Figure 2.

Basic breathing and cough techniques to help expectorate sputum. (A) Pursed-lip breathing: following inhalation, bring the lips loosely together and exhaled through the mouth against resistance. (B) Huff cough: with mouth open, inhale either a normal or deep breath, hold for 2–3 seconds, and then exhale using your abdomen, making a “HAA” sound, as in fogging a mirror. (C) ACBT is comprised of cycles of shallow and deep breathing, followed by huff and strong, active coughs. There are three steps to ACBT. Step 1: take 8 to 10 slow, shallow, relaxed breaths (also known as Breathing Control) in through the nose and out through pursed lips. Step 2: take 3 to 5 slow deep breaths, expanding the lung bases. If coughing is triggered by deep breathing, return to Step 1. Repeat Steps 1 and 2 until there is a sensation of secretions in the chest or throat, then proceed to the next step. Step 3: perform 2 to 3 huff coughs followed by strong, active coughs to expectorate the sputum. ACBT, Active Cycle of Breathing Technique.