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why do we cough
coughing is a pulmonary defense mechanism that attempts to maintain the airway, It is the major defense mechanism against retained secretions, the cough mechanism is often destroyed or inadequate in pulmonary disease ( commonly from destruction of cillia)
weak patients should cough how
have the patient draw in several breaths, holding each until a larger volume is attained
series of three coughs
patient starts with a small breath and a small cough, then bigger breath and harder cough, and finally a really deep breath and a hard cough
cough twice in one breath
patient takes a deep breath and coughs twice with the air from that breath
Modified heimlich maneuver
an assisted cough is used with patients suffering from neuromuscular disorders that cause the cough mechanism to be ineffective (quadraplegia, paraplegia, guillainbarre, myasthenia gravis) the manuel compression is applied to the abdomen and lateral thorax at the exact time the patient reaches peak inspiratory effort
patient takes three deep breaths, at the end of the third breath the patient is encouraged to perform two hard coughs this technique increases the volume available for a more effective cough
patient generates pressure from deep in the lungs it is often used in conjuction with autogenic drainage technique
supporting a surgical incesion or injured area with hands, pillow or blanked patiens with abdominal surgery should bend knees and splint incesion
patient is instructed to take a deep breath at the end of maximal inspiration the patient is instucted to sniff additional air sniffing used the diphragm
perched lip breathing
for patients who experinece premature airway closure (COPD or ashma) patiens should be instructed to inahlae through the nose and exchal through perched lips
breathin is concentrated over specific lung area affected by atelectasis, secretions or decreased airflow
concentrated breathing technique used to direct secretions to central airways patient takes shallow breaths, working up to deeper breaths as secretions move to the larger airways while suppressing the need to cough used mostly with CF patients it is a very time consuming and difficult technique to teach and to learn therefore it is seldom used in most hospitals however when done correctly it is very effective
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