Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Secretion Clearance Technique

Secretion clearance consists of deep breathing, controlled coughing and huffing.

Deep breathing: Do deep breathing exercises 4 to 5 times a day, sitting or standing.

  • Relax your shoulders.
  • Take a deep breath in through your nose.
  • Breathe out slowly through your nose.
  • Breathe out longer than you breathe in.
    • Count to 1 when you breathe in.
    • Count to 3 when you breathe out.
  • Repeat 5 deep breaths as above and rest.
  • Try 5 more deep breaths in and out and rest.

Try blowing the air out through pursed-lips. Shape your lips like you are going to whistle, then blow out slowly. This will help you breathe easier.

Controlled Coughing: Controlled coughing should be done after each set of breathing exercises:

  • Take a deep breath in.
  • Cough deeply 2 times with your mouth slightly open.
  • Follow each set of breathing exercises with 2 controlled coughs.

Huffing: If it is hard for you to cough, try huffing:

  • Take a medium breath in.
  • Make a sound like “ha” to push the air out very fast with your mouth slightly open.
  • Do this 3 to 4 times, and then cough.