Assisted Coughing
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Description[edit | edit source]
In conditions such as spinal cord injury or neuromuscular disease an individual may require assistance to cough using manual techniques or a medical device. Manual assisted cough is the compression of the diaphragm by another person to replace the work of abdominal muscles in order to facilitate a cough. A medical device can be used to assist coughing effort by a positive pressure breath followed by a rapid change to negative pressure.[1]
Indication[edit | edit source]
Prevention and treatment of sputum retention
Clinical presentation[edit | edit source]
- Subjectively 'chesty'
- Aubible secretions at the mouth
- Crackles heard on auscultation
- Tactile fremitus
- Hypoxemia
Contraindications[edit | edit source]
Manual assisted cough | Cough assist device |
---|---|
Direct pressure should be avoided to rib fractures or surgical sites. | Undrained pneumothorax
Frank haemoptysis Vomiting Facial fractures CVS instability Raised intracranial pressure (ICP) Recent upper GI surgery Lung abscess |
Precautions[edit | edit source]
Manual assisted cough | Cough assist device |
---|---|
Immediately following surgery
Paralytic ileus Rib fractures Raised ICP Undrained pneumothorax Osteroporosis Pain Unstable spine |
Oxygen dependency
Bronchospasm Emphysema Patient complience Airway obstruction |
Cough assist device troubleshooting[edit | edit source]
Please also see non-invasive ventilation for more information on positive pressure devices
Resources[edit | edit source]
http://www.icid.salisbury.nhs.uk/ClinicalManagement/SpinalInjuries/Pages/AssistedCoughing.aspx