Ventilator Dependent Quadriplegic Demonstrates CoughAssist

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Look Mom, No Hands

Bill Miller is a C1/C2 ventilator-dependent quadriplegic who was injured in 1997. He credits the CoughAssist machine as what has kept his lungs healthy for nearly two decades. “I have not had any respiratory-related hospitalizations since being discharged from Shepherd Center in 1997,” shares Bill, which is a truly remarkable statistic given that he is mechanically ventilated 24/7.

The CoughAssist machine (also called the in-exsufflator) is used to clear secretions from the user’s airway and lungs. It is an alternative method of secretion removal to suctioning, which requires a plastic catheter to be inserted through the trach down into the lungs, and can oftentimes be uncomfortable, even painful for the user.

Alternatively, the CoughAssist machine is non-invasive, and for many individuals is just as effective, if not more effective, than suctioning.

“Basically it’s air in and air out. You put it on inhale, and it fills me up with a big breath of air. And then I’ll nod, and we’ll flip the switch [to exhale] and then out comes secretions and air also.”

At 1:11, Bill and his assistant display the machine itself and the circuit attached to it. Then at 3:20, Bill’s assistant displays a foot-long extension tube that attaches to the main circuit. Bill recommends using this extension as it catches the secretions that come out, and it is easier to wash than the circuit that attaches to the machine.

The demonstration begins at the 3:40 mark in the video. Bill’s assistant turns on the CoughAssist machine, removes the vent circuit from Bill’s trach, and attaches the CoughAssist circuit. The machine fills Bill’s lungs for a couple seconds, then when Bill nods, the assistant switches to exhale mode, and firmly pushes on Bill’s chest with her hand to help expel the secretions.

These steps are repeated several times with the assistant removing the CoughAssist circuit briefly between cycles. Bill says he usually does 3-5 cycles per session when using the CoughAssist depending on the amount of secretions he’s feeling or hearing in his chest.

Bill uses the machine on manual mode, which allows him and his assistant to control the inhale and exhale times. He also makes note that his trach is cuffless, and reminds users that if they have a cuffed trach, the CoughAssist might need to be used in a different manner, so check with a doctor first. The CoughAssist procedure is comfortable for him. “I hated being suctioned,” he shares. The CoughAssist has proven to be very effective for Bill, and has helped maintain his overall health for many years.

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