What is an “assist cough?”
An “assist cough” is a way to help a person who cannot cough well clear the airway of mucous. After some spinal cord injuries the ability to cough is weak or absent. This can be a problem because the person will not be able to clear mucous out of the throat or lungs. Problems with poor coughing can lead to pneumonia. The “assist cough” is a way to help prevent this from happening.
When does a person need an “assist cough?”
A person who has been trained in this area should do an “assist cough.” This can be done during suctioning, in-exsufflation or when:
~The person tells you it is needed ~The person is trying to cough ~The person is short of breath ~You hear or feel congestion in the person’s chest
How is an “assist cough” done?
Place the person on his/her back, if possible. If the person is sitting, make sure the wheelchair is locked. If the person is in a reclining wheelchair, recline the chair back and lock it.
Place the thumb of each hand together and spread your fingers wide apart, forming what looks like a butterfly. Next, put your butterfly hands on top of the person’s stomach area. Do not put them on top of the ribs or bony areas.
Ask the person to take 3 - 5 deep breaths. On the last breath, you will help the person breathe out by pushing in and up, using a firm, steady pressure. Use smooth motion. At the same time you are pushing, ask the person to try to cough as hard as possible.
You may repeat this as needed. The person may wish to rest between coughs.
Other Assist Cough Techniques
Assist Cough Butterfly Technique:
Assist Cough Forearm Technique:
If the mucous is thick and hard to cough up, you can increase the amount of water the person drinks and call the doctor. Please note that an increase in water may affect how much urine a person makes so pay close attention to urine volumes especially in people with intermittent catheterizations (ICs). The frequency of bladder programs may need to be changed.
If the person has a colostomy (or other type of ostomy) or a feeding tube in the stomach area, avoid placing your hands on that area; work around it.
Have tissues ready to help the person clean his mouth after coughing.
If this is being done during suctioning, you will do the pushing when the catheter is coming out of the trach tube.
See the suctioning lesson for more information.
This will help the mucous come out easier. Follow the instructions for suctioning and just add this step.
The person who is giving the extra breaths with the Resuscitator Bag is usually the same one who will do the “assist cough."