Place it near the end of a gross-out scene, after the setup has made the audience expect something bad. Follow it with the classic fart sound for a second crude payoff, then close with the SpongeBob fail sound to turn the moment into a joke.
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This eight-second clip captures a child coughing hard and then vomiting, with the coughs coming in rough bursts before the gagging takes over. It feels queasy, uncomfortable and gross in a way that makes listeners wince, which is why it works for sick-day jokes and exaggerated reaction edits.