Ethan Rhodes
There are several ways in which hospitals can help to remove mucus from the lungs. One method is a bronchoscopy, which involves inserting a bronchoscope into the lungs to examine them and perform procedures such as taking tissue samples or giving medicine. Another method is the use of a cough assist machine, which blows air into the lungs and then quickly pulls it out, along with any mucus, mimicking a strong cough. Additionally, hospitals may use a mini-trach, which is a small tube inserted into the neck to help clear mucus, and a device called a Flutter, which uses back pressure to keep airways open and vibrations to loosen secretions from airway walls.
| Characteristics | Values |
|---|---|
| Devices | Cough assist machine, Bronchoscope, Mini-trach, Airway Clearance (Flutter) |
| Purpose | To clear mucus from the lungs |
| Function | Blows air into the lungs and pulls it out quickly, removing mucus |
| Usage | Used twice a day routinely, or more often when sick |
| Cleaning | Wash daily with warm soapy water, sterilise weekly by boiling or using a steam steriliser |
| Precautions | Use only as prescribed, do not change settings, keep out of reach of children |
| Side Effects | Bleeding, tear in the food pipe, change in voice, dislodging of the tube, neck swelling |
| Procedure Time | 15 minutes to 1 hour |
| Anesthesia | General anesthesia or sedative with numbing medicine for nose and throat |
| Recovery | Time in a recovery room, possible confusion and sleepiness, vital signs monitored |
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What You'll Learn
Cough assist machines
The process of using a cough assist machine is also known as "breath stacking" and can be performed as many as four times per day, or as frequently as once an hour. It is important that the patient is comfortable throughout the process, and therapists should take the time to explain what the device is and how it feels. The pressure should start on a low setting and be adjusted upwards if secretions are not being removed.
There are several types of cough assist machines available, including the Synclara Cough System, which is designed for both paediatric and adult patients. This system uses Mechanical Insufflation-Exsufflation (MIE) technology to clear secretions from the upper airways. It is a non-invasive device that simulates a natural cough through swift changes in air pressure.
Another example is the CoughAssist T70, a portable, compact device weighing less than 9 lbs. This device gradually applies positive air pressure to the airway and then rapidly shifts to negative air pressure, simulating a deep, natural cough.
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Bronchoscopy
How it's Performed
The procedure can be performed on an outpatient basis, allowing the patient to return home the same day, or as part of a longer hospital stay. It typically lasts between 15 minutes to 1 hour. The specific process may vary depending on the patient's condition and the healthcare provider's methods.
Before the procedure, the patient may be asked to remove their clothes and change into a hospital gown. They may also be asked to remove any jewelry or other objects. The patient will then lie down on a table with their head slightly raised. An IV (intravenous) line may be inserted into the patient's arm or hand to administer medication and fluids.
During the procedure, the patient will usually remain awake but will be given a sedative to help them relax. Antibiotics may be administered before and after the procedure to prevent infection.
Aftercare
Following the procedure, the patient will be taken to a recovery room, where their vital signs will be monitored. They may experience sleepiness, confusion, and mild throat pain. Eating and drinking are restricted until the gag reflex returns. A chest X-ray may be performed to ensure the lungs are unaffected. The patient may be instructed to cough and spit into a basin, allowing nurses to check for the presence of blood in the saliva.
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Airway Clearance Flutter device
The Flutter device is a handheld tool designed to help clear mucus from the lungs in people with hypersecretory lung disorders. It is a type of lung exerciser that uses OPEP (Oscillating Positive Expiratory Pressure) technology to loosen and remove mucus from the airways, promoting better breathing and improved respiratory health.
The device consists of a hardened plastic mouthpiece at one end, a plastic perforated cover at the other, and a valve on the inside created by a high-density stainless steel ball resting in a plastic circular cone. When a person exhales through the mouthpiece, the ball moves up and down, creating an opening and closing cycle that repeats throughout exhalation. This movement creates oscillations of expiratory pressure and airflow, vibrating the airway walls, loosening mucus, and facilitating its movement up the airways.
