Which device is recommended for a patient to help remove secretions when they have a strong cough?

The recommended device for helping a patient remove secretions when they have a strong cough is a vibratory PEP (Positive Expiratory Pressure) device, such as the Acapella. This device is designed to aid in the clearance of mucus by creating oscillatory positive pressure during exhalation, which can enhance airway secretions’ movement and promote their clearance. The vibratory action facilitates the loosening of secretions, making it easier for the patient to expel them while coughing.

In contrast, an inhalation challenge is typically used to evaluate airway responsiveness rather than for secretion clearance. An oropharyngeal airway is meant to keep the airway open by preventing the tongue from obstructing it but does not actively assist in the clearance of secretions. Similarly, a nasopharyngeal airway serves the purpose of maintaining an open airway and does not provide the mechanism necessary for effective mucus clearance. Therefore, the vibratory PEP device is the most appropriate choice for promoting secretion clearance in patients with effective coughing capabilities.