Airway clearance
through the mechanically assisted coughing system

This technique aims to assist or substitute weakened respiratory muscles that cannot generate an effective cough.

In clinical practice, the technique is mainly used for patients with neuromuscular disorders. Its benefits include alleviating an ineffective cough, helping to eliminate respiratory secretions and reducing respiratory infections.

The procedure consists first of applying positive pressure to the airways through a mechanical device (Cough-Assist®), which fills the lungs (insufflation), and then transforming that positive pressure into negative pressure (exsufflation). This abrupt change in pressure in such a short time generates air flows that can clear respiratory secretions.

If the exsufflation is accompanied by abdominal compression, the procedure is even more effective.

Usually, each session consists of 3–6 cycles. Each cycle is made up of an insufflation phase (1–3 seconds), an exsufflation phase (1–3 seconds) and a rest phase (0–5 seconds). A pressure of around 30–50 cmH2O is used, followed by approximately 30 seconds of rest to prevent hyperventilation. The procedure can be carried out several times a day, preferably in the morning, before meals and before sleep.

This device is easy to use, and its inhalation and exhalation time can be adjusted according to the patient’s needs.

It can be used with different interfaces: a face mask, a mouthpiece, a connector for an endotracheal tube or a tracheostomy cannula.

Child mask.

Adult mask.
If using a face mask, make sure the patient’s nose and mouth are covered and remember that there should be no leaks.

Endotracheal tube connector.

Mouthpiece.

How to use the assisted cough system

Connect the power cable to the back of the device and plug it into the mains.

Attach two bacterial/viral filters to the tubing. One at the patient interface end, and the other at the device outlet end.

Make sure the device is plugged in. Press I/O to turn on the device and select ‘Therapy’ to begin treatment. The OXIGEN salud team will have already configured the therapy parameters according to the doctor’s prescription.

To stop the therapy, select ‘Stop’. To turn off the device, press I/O. The unit should then go back to 0 cmH2O.

How to use the assisted cough system: manual mode

Attach the patient interface (put the mask on the patient or insert the mouthpiece, connector or cannula).

Set the switch to manual mode.

Put the switch in the inhalation position (on the right) and watch the pressure rise on the gauge for 2 or 3 seconds.*

Quickly put the switch in the exhalation position (on the left) to induce a cough and keep it there for 1 or 2 seconds. The switch can be left in the neutral position or moved back into the positive pressure position to start another cough cycle, as required.*

Remove the interface after 3 or 6 cycles. Wait for the patient to recover their normal breathing pattern or reconnect them to the ventilator. During the rest period, any secretions can be detected in the mouth, throat or tracheotomy tube.*

*As per the doctor’s prescription.

How to use the assisted cough system: automatic mode

Attach the patient interface (put the mask on the patient or insert the mouthpiece, connector or cannula).

Set the switch to auto mode.

The device will move from positive pressure to negative pressure, then to position 0 to start the inhalation again.

Remove the interface after 3 or 6 cycles. Wait for the patient to recover their normal breathing pattern or reconnect them to the ventilator. During the rest period, any secretions can be detected in the mouth, throat or tracheotomy tube.

Maintenance and cleaning

The device can be cleaned with a damp cloth and a non-abrasive soap. Never submerge them in water. Leave it to dry before using it again.

Do not use any abrasive or flammable products.

Precautions and safety measures

Begin the treatment with a lower positive pressure, then increase it gradually (each day or according to tolerance), if any pain or discomfort occurs in the chest during the first use of the device.

Place the device somewhere where the side and back air inlets are unobstructed.

Never use the device without attaching a filter to the back of it.

The device is designed for intermittent use only. It must not be used for more than five minutes without interruption; after this time, the unit must be turned off or left on standby for at least five minutes. Turn off the unit when it is not in use.

Keep the cable away from hot surfaces.

Do not use the device if its cable or plug is damaged or if it has been dropped, damaged or submerged in water. Do not use extension cables or multi-socket adapters.

Do not place or store the device where it might fall. Make sure the device is placed on a stable, clean, dry, flat surface.

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