To use the device, one must first get into a comfortable position, with shoulders and arms relaxed. The Flutter can be used while sitting or lying down, or in a position advised by a respiratory physiotherapist. The user should then breathe in slowly through their nose at a comfortable speed, followed by breathing out through their mouth without the device. After pausing for a few seconds, the mouthpiece of the Flutter is placed in the mouth, ensuring a tight seal with the lips. The user then breathes in slowly through their nose, slightly deeper than normal, and pauses for a few seconds to allow their lungs to fill. Finally, they breathe out through the Flutter at a steady rate, feeling the vibrations in their chest.
The frequency of the oscillations can be adjusted by changing the inclination of the device slightly up or down from its horizontal position. The user should select the position that results in the greatest vibration sensation in the chest, as this maximizes airway vibration and mucus loosening.
It is important to keep the Flutter device clean to avoid bacterial growth and potential infections. The manufacturer's instructions should be followed for specific cleaning recommendations, including daily washing in warm soapy water and weekly sterilization by boiling or using a steam sterilizer.
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Mini-trach
A mini-tracheostomy, or mini-trach, is a procedure that may be required for patients with a large volume of mucus in their lungs. The procedure involves the insertion of a small tube into the patient's neck, which helps to clear the mucus. The benefits of a mini-trach far outweigh the risks, and it may even be life-saving for some patients.
Some bleeding is to be expected after the insertion of a mini-trach, and if the bleeding does not settle, the patient may need to go to the operating room to have it stopped. There will also be a small scar on the front of the neck after the tube is removed. Other risks include a small risk of a tear in the food pipe, a change in voice, the tube becoming dislodged, or temporary neck swelling.
After insertion, the tube must be cleaned two to three times per day or more, especially after surgery and when there is a lot of mucus buildup. To clean the tube, one must wash their hands and place a half-strength peroxide solution in one bowl and sterile salt water in another bowl. The inner cannula should be removed by holding the neck plate of the mini-trach still, and then it is placed in the peroxide solution until crusts are softened or removed. A brush or pipe cleaner can then be used to clean the inside, outside, and creases of the tube. It is important to avoid using scouring powder or steel wool pads. The tube should then be rinsed in saline or sterile salt water and reinserted while holding the neck plate still.
The mini-trach is removed as soon as the volume of mucus reduces and the patient can cough well. The wound is then dressed, and it will heal without needing stitches. Patients will not be discharged from the hospital with a mini-trach in place.
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Antibiotics
Oral antibiotics are the primary treatment for repeated lung infections caused by bronchiectasis. The standard course of treatment is 14 days. However, for difficult-to-treat infections, intravenous (IV) antibiotics may be prescribed. These antibiotics are administered through an IV line inserted into the patient's arm, and a healthcare provider may assist in arranging for at-home IV administration.
Inhaled antibiotics, administered through a nebuliser, are also an option for those with chronic infections. Nebulisers convert the medicine into a fine mist, which is then pumped into the lungs. Antibiotics delivered via nebuliser increase the risk of bacterial resistance, so regular phlegm samples may be required to monitor for any resistance.
Additionally, antibiotics may be prescribed to address underlying conditions associated with mucus production, such as allergies or sinus infections.
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Frequently asked questions
Hospitals use a variety of methods to remove mucus from lungs, including:
- Bronchoscopy: A bronchoscope is inserted into the lungs to examine them and remove mucus.
- Mini-trach: A small tube is inserted into the neck to help clear mucus.
- Cough assist machine: This machine blows air into the lungs and then quickly pulls it out, along with any mucus.
- Airway Clearance (Flutter): A device that helps loosen and clear mucus by creating vibrations in the airways.
A bronchoscopy is a procedure used to examine the lungs and remove mucus. It typically takes 15 minutes to 1 hour and involves inserting a bronchoscope—a thin, flexible tube with a light and camera—into the lungs. You may be given antibiotics, sedatives, and numbing medication during the procedure.
A cough assist machine mimics a strong cough by blowing air into the lungs and then quickly pulling it out, along with any mucus. It delivers positive pressure when you inhale and switches to negative pressure to pull out air and mucus. This helps clear mucus and reduce the risk of lung infections.
Airway Clearance (Flutter) is a device used to help loosen and clear mucus from the airways. It is used by breathing out through the device, which creates slight resistance and back pressure to keep the airways open. This also causes vibrations that help loosen mucus from the airway walls. It is important to keep the Flutter clean to prevent bacterial growth and infections.
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