Find out how a cough assist machine can help your child if they have difficulty clearing mucus from their lungs.
Key points
Coughing clears mucus from the lungs and helps protect them from infection.
A cough assist machine blows air into the lungs and pulls it out quickly to clear mucus.
Cough assist delivers pressurized air when your child breathes in, then switches to a negative pressure to pull out air and mucus like a cough would.
Cough assist treatment can help a child if they have frequent lung infections, weak chest or abdominal muscles or a weak cough.
Always use the cough assist machine as instructed. If your child does not like the machine, your child’s team can change the settings.
Introduction
Our
lungs produce secretions (mucus) to trap bacteria and any dust or other particles that we breathe in every day. A
cough is the body’s natural way of clearing this mucus from our airways. Clearing mucus by coughing allows us to breathe more easily and reduces the risk of lung infections such as
pneumonia.
More information
What happens when we cough?
Most of the time, we cough as a reflex (an automatic response). There are three phases to a normal cough reflex.
Taking a big breath in.
Forcefully breathing out with the vocal cords closed.
Rapidly opening the vocal cords and forcefully pushing the air and any mucus out of the lungs.
About the treatment
What is a cough assist machine?
When we get sick, we are less able to create a strong cough. Some children have a weak cough even when they are not sick.
A cough assist machine mimics a strong cough to help your child clear their lungs and reduce the risk of lung infections. It can help if a child has:
a tracheostomy, ventilator or other supports to help them breathe
Signs your child might benefit from using a cough assist machine
Your child may benefit from a cough assist machine if:
their cough is weak
they have frequent lung infections, such as pneumonia
they have mucus blocking/plugging the lower airways resulting in collapse of some areas of the lung
Risks of the treatment
What are the risks of using a cough assist machine?
When used properly, the following are very low risks:
Pneumothorax (an air leak in the lungs) if too much air is blown in.
Food entering the airway. Your child’s health-care team can create a feeding plan to minimize this risk.
Worsening acid reflux.
Preparing for the treatment
How do I prepare for cough assist therapy?
Your health-care team will first try the treatment on your child and determine the most appropriate settings.
They will then help you to obtain a device for your child and provide teaching to help you administer the therapy at home.
How do I help my child get used to cough assist?
Your child will need some time to become familiar with the sounds and sensation of the machine. Let them play with the equipment and push the buttons so they can hear sounds.
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 at home.
Treatment
How does the cough assist machine work?
The cough assist machine includes a mask, mouthpiece or tracheostomy adaptor that is applied to the airway.
As your child breathes in, the machine blows air into the lungs slowly. After a short pause, the machine quickly pulls the air out, along with any mucus, much like a cough. Mucus can also be suctioned out after treatment.
How much does a cough assist machine cost?
A cough assist machine may be covered by your province’s public health insurance program. You can speak to your child’s health-care provider for more details.
How will I know how to use the cough assist machine?
After the machine arrives, a respiratory therapist (RT) will teach you, your family and any other caregivers how to use it.
Only use the machine as prescribed by your doctor and shown by your respiratory therapist. Do not change the settings on the machine yourself.
Your doctor will decide when and how often you should use cough assist with your child. Most children use it routinely twice a day. If your child is sick and has more mucus than usual, you can use the cough assist machine more often until your child feels better.
You will also be taught to put the oxygen saturation monitor sensor on your child so oxygen saturations can be monitored during the therapy.
More information about the treatment
Do not use cough assist if your child:
has a headache
is vomiting
experiences aspiration (food or secretions have entered the airway)
is feeling stomach bloating
has low oxygen saturation levels
has bronchospasm or wheezing
is breathing too slow or fast
has an irregular heartbeat
feels pain in the chest, ribs or spine
Helping your child
What if my child does not like using the machine?
While it might feel strange at first, most children adapt to using the cough assist machine very quickly.
If your child does not like using their machine, you can speak to your child’s doctor, nurse practitioner or respiratory therapist. They can help adjust the machine’s settings to make using the machine more comfortable for your child.
At SickKids
At SickKids
In Ontario, the cost of a cough assist machine is covered by the Ontario Health Insurance Plan (OHIP). If eligible, an application will be submitted to the province’s Assistive Devices Program, and once approved, you can obtain a machine from the Ontario Ventilator Equipment Pool (VEP).
