If possible, sit upright on a chair or edge of bed with feet firmly on the floor, head flexed, and shoulders relaxed.
Alternatively, elevate head of bed and flex knees.
Another alternative: Lie on your side, keeping upper body flexed forward and knees bent toward body.
Measures that Help Effective Coughing
Inhale deeply and slowly through the nose several times before the cough.
Breathe in deeply and slowly and hold breath for two seconds.
Contract abdominal muscles to promote a more effective cough.
Cough several consecutive coughs from the beginning of the breath to the end of the breath. (The beginning of the breath clears large airways, and the end of the breath clears smaller airways.)
Pause at the end of the breath. (This is important to prevent uncontrolled coughing.)
Repeat as needed.
Use this procedure when you cannot perform cascade coughing.
Follow the same procedure as cascade coughing, except: Say "huff" instead of coughing.
Use this procedure when abdominal muscles are paralyzed.
Follow the same procedure as cascade, except: Press inward or upward on the abdominal muscles when coughing.
Complications of Ineffective Coughing
Collapse of airways.
Rupture of alveoli.