A cough is a natural, protective reflex designed to keep the respiratory tract clear of foreign particles, irritants, and excess mucus. The reflex begins when sensory nerves in the airways detect an irritant, triggering a signal to the brainstem’s cough center. This involuntary mechanism forcefully expels air to protect the lungs. Coughing is also subject to voluntary control, involving higher brain centers like the cerebral cortex. This control allows a person to choose when and how to cough, which is necessary for maximizing airway clearance and preventing the spread of germs.
Executing a Productive Cough
A controlled, productive cough, sometimes called “huffing,” is a technique used to move mucus from the smaller airways into the larger ones where it can be expelled more easily. This method is generally gentler than a harsh, explosive cough and can be more effective for clearing deep congestion. The process begins by sitting comfortably in an upright position with your chin slightly tilted upward.
Next, take a slow, deep breath through your nose until your lungs are about three-quarters full, and hold this breath for two or three seconds. This pause allows the air to get behind the mucus, separating it from the lung wall. Instead of a sudden, sharp expulsion, forcefully exhale the air through an open mouth as if you are trying to fog up a mirror.
This forceful but slow exhalation, known as the “huff,” uses the abdominal muscles to create the necessary pressure without causing the small airways to collapse. Repeat the huff one or two more times to move the secretions upward. After the huffing cycle, a single, strong cough should be used to clear the mucus that has reached the larger airways.
Coughing to Stop Germ Spread
Respiratory etiquette is crucial for preventing the transmission of infectious agents through airborne droplets. The accepted method for managing a cough in public is to cover your mouth and nose immediately with a tissue. Tissues should then be discarded into a no-touch waste receptacle immediately after use.
If a tissue is not available, cough into your upper sleeve or the crook of your elbow, not your hands. This method is preferred because it keeps your hands clean, preventing germs from transferring to frequently touched objects like doorknobs and phones.
Hand hygiene must be performed immediately after coughing, even if you used your elbow. Wash your hands with soap and water for at least twenty seconds. If soap and water are unavailable, use an alcohol-based hand sanitizer containing at least 60% alcohol as an alternative.
Signs That Require Medical Attention
While most coughs are temporary symptoms of a common cold or minor irritation, certain signs indicate the need for professional medical evaluation. A cough that persists for longer than three weeks is classified as a subacute or chronic cough and should be investigated by a healthcare provider. This duration suggests the underlying cause is more than a simple viral infection.
Immediate medical attention is necessary if a cough is accompanied by red flag symptoms. These include coughing up blood or pink-tinged, frothy phlegm. Other urgent warning signs are chest pain, difficulty breathing, or shortness of breath.
A fever of 100.4°F (38°C) or higher lasting more than a few days, unexplained weight loss, or night sweats are also concerning symptoms. A change in the color or consistency of mucus, such as thick, greenish-yellow phlegm, may indicate a bacterial infection like pneumonia that requires treatment. If the cough is severe enough to cause vomiting or fainting, medical consultation is also advised.