Spinal Cord Injury: Assisted Cough

Topic Overview

People who have had a spinal cord injury (SCI) don't always have the ability to cough forcefully. A forceful cough is important, because it will help you bring up mucus in the lungs, which can help prevent some lung complications, such as pneumonia.

But some people shouldn't try assisted cough. Don't use an assisted cough if you:

• Are in pain.
• Have internal problems, especially with the abdomen. Pushing on the abdomen could cause more problems.
• Have a chest injury, such as a broken rib.
• Are pregnant. Most specialists don't recommend using an assisted cough for pregnant women, especially in the second and third trimesters of pregnancy.

Assisted cough techniques

If your cough is weak, and if it is difficult to bring up mucus or you know you have lots of mucus, you need an assisted cough. In an assisted cough, another person pushes on your chest to help you cough. An assisted cough is done while you are sitting up in a bed or chair. If you are in a wheelchair, be sure to put the brakes on.

• Your caregiver places the heel of one hand on your abdomen just above your navel and places the other hand on top of the first hand. He or she interlocks the fingers so that they are pulled away from the body.
• The caregiver keeps his or her elbows straight.
• You take a deep breath and hold it.
• You cough while your caregiver pushes upward and under the rib cage, one time. It may take practice to coordinate the cough with the motion.

See a picture of this type of assisted cough.

Another technique may be used if the first one doesn't work or if you are obese.

• Your caregiver places his or her hands on the lower part of the rib cage, with the fingers wrapping around your sides pointing toward the back and the thumbs pointing inward, toward the center of the chest.
• You take a deep breath and hold it.
• You cough while the caregiver squeezes the ribs up and in. It may take practice to coordinate the cough with the motion.

See a picture of this other type of assisted cough.

If you have enough arm strength, you may be able to help yourself cough:

• Wrap both arms around your abdomen just below the rib cage.
• Take a deep breath, and hold it.
• Cough and throw your upper body forward over your arms while hugging your abdomen.

See a picture of a self-assisted cough.