The Techinque for manual assist cough

[angela929]

Does anyone can help me find out the exact site and reflex that is involoved during manual assist cough/ tracheal tickling. How deep should I apply on the tracheal and why is at that point?

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[thomas bibu]

hi angela,

well, I try out manual cough assist techniques only in children.
the tracheal stimulation or tickling can be done by placing index finger or thumb on anterior side of the neck against trachea just above sternal notch with gentle but firm inward pressure in circular pattern as the child begins to exhale.

if you wish to read more please click on the link below
Pulmonary Rapidly Adapting Receptor Stimulation Does Not Increase Airway Resistance in Anesthetized Rabbits -- YU et al. 160 (3): 906 -- American Journal of Respiratory and Critical Care Medicine

I have copied the segment that highlights the effect of tickling the airway for your quick reference.

"Effects of Tickling the Airway
We examined the mechanically induced cough in the open-chest rabbit preparation. As expected, tickling the airway evoked cough. Typically, the rabbits showed one or two expiratory movements, manifested as an increase in the positive pressure swing during the inflation phase of the ventilator. However, respiratory movements also occurred during deflation phase."

personally I seldom use this technique as I don't often get desired responses. however, I welcome any suggestions from colleagues regarding modifications to improve the outcome.

cheers,

thomas

[hasanj]

involves the manual application external pressure to the epigastric region or thoracic rib cage during exhalation to expel secretions from the airway. It is seldom combined with other airway clearance modalities and is usually employed when mucociliary function is unencumbered and neuro- muscular disease is present.