• The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

Coughing up and mobilising secretion

Coughing up secretion is very important to enable you to breathe freely. Coughing is a protective reflex for cleaning the respiratory tract since it loosens the mucous which can then be transported out of the airways.

Coughing requires abdominal and rib muscles. For people with spinal cord injury, these muscles may be impaired depending on the diagnosis, the type of paralysis and the impairment level. It is therefore possible that they will need support when coughing up secretion.

How can coughing up be supported?

  • Move into a good body position.
  • Breathe in deeply and deliberately.
  • Increase pressure by closing the vocal folds – the counter pressure that is created expands the bronchial tubes.
  • Cough strongly and briefly but without cramping.
  • Breathe deeply between coughs.

It is harder to cough up thick mucus. You should therefore drink enough, especially tea (anise, fennel, thyme, ribwort, mallow and licorice).

Inhalations can help to liquefy the mucus. Best suitable are inhalations using a saline solution. Sodium chloride is atomised into tiny drops by using an ultrasonic or injector nebuliser. They go deeply into the respiratory tract when inhaling whereas with standard inhalation procedures the bronchi cannot be reached. Saline solutions and nebulisers can be bought in pharmacies.

Manual assistance by a caregiver

A powerful coughing action is needed to cough up mucous or during swallowing. If the person lacks strength in their abdominal muscles, a caregiver may help them to cough up secretions.

Sudden pressure is exerted on the abdominals and lower chest area in connection with the coughing mechanism.

16 170 06 Atemmanagement EN Seite 09

Mobilising secretion with Cough Assist

If the respiratory muscles are weakened or partially paralysed, the ability to cough efficiently and to expel possible secretion is diminished. The device Cough Assist offers efficient support to release (to mobilise) the secretion. By switching fast from positive pressure during the inhalation phase to negative pressure during the exhalation phase, natural coughing up is simulated.

In order to follow an efficient therapy without complications when using Cough Assist, patients and support staff must be instructed by qualified professionals.

What is needed for the therapy?

  • Cough Assist equipped with a device filter, tube and mask / mouthpiece or catheter mount (if tracheal tube present)
  • Towels to absorb coughed-up secretion
  • Extractor system if needed
  • Possibly NaCl 0.9 % 10 ml in Mini-Plasco ampoules to better liquefy and therefore mobilise thick secretion

16 170 06 Atemmanagement EN Seite 10

Preparation of the therapy

  • If possible, put the patient in an upright position.
  • Position the arms in such a way that there is enough space to extend the chest.
  • Check the device settings before each use – the settings should be made upon consultation with a doctor or qualified nursing staff.
  • Put on the mask, mouthpiece or catheter mount.

Procedures

  • One cycle:
    • put toggle switch on “inhale” for 2 – 4 sec.
    • switch immediately to “exhale” for 3 – 5 sec.
    • take a short break (1 – 2 sec.)
  • Repeat cycle 3 – 6 times
  • Depending on how much secretion is present, suctioning and/or cleaning of the mask, mouthpiece or Mount Catheter is necessary.
  • If not all secretion was mobilised, further cycles can be performed after a recovery phase (several minutes, depending on how the person feels).
  • If the person using Cough Assist does not need any assistance and is able to install the mouthpiece / mask by him / herself, he or she can choose auto mode. The individually set device then performs the pressure change automatically, from inhale to exhale followed by a break.

The tubes need to be exchanged once per week. If dirty in between, they should be cleaned under flowing water and allowed to dry.

Comments (0)

There are no comments on this topic yet.
Be the first to comment!

Rate this post

Forum
Most Recent Answers
5277 odyssita
Explaining what life with a chronic disability is like
Hi cAro, all the best for your research! I am very curious to hear about the results once they are being published. Thank you for researching this...
6 odyssita 2018-05-02
5193 Wheelie
Scewo
Good news for all who would like to try out the Scewo by themselves: according the Scewo constructors, the feedback on their invention was so...
5 Johannes 2018-03-12
Ask the Expert
Most Recent Answers
3 Dr._Hans_old 2015-07-20
3 Dr._Hans_old 2015-05-07

Blog
Most Recent Blog Posts
Wheelchair chefs: the success stories
Disabilities matter but ambition rules
0
lorenzo.deluigi 2020-07-22 In News
Make to Care, a competition promoting innovations
Which one of these four innovative projects convinces you the most?
0
kitwan 2020-07-02 In Society
Wheelchair users’ game of thorns
The fight for personal space, safety and independence
0
Wiki
Most Read
Anatomy and physiology of respiration
Breathing is the most normal thing in the world for us. We hardly think about it, even though we breathe in and out about 20,000 times per day. We breathe more when we are active and exerting ourselves, and we breathe less when we are...
Social skills increase quality of life
Today strawberry yogurt is on Anna’s* grocery list. In front of the dairy section she notices that she cannot reach the yogurt sitting in a wheelchair. Many stressed people are rushing through the crowded store during rush hour and she does not...
Mobilisation / Transferring
What do I need to consider with regard to the shoulders? The shoulder is the most heavily-strained joint with regard to mobilisation – that applies to sitting up and transferring. It is therefore important to protect the shoulders whenever it is...

About the Community
Most Recent Topics
2020-08-04 In Latest
An unconventional book on ignoring disability
"A picture is worth a thousand words." How about blank pages? Recently, a blank book has been released to express the absurdity people with disabilities are experiencing every day, as there is...
0
2020-07-16 In Latest
Free masks for high-risk patients with SCI
People with high-level tetraplegia, paraplegics of higher age and those with pre-existing health conditions are more susceptible to a severe development of COVID-19. For this reason, the European...
0
2020-07-03 In Latest
A COVID inspiration porn?
Over three months since the COVID-19 declared pandemic, many countries are still debating whether to make wearing face masks compulsory to help prevent the spread of the disease. Noam Gershony, an...
0

Contact

Swiss Paraplegic Research
Guido A. Zäch Strasse 4
6207 Nottwil
Switzerland

This email address is being protected from spambots. You need JavaScript enabled to view it.
T 0800 727 236 (from Switzerland, free of charge)
T +41 41 939 65 55 (from other countries, charges apply)

Be part of the Community – sign up now!