Manually Assisted Cough Techniques

Summary

This video demonstrates several techniques for assisting patients with mucus clearance through manual coughing methods. The four main techniques covered include the Costophrenic Assist, Anterior Chest Compression, Himic Technique, and PNF Counter-Rotation. Each method focuses on facilitating deeper breaths and promoting effective coughing to help clear mucus. The techniques vary in their application, with some targeting the rib muscles, others using body weight, and one relying on counter-rotation. The video also highlights safety considerations and contraindications for specific techniques.

Takeaways

• 😀 The C Costophrenic Assist technique helps a patient take a deeper breath by applying pressure to the bottom ribs and encouraging lung expansion.
• 😀 The technique involves placing hands on the patient's ribs, pulling downwards during inhalation to stretch the intercostal muscles and promote a deeper breath.
• 😀 When the patient coughs, the therapist applies downward pressure on the ribs, assisting in expelling air behind the cough for more effective mucus clearance.
• 😀 The Anterior Chest Compression technique is used for patients with larger chest walls, where forearms are used to apply pressure, leveraging body weight to facilitate deep breathing.
• 😀 The purpose of the Anterior Chest Compression is to help patients take a full breath and effectively cough, using a compression technique on the chest.
• 😀 The Hemik technique, a modified version of the Heimlich maneuver, can be used in specific cases where coughing is needed, but caution is required as it can be uncomfortable and potentially harmful if done improperly.
• 😀 For the Hemik technique, place the heel of your hand just below the xiphoid process and ask the patient to breathe in and hold it before applying a controlled push while saying 'cough'.
• 😀 The patient's position for certain techniques, like hook line, is important for effective breathing exercises and coughing assistance.
• 😀 PNF (Proprioceptive Neuromuscular Facilitation) counter-rotation techniques are used to help patients dissociate upper and lower body movements during coughing.
• 😀 Choosing the appropriate cough technique depends on patient feedback and safety considerations. Techniques like anterior chest compression may not be suitable for everyone, such as post-sternotomy patients.

Q & A

What is the primary purpose of the self-assisted cough techniques?

The self-assisted cough techniques are designed to help patients clear mucus from their airways, especially when they are unable to do so effectively on their own. These techniques facilitate a stronger and more productive cough.

What is the C costophrenic assist technique, and how does it work?

The C costophrenic assist technique involves placing hands on the bottom of the ribs and pulling downward during inhalation. This technique aims to stretch the intercostal muscles, helping the patient take a deeper breath, which is crucial for clearing mucus when they cough.

Why is it important to help a patient take a deeper breath before asking them to cough?

Helping a patient take a deeper breath before coughing increases the volume of air in the lungs. This deeper inhalation helps to generate more forceful airflow when the patient coughs, making the cough more effective for clearing mucus.

What is the role of the forearms in the anterior chest compression technique?

In the anterior chest compression technique, the forearms are placed on the patient's chest to apply pressure, helping facilitate deeper breathing. This technique uses body weight to encourage the patient to take a fuller breath, aiding the effectiveness of the cough.

What are the risks associated with using the Heimlich technique in this context?

The Heimlich technique, when used incorrectly or inappropriately, can be painful and uncomfortable. It should not be used immediately after a patient eats, as it could lead to regurgitation. Additionally, it is similar to the technique used in choking situations and should be applied with caution.

Why is it crucial to time the 'cough' command properly during the Heimlich technique?

Timing the 'cough' command properly during the Heimlich technique is crucial to ensure the force applied through the hand placement matches the patient's natural cough reflex. Incorrect timing can reduce the effectiveness of the technique and may cause discomfort.

What is the PNF counter-rotation technique, and how is it used in assisted coughing?

The PNF (Proprioceptive Neuromuscular Facilitation) counter-rotation technique involves using two hand placements—one on the pelvis and the other on the shoulder—while encouraging the patient to breathe in and cough. This technique is designed to help coordinate the upper and lower body movements to enhance the effectiveness of the cough.

What is the correct patient positioning for the PNF counter-rotation technique?

The correct patient positioning for the PNF counter-rotation technique is in a hook-lying position, with knees bent. This posture allows the therapist to apply the correct pressure and movements to facilitate deeper breathing and a stronger cough.

Why is it important to avoid using certain cough techniques on patients with specific conditions?

Certain cough techniques may be contraindicated for patients with specific conditions, such as after a sternotomy (chest surgery), as they may cause discomfort or injury. It is essential to assess the patient’s condition and ensure that the technique is safe for them.

How can caregivers determine which coughing technique to use with a patient?

Caregivers should select the most appropriate coughing technique based on the patient’s comfort, the effectiveness of the technique, and any medical conditions that might contraindicate certain techniques. It's also important to ensure that the chosen method is safe for both the patient and the caregiver.