The removal of secretions due to a poor cough by applying a positive pressure followed by a negative pressure to the patient airway to simulate a cough
Key Points
Biggest success will come with:
Patient synchrony
A high differential between positive and negative pressures
No leak in the system
Lift the chin to ensure airway is open and patent
Look for peak cough flow to be:
240 Lpm or higher, higher is better
Under 150 Lpm would require deep suctioning to remove secretions
Setting Pressures:
Start with lower settings and work up to what would be normal ventilation pressures, then look at your peak cough flow for adequacy
Never make the expiratory pressure greater than the inspiratory pressure
Ideal settings would be +40/-35; however patient tolerance is preferred over a set it and forget it method
Setting Times
Use the yellow and blue clock or watch patient inhale and look for the breath to cycle when the patient is at end inspiration
Start with what would be a normal I-time for that patient