Introduced at Boston Medical Center in 2010, the award-winning ICOUGH℠ program is designed to prevent pulmonary complications after surgery. This pulmonary care program includes early and frequent mobilization, lung exercises, oral hygiene, and education. The ICOUGH program has been implemented by hospitals nationally and internationally.

The acronym ICOUGH stands for:

I Incentive Spirometry: Deep breathing exercises will help keep your lungs healthy and prevent lung problems. This breathing exercise needs to be done 10 times each hour.

C Cough and Deep Breathe: After surgery taking deep breaths and coughing helps to clear your lungs. This helps the lungs do the vital job of delivering oxygen to the tissues in your body.

O Oral Care: Brushing your teeth and using mouthwash twice a day keeps your mouth clean from germs.

U Understanding Patient Education: Is important for you and your family to take an active part in your recovery. We want your pain to be controlled so you can take deep breaths, cough, get out of bed for a walk and be sitting up at mealtime.

G Get out of Bed: Walking will help clear secretions from your lungs, help your circulation and help to regain your strength.

H Head of Bed Elevated: It is important to keep the head of the bed elevated between 30-45 degrees. Being in an upright position after your operation will help with your breathing.

Recent ICOUGH Research:

Joint Commission Journal on Quality and Patient Safety: The I COUGH Multidisciplinary Perioperative Pulmonary Care Program: One Decade of Experience (Michael R. Cassidy, MD; Pamela Rosenkranz, RN, BSN Med; Ryan D. Macht, MD; Stephanie Talutis, MD; David McAneny, MD, FACS)


Click here to watch a video about the ICOUGH Program

ICOUGH App Wins Health Devices Achievement Award

Two Boston University Chobanian & Avedisian School of Medicine students, Andrew Chu and Samir Haroon, developed the smartphone application to support ICOUGH.

ICOUGH Patient Education Materials:

Click here to download “ICOUGH” Materials (Please Note: The ICOUGH Program is proprietary to Boston Medical Center. These resources are being made available to those who have been approved usage and a password will be required to download any files.)

Contact Us:

For more information about the usage of ICOUGH materials or information about adopting the ICOUGH Program at your institution, please contact: 
Pamela Rosenkranz, RN, BSN, MEd, Director of Clinical Quality and Patient Safety Department of Surgery, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine
Email: pamela.rosenkranz@bmc.org


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