Assisted Cough in a Spinal Cord Injury

Assisted Cough in a Spinal Cord Injury – What is it?

Assisted cough is a technique to help a person cough. It is often done to help people who cannot cough forcefully on their own due to a spinal cord injury. Performing assisted cough is important, because coughing helps the body to get rid of mucus. Performing the technique regularly helps prevent lung problems, such as pneumonia.

What are the risks?

Performing this technique incorrectly can cause the person you are helping to feel pain or get injured. Because of this, it is important to perform assisted cough the way you were shown by the person’s health care provider, even if the instructions are different from those that follow.

How to perform assisted cough

There are two assisted cough techniques for someone who is sitting up. You should only perform these techniques if you have been trained to do so and if a health care provider has said that you are doing them correctly. Every person is different, and some techniques may work better than others.

Technique 1

  1. Stand directly in front of the person so you are facing him or her. Lean over.
  2. Position the palms of your hands underneath the person’s rib cage with your thumbs pointing up toward the chest. Spread your fingers out and gently wrap them around the ribs.
  3. Have the person take a couple of deep breaths.
  4. Have the person hold his or her breath.
  5. Have the person turn his or her head to one side if possible so you can avoid the direct path of the cough. If this is not possible, talk with the person’s health care provider because the technique may not be safe.
  6. Have the person cough while you gently squeeze the ribs up and in.

Technique 2

  1. Stand directly in front of the person so you are facing him or her. Lean over.
  2. Place the heel of one palm under the person’s ribs in the area above his or her navel.
  3. Place your other hand over the first hand.
  4. Interlock your fingers and pull them back gently. Make sure your elbows stay straight.
  5. Ask the person to take a deep breath and hold it.
  6. Ask the person to turn his or her head to one side if possible so you can avoid the direct path of the cough. If this is not possible, talk with the person’s health care provider because the technique may not be safe.
  7. Have the person cough while you gently push up and under the rib cage with the heel of your hand. Your hand should make a scooping motion.

Important information

  • You may need to use a suction device after doing an assisted cough. A suction device is a tool that helps remove mucus and other discharge from the mouth. Ask the health care provider whether you should use this device.
  • It is best to perform the assisted cough when the person has an empty stomach.
  • If the person is in a wheelchair, make sure the wheels are locked before you perform assisted cough.
  • If the person you are helping is in pain, is pregnant, or has chest or abdominal injuries, ask his or her health care provider whether it is safe perform assisted cough. Do notperform assisted cough without the health care provider’s permission.
  • Talk with the person’s health care provider about the best hand position to use and about different techniques that may work in your situation. Working together, you and the health care provider can develop a system that works best for your specific situation.
  • If you are having trouble performing assisted cough or have any questions, contact the injured person’s health care provider. These techniques get easier with practice.

Contact a health care provider if:

  • The injured person has discomfort or pain after an assisted cough.
  • The injured person cannot successfully cough with an assisted cough.

Get help right away if:

  • The injured person is having breathing problems or shortness of breath.
  • The injured person has a fever.
  • The injured person has severe discomfort or pain.
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