Cough- assist ( MIE) mechanical inhale and exhale helps ALS weakened muscles due to degeneration of motor neurons to remove secretions and clear lungs.

* Place tubing on machine and check settings.

* Inhale time - 2;     Exhale - 1.5;         Pause - 2

* Check pressures on machine

A.  Occlude open end

B.   Turn machine on

C.    Check pressures and adjust as needed

*  Inhale -  30;         Exhale  +  40

*   Place on patient's trach and turn on machine

*   Perform 5 cycles 30/40 and stop

*   Allow recovery time ( ask patient if ready);   Repeat times 5

*   Assess for clear lungs. Continue if not clear

*   For secretion clearance: no more than 5 cycles at a time until clear

To deflate cuff ( trach balloon) and capture secretions above the trach

*   Change settings of MIE to: Inhale -  5;  Exhale -  0;  Pause -  5

*   Use 10 ml syringe to deflate cuff, after 2 seconds, inflate the cuff and turn of the machine, remove tubing off patient and suction trach and mouth.

*  Use PMV ( Posse Muir Valve ) as speaking valve after deflating the cuff.


ventilator type & modes part I mechanical ventilation 2RESPIRATORY CARE: PB840 Patient Connect RESPIRATORY CARE: PB840 Initiation Checkoff