Mechanical in-exsufflation (CoughAssist)MMechanical in-exsufflation (CoughAssist)Mechanical in-exsufflation (CoughAssist)EnglishRespiratoryChild (0-12 years);Teen (13-18 years)Lungs;TracheaRespiratory systemNon-drug treatmentCaregivers Adult (19+) Hospital healthcare providersNA2017-06-29T04:00:00ZReshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Tuyen Tran, RRT;Amy Glicksman, MD000Flat ContentHealth A-Z

 

 

Mechanical in-exsufflation (CoughAssist)2967.00000000000Mechanical in-exsufflation (CoughAssist)Mechanical in-exsufflation (CoughAssist)MEnglishRespiratoryChild (0-12 years);Teen (13-18 years)Lungs;TracheaRespiratory systemNon-drug treatmentCaregivers Adult (19+) Hospital healthcare providersNA2017-06-29T04:00:00ZReshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Tuyen Tran, RRT;Amy Glicksman, MD000Flat ContentHealth A-Z<figure><img src="https://assets.aboutkidshealth.ca/akhassets/trach_cough_assist01_EN.jpg" alt="A child using a cough assist machine with a tracheostomy adapter" /><figcaption class="asset-image-caption">A child using a cough assist machine with a tracheostomy adaptor</figcaption> </figure> <p>A CoughAssist machine mimics a strong cough to help your child clear their lungs and reduce the risk of lung infections. CoughAssist delivers pressurized air when your child breathes in, then rapidly switches to a negative pressure to suck the air out of the lungs. This causes your child to cough. </p><h2>Who will benefit from using CoughAssist?</h2><p>Your child may benefit from CoughAssist if:</p><ul><li>they have a weak cough and are unable to perform LVR</li><li>they have difficulty clearing secretions</li><li>their lungs have collapsed due to secretions or plugs.</li></ul><h2>Who should not use CoughAssist?</h2><p>CoughAssist <strong>is not </strong>suitable if your child:</p><ul><li>has untreated tension pneumothorax</li><li>has active bleeding in the lungs</li><li>has a suspected or confirmed head injury and/or c-spine (neck) injury</li><li>has an unrepaired tracheoesophageal fistula</li><li>has uncontrolled asthma or bronchospasm.</li></ul><p>CoughAssist <strong>may not be </strong>suitable if your child:</p><ul><li>has a history of bullous emphysema</li><li>is susceptible to pneumothorax or pneumomediastinum</li><li>has had any recent barotrauma</li><li>has certain heart conditions (for example has a single ventricle or Fontan circulation), unless it is approved by their cardiologist</li><li>has increased intracranial pressure, unless it is approved by their neurosurgeon</li><li>has a burn, open wound, infection or skin graft on the thorax</li><li>has recently received a transvenous pacemaker or subcutaneous pacemaker</li><li>has suspected tuberculosis</li><li>has had a lobectomy/pneumonectomyor other chest surgeries in the past six weeks</li></ul><h2>What are the parts of the CoughAssist machine?</h2> <figure><img src="https://assets.aboutkidshealth.ca/akhassets/trach_cough_assist_machine_EN.jpg" alt="A cough assist machine with a tracheostomy adapter patient connector" /><figcaption class="asset-image-caption">A cough assist machine with antibacterial filter, tubing and a tracheostomy adaptor</figcaption> </figure> <p>The CoughAssist machine features:</p><ul><li>an power on/power off button</li><li>control buttons to perform certain actions</li><li>a manual switch to activate the insufflation (air-in) and exsufflation (air-out) phases</li><li>display screen</li><li>breathing circuit connection.</li></ul><h2>How do I use CoughAssist with my child?</h2><h3>Before you start</h3><ol><li>Make sure two people are available to use CoughAssist with your child.</li><li>Gather your equipment:</li><ul><li>CoughAssist machine </li><li>bacteria filter</li><li>flexible tubing</li><li>tracheostomy adaptor</li><li> <a href="/Article?contentid=2962&amp%3blanguage=English">oxygen saturation</a> monitor (oximeter)</li><li> <a href="/Article?contentid=2928&amp%3blanguage=English">suction machine</a>.</li></ul><li>Check that the suction machine is working and ready.