Cough Assistance

1
Cough Assistance

• Techniques

2
Cough Assistance

• Definition
• assisting the patient through instruction and
  demonstration to produce an effective cough
• Goal
• to improve bronchial hygiene

3
Cough Assistance

• Indications
• Post-op abdominal and thoracic surgery
• Weak npc because of acute disease
• Painful cough from surgery, injury
• Artificial airways
• Glottic disease
• Weak respiratory or abdominal muscles
• E.g., neurological disease

4
Cough Assistance

• Techniques
• Applying pressure (splinting) to abdomen or chest
  during FET
• Inflate lungs with PPV
• Abdominal thrusts (quad coughing)
• Quadraplegic patients
• Huff
• Inhale to mid lung volumes and forcefully exhale
  with an open glottis to ERV

5
Breathing Instruction/Retraining

• Definition
• Techniques designed to assist patients with
  muscular weakness, post-op pain, or chronic
  pulmonary disease to develop an efficient
  ventilatory pattern and effective cough

6
Breathing Instruction/Retraining

• Goals
• To improve ventilation and oxygenation
• To strengthen ventilatory muscles
• To prevent atelectasis
• To decrease WOB
• To improve cough

7
Breathing Instruction/Retraining

• Techniques
• Diaphragmatic breathing
• Therapists hand is placed on the patients
  epigastric area and instructed to raise the hand
  while inhaling
• Segmental breathing
• Therapist places hands on the lateral aspects of
  the patients chest and instructs the patient to
  expand that portion of his/her chest and raise
  the hands