Hey Lisa,
It is probably the combination it the vest and his ventilator. Don't get me wrong, he still gets congested...the vest breaks it up and they suction it out. As far as Chris getting a cought assist machine, his pulmonologist doesn't believe in using one with him (I'm not sure why). He had one before he was vented and used it quite frequently. When his breathing crashed, my dad actually used it to help Chris breathe until the paamedics arrived. (God that feels like decades ago.) Once he was trached and vented, it was returned. I think they thought he might blow a lung out with it. And because all other methods are working for Chris (suctioning, nebulizer treatments, the vest) he is fine with not having one. It's his decision...who are we to argue it.
Alison
P.S. I wouldn't think the vest would help in keeping a PALS from being vented......I would like to know if, in the study, it did keep a vented patient from getting pneumonia....