A man with bulbar motor neurone disease has an ineffective cough. Unassisted breath stacking plus manual assisted cough has not produced adequate

Question

A man with bulbar motor neurone disease has an ineffective cough. Unassisted breath stacking plus manual assisted cough has not produced adequate clearance, but he can cooperate with a lung-volume-recruitment bag. What should be tried next?

Accepted Answer

Introduce assisted breath stacking and use mechanical cough assist if this is ineffective

Answer

Start long-term prophylactic antibiotics without altering cough augmentation

Answer

Use routine tracheal suction as the only community cough strategy

Answer

Continue unassisted breath stacking unchanged until peak cough flow normalises

Answer

Proceed directly to tracheostomy ventilation without another augmentation method

HSV encephalitis — SCE Neurology MCQ

A man with bulbar motor neurone disease has an ineffective cough. Unassisted breath stacking plus manual assisted cough has not produced adequate clearance, but he can cooperate with a lung-volume-recruitment bag. What should be tried next?