FAQ – Cough assist care

When to consult your healthcare team

Respiration/respiratory muscles

Your child experiences chest/abdominal pain during lung volume recruitment technique or manual thrusts.
You are unable to clear your child’s secretions.
Your child’s abdomen does not move outwards during lung volume recruitment technique or insufflation/exsufflation technique.

Equipment

A leak around the mouthpiece or through the nose that persists during lung volume recruitment technique or insufflation/exsufflation technique.

Health

Your child experiences severe dizziness that lasts after 2 consecutive sessions of cough assist.
Your child’s abdomen remains bloated and/or your child burps after lung volume recruitment technique or insufflation/exsufflation technique

Your child’s healthcare team will verify your cough assist techniques, the equipment used and any adjustments that may be required, during your child’s follow-up appointment.

Do not hesitate to contact your healthcare team with any specific questions concerning your child.

PLEASE NOTE: The information in this section is meant as a general guide to help parents and caregivers with common issues and is not intended to replace the care provided by your child’s healthcare team.

Discuss your child’s unique needs with the healthcare team, including WHO and WHEN to contact when problems arise.

Stomach upset during lung volume recruitment technique or insufflation/exsufflation technique

Possible cause(s)

The technique was applied during or immediately following a meal

What to do?

Stop the technique immediately unless your child is really congested with secretions.
Avoid applying the technique within 2 hours before or after a meal.
If needed, suction the secretions.

Chest/abdominal discomfort or pain during lung volume recruitment (breath stacking) or insufflation/exsufflation technique

Possible cause(s)

Sore chest or abdominal muscles
Too much air in the lungs

What to do?

It is normal that your child feels a slight pulling of the chest muscles when the therapy is first started. This discomfort will gradually disappear.

If he feels pain:

Stop the technique immediately.
Contact the healthcare team as soon as possible.

Dizziness or fatigue

Possible cause(s)

Less than 10 minutes between each session
Session is too long

What to do?

Let your child rest.
Wait 10 minutes between each session.

If the dizziness is severe:

Stop the technique immediately.
If the symptoms reappear again, contact the healthcare team.

Bloating of the abdomen with burping after lung volume recruitment technique or insufflation/exsufflation technique

Possible cause(s)

Air is entering the stomach instead of the lungs

What to do?

Remind your child to relax during the insufflations of air; he must not resist air entry.

If the discomfort persists:

Stop the technique immediately.
Quickly contact the healthcare team.

Inability to expectorate (clear) the secretions

Possible cause(s)

Poor technique
Thicker secretions
More secretions than usual

What to do?

Review the technique.
Combine more than one technique at a time (ex, pulmonary hyperinflation with abdominal thrusts) in order to increase the efficacy of secretion clearance.
Make sure that the humidity level is adequate.
If the problem persists, contact the healthcare team as soon as possible.

Leak around the mouthpiece during lung volume recruitment technique or insufflation/exsufflation technique

Possible cause(s)

Poor seal around the mouthpiece

What to do?

Make sure that your child closes his mouth firmly around the mouthpiece.
Make sure that the mouthpiece is properly inserted in the modified ventilatory bag.
If needed, use a facial mask.
If the problem persists, contact the healthcare team.

Leak from the nose during lung volume recruitment technique or insufflation/exsufflation technique

Possible cause(s)

The air is leaking through the nose rather than going to the lungs

What to do?

Use a nose clip.
If the problem persists, use a facial mask.
If the problem continues to persist, contact the healthcare team.

Abdomen does not move outwardly during lung volume recruitment technique or insufflation/exsufflation technique

Possible cause(s)

Poor technique
Lack of collaboration by your child

What to do?

Review the technique.
Make sure that there is no leak (mouthpiece, facial mask, tubing).
Make sure that your child is relaxed.
If the problem persists, contact the healthcare team.

For specific advice on your child or any other questions, do not hesitate to contact your child’s healthcare team.

https://complexcareathomeforchildren.com/respiratory-support/cough-assist-care/faq-cough-assist-care/

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