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To the Editor.—
The commentary, "The Indiscriminate Use of IPPB" (231:1141, 1975) implies that the staff of a respiratory therapy department may be incompetent.I am sorry that Drs Barach and Segal work in an institution where the respiratory therapy staff find hand bulb nebulizers, spontaneous coughing, and deep breathing as "inappropriate and old fashioned." This respiratory therapy staff is not representative of all in the United States.A staff of professional respiratory therapists owe it to their patients to utilize the most beneficial and least expensive methods for treatment of physiological disorders. This type of staff often approaches the physician with recommendations for discontinuance of the use of IPPB and implementation of coughing and deep breathing techniques. This does not rule out IPPB as an effective modality in the treatment of patients that cannot, for a variety of reasons, effectively cough and deep breathe. The use of IPPB may
Smith FR. IPPB. JAMA. 1975;234(5):481–482. doi:10.1001/jama.1975.03260180021010