My amazing RT at MUSC emailed me this the other day,... she also gave me a lesson on it as well.. Hope this helps
Autogenic Drainage
What is Autogenic Drainage?
Autogenic drainage was first described by Jean Chevaillier in 1967. It is a breathing technique that helps the
patient drain the lungs from within (Autogenic) by breathing at different lung volumes in 3 phases:
Phase 1 - unsticking / loosening the phlegm in the small airways
Phase 2 - collecting / moving phlegm to the middle airways
Phase 2 - evacuating / moving the phlegm out by huffing
Unsticking
Sit in a relaxed position; clear your nose and throat of secretions.
Start the session with breathing control, breathing in through the nose and out through the mouth.
Inhale through the nose and take in a deep breath and hold for 3-4 seconds; then exhale air out of the mouth
for as long as you can to reach low lung volume.
Inhale through the nose a small breath and hold 3 seconds.
Exhale through the mouth and squeeze out as much air as you can.
Repeat this low lung volume breathing at least 3 times or until you:
hear the secretions crackle while exhaling
feel the secretions moving, or
feel an urge to cough.
Collecting
Take a deep breath and hold for 3-4 seconds and exhale (but not as low as in the unsticking phase).
Inhale through the nose a slightly larger breath and hold for 3-4 seconds.
Exhale through the mouth a normal sized exhalation.
Repeat normal sized breaths with breath hold after inspiration and normal exhalation for 3 breaths.
Evacuating
Take a deep breath and hold for 3-4 seconds.
Exhale forcefully with a huff cough.
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Autogenic Drainage
Each phase should take approximately 2-3 minutes. Coughing should be avoided until the evacuation phase,
but if patient must cough, they should do 2-3 huff coughs. As patient becomes more comfortable with autogenic
drainage they will likely learn to move secretions by developing their own personal method.
Huff Coughing: Normal coughing may cause bronchial closure, use of excessive energy and little sputum
production. Huff coughing is a gentle coughing technique that includes 3 mini Huff coughs to loosen secretions
from the peripheral small airways and a final forced Huff to expectorate the sputum.
Deflation Breaths - have patient deflate excess air from their lungs by slowing breathing rate down and
perform prolonged exhalation (4-5 seconds) for 3-4 breaths
Take a slow deep breath but not a maximum breath.
Shape your mouth like an "O" .
Do a mini / short cough by contracting the upper abdominal muscles. This can be described as pushing a
tennis ball out of an open mouth while making a "huff" noise.
Take in a quick partial breath and repeat "huff" a second time with this smaller breath.
Take in an even smaller breath and "huff" for a third time. (the patient is now at a very low lung volume
that helps loosen the secretions from the lungs)
Take a forced full breath but not a maximum breath.
Give a forced, hard "huff" and cough out the sputum.
Repeat the steps if airway secretions are not cleared.
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