</li><li> <a href="/Article?contentid=2927&amp%3blanguage=English">Suction</a> your child's tracheostomy.</li><li>Use the oximeter to make sure your child's oxygen saturation level is within their target range. </li></ol><h3>Using CoughAssist in manual mode</h3><ol><li>Have your child sit comfortably, or lie down in bed, with good head and neck support. </li><li>Attach the filter, tubing and tracheostomy adaptor to the front of the device.</li><li>Check that the pressure on the CoughAssist is set as prescribed by your healthcare team.</li><li>Turn on the CoughAssist machine. It will be in Standby mode. </li><li>Connect the tracheostomy adaptor to your child.</li><li>Press the therapy button to begin the treatment.</li><li>Move the lever to the INHALE side and hold while you call out clearly “in, in, in” (three seconds).</li><li>Quickly switch the lever to the EXHALE side and call out “cough, cough, cough” (three seconds).</li><li>Steps 7 and 8 are one cycle. Do at least three cycles, or the number of cycles prescribed by your healthcare team.</li><li>If your child needs to be suctioned, remove the tracheostomy adaptor and suction them. </li><li>Reattach the adaptor.</li><li>Three cycles (steps 7-8, three times) equal one set.​ Complete three sets, or the number of sets prescribed by your child's healthcare team.<br></li><li>Remove the tracheostomy adaptor and suction your child as needed.</li></ol><p>It is recommended that you do two CoughAssist treatments a day; more when your child is sick.</p><h3>Using CoughAssist in auto mode</h3><p>To use CoughAssist in auto mode, complete the steps above without adjusting the lever. The machine will be set to run the cycles. Count the cycles to make sure you are giving your child the correct treatment as prescribed by your healthcare team.</p><div class="caution"> ​​​ <h3>Precautions</h3><ul><li>Always use CoughAssist at least one hour after your child’s last feed or meal.</li><li>Do not use CoughAssist if your child:</li><ul><li>has a headache</li><li>is vomiting</li><li>experiences aspiration (for example has accidentally inhaled food)</li><li>has lots of air in their stomach</li><li>has low oxygen saturation levels without quick recovery</li><li>has a bronchospasm</li><li>has an irregular heart beat</li><li>feels pain in the ribs or spine</li><li>is breathing too slow or too fast.</li></ul></ul><p>Your healthcare team will review these CoughAssist precautions with you.</p></div><h2>How can I help my child get used to CoughAssist?</h2><p>Your child will need some time to become familiar with the sounds of the CoughAssist machine. Let them play with the equipment and push the buttons so they can hear the sounds.</p><p>When your child is comfortable with the sounds, let them try one assisted breath. Be patient. It will take some time for them to be comfortable using the machine.</p><h2>How do I clean and maintain the CoughAssist machine?</h2><h3>After every use</h3><ul><li>Wipe the external surface with a damp cloth.</li></ul><h3>Weekly</h3><ul><li>Wash the breathing hose and tracheostomy connector with a solution of mild liquid soap and water. Rinse thoroughly. Allow parts to air dry completely before using them again.</li></ul><h3>Every two weeks</h3><ul><li>Wash the air inlet filter in warm water with a solution of mild liquid soap and water. Rinse thoroughly. Allow the filter to air dry completely.</li><li>Replace the bacterial filter. Do not clean it.</li></ul><h3>Every six months</h3><ul><li>Replace the air inlet filter.</li></ul><h3>As needed</h3><ul><li>Replace the mask if it becomes torn or if it can no longer maintain a good seal.<br></li></ul><p></p> <a class="btn btn-primary" href="https://www.aboutkidshealth.ca/trachvent">Return to trach-vent learning hub</a><br>Mechanical in-exsufflation (CoughAssist)Truehttps://www.aboutkidshealth.ca/Article?contentid=2968&language=Englishhttps://www.aboutkidshealth.ca/Article?contentid=2966&language=English

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