A 9-year-old boy with congenital muscular dystrophy requires assistance with airway clearance after experiencing an ineffective cough. Which recommendation should the specialist make?

The recommended approach for a 9-year-old boy with congenital muscular dystrophy who is experiencing ineffective cough would be the use of an in-exsufflator. An in-exsufflator is a device designed to assist with airway clearance by providing positive pressure followed by negative pressure, simulating a cough. This action helps to mobilize secretions and improve airway clearance, which is particularly beneficial for patients with weak respiratory muscles, such as those with muscular dystrophy.

Congenital muscular dystrophy often leads to respiratory muscle weakness, making effective cough difficult. The in-exsufflator compensates for this weakness by generating a forced exhalation, allowing for the effective expulsion of mucus from the lungs. This method is non-invasive and can be used safely in children, making it a suitable option for managing airway clearance in this scenario.

Other methods, while helpful in various contexts, may not provide the same level of effectiveness for this particular patient's condition. Cool aerosol therapy typically offers moisture and helps with airway hydration but does not effectively assist with mucus clearance. A PEP (Positive Expiratory Pressure) device can be beneficial for maintaining airway patency and improving airflow but may not be sufficient for those with significantly compromised cough strength. IPPB (Inter