathing out through your flutter valve for about 5
minutes. Stop and huff cough 3 times. To do a huff cough, take a deep breath and hold it
for 1-3 seconds. Then, force the air out of your lungs and say the word “huff” at the same
time. Keep breathing out through the flutter for another 5 minutes and repeat huff
7. Repeat breathing through the flutter valve and huff coughing for 20 minutes or until your
cough no longer produces sputum.
8. NOTE: it is very important to pace yourself as you breathe out on the flutter valve.
Pause for a few seconds between breaths. If you feel dizzy or get a headache while
using the flutter, you may be breathing too fast. If you have these symptoms, stop
using the flutter for a few minutes and breathe normally. When you begin to use
the flutter again, take more time between flutter breaths.
9. Your doctor has ordered the therapy to times per day.
10. After each session, take the Flutter apart and place all of the parts in a clean bowl lined
with paper towels to dry.
Cleaning the Flutter
The Flutter should be cleaned twice weekly or more often if it is visibly soiled. One of two
methods can be used to clean your Flutter.
1. Remove the mouthpiece from the Flutter.
2. Place all of the pieces to the Flutter on the top shelf or silverware rack of the dishwasher
and wash with your normal dishwasher soap.
Or if you do not own a dishwasher, you can
1. Wash all four parts of the Flutter in warm soapy dishwater for five minutes.
2. Rinse all of the parts and then place them in a bowl with enough rubbing alcohol
(isopropyl alcohol) to cover the Flutter. Soak the Flutter device in the alcohol for five
3. Remove the Flutter from the alcohol and rinse with sterile water. Do not use water from
the faucet, bottled, or distilled water. You can make water sterile by boiling it for five
minutes. Use this water once and then throw it out.
4. Place the Flutter in a clean bowl lined with paper towels to dry.
Return Clinic Appointments
Please bring in your flutter so your therapist can review your technique.
If you would like to do this technique while in the hospital, you need to bring in your own flutter
If you have questions or need more supplies, contact UW Home Health at (608) 203-2273.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 5/2016 University of Wisconsin Hospitals
and Clinics Authority, All rights reserved. Illustrations prepared by Stuart McVicar, RRT. Produced by the
Department of Nursing. HF#4915