Do you know how to get enough force behind the air to move secretions upon expiration? Firstly, you need a large amount of air in your lungs (see the section on breathing techniques). Many people also need additional cough assistance. Several techniques could be used. We will now describe manually and mechanically assisted coughing.
Manual cough assist
A helper puts pressure on the chest or stomach, or a combination of the two, at the same time as you cough. The images below show some suggestions. Along with your helper, you can find out what works for you.
A helper puts pressure on the chest with both hands.
A helper puts pressure under the chest.
A helper puts pressure on both sides of the chest.
A helper puts pressure under the chest with one hand and over with the other hand.
Image/Source: NKH with T. Andersen/B. Hov
Mechanical cough assist
Performed with the help a ‘cough assist machine’. The technique is called mechanical insufflation - exsufflation (MI-E). This means that a machine will give you a deep aspiration with the help of positive pressure followed by a deep expiration with negative pressure. A rapid change from positive to negative pressure simulates and supports a strong airflow in the same way as a normal cough. The therapy can be administered via a mask, mouthpiece or tracheostomy.
Source: Philips Respironics.
See the video of Jørgen receiving therapy with a cough assist mask.