Deep Breathing Exercises and Effective Coughing 
 
Deep breathing exercises (DBE) 
 
Definition: 
Controlled slow maximal inspirations with relaxed expiration to improve lung expansion and prevent atelectasis. 
 
Physiological Basis: 
– Increases transpulmonary pressure 
– Recruits collapsed alveoli 
– Improves functional residual capacity 
– Enhances ventilation–perfusion matching 
 
Indications: 
– Post-operative patients (especially abdominal or thoracic surgery) 
– Prolonged immobilization 
– Pneumonia 
– Neuromuscular weakness 
– Pulmonary rehabilitation 
 
Technique: 
1. Position patient upright or semi-Fowler’s 
2. Slow deep inspiration through the nose 
3. Inspiratory hold for 2–3 seconds 
4. Slow expiration through the mouth 
5. Repeat 5–10 times hourly 
 
Common Errors: 
– Rapid shallow breathing 
– Shoulder elevation 
– No inspiratory hold 
 
Effective coughing 
 
Purpose: 
Clears airway secretions to prevent mucus plugging, atelectasis, and infection. 
 
Physiology: 
1. Deep inspiration 
2. Glottic closure 
3. Increased intrathoracic pressure 
4. Sudden glottic opening 
 
Technique: 
1. Sit upright 
2. Deep diaphragmatic breath 
3. Hold for 2 seconds 
4. Perform 2–3 sharp coughs 
5. Expectorate sputum 
 
Huff Cough: 
– Medium breath in 
– Forceful exhalation with open glottis 
– Preferred in COPD 
 
Clinical Note: 
Always teach deep breathing before coughing to mobilize secretions. 
 
Key assessment points for OSCE: 
Mention positioning, physiology, and prevention of atelectasis.