Breas Clearway 2 User manual

A Patient Guide
to the Clearway 2

Why do I need to use
aClearway 2?
2 3
Cough is essential to prevent a build up of mucus/phlegm from our airways. Mucus is important as
it traps dirt and bacteria. The mucociliary escalator transports the mucus to the larger airways and is
usually cleared with a cough. In order for a cough to be strong and effective the following occurs:
•A deep breath in.
•A short pause and closure at the top of our airway allowing pressure to build up in the chest.
•A good strong expiratory muscle contraction (abdominal muscles and intercostal muscles).
These components are essential to get enough air into the lungs, so that when the expiratory muscles
contract, the air comes out faster, clearing the mucus up towards the mouth. If we have aweakness
in the muscles that we use to take in a deep breath, or in our expiratory muscles, our cough strength
decreases and becomes less effective resulting in a build up of mucus within the lungs.
The Clearway 2 is a mechanical insufflation-exsufflation device. These devices can help improve
your cough strength. Your device will be set up by your physiotherapist/clinician.
The Clearway 2 gives a deep breath in (insufflation) followed by a rapid suck out (exsufflation). This
simulates what naturally happens when you cough and therefore can make your cough stronger so
you can bring mucus up in to your mouth or high enough to be cleared.
Irritation Breath in Compression Expulsion

Navigation of your
Clearway 2
On/Off –Press once to
turn device on, to turn
off, press once then
confirm using the
touchscreen
Start/Stop – Press
to start or stop
treatment
Air Outlet – Attach
large tubing here
Insufflation/Exsufflation Trigger
(for use in manual mode) –Move
the switch up for insufflation, hold
to maintain pressure until switch
is released; move down to
activate exsufflation.
4 5

Navigation of your
Clearway 2
External Battery –
Clearway 2 connector
cable required
Mains power
connection Hand control –for use
in manual mode
6 7
Air inlet filters
and cover

B
A
Setting up your Clearway 2
1
2
3
4
Place the Clearway 2on a clean, smooth, hard surface (not carpet).
Connect to the mains or battery.
Attach the breathing circuit to the air outlet on the side of the
Clearway 2.
Attach breathing circuit to the interface.The bacterial filter should be
at the end of the circuit closest to interface.This helps to protect the
breathing circuit from any secretions.
Interface options
Catheter Mount
Mouthpiece & nose clip
Facemask
A
E
B
D
C
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Tubing
Carbon dioxide leak port
(for use in NIV and IPPB
modes).
Oxygen supply connection
if required.
Bacterial filter
C
D
C
B
A
D

Entraining oxygen to your Clearway 2Information about treatment and settings
If you need supplementary oxygen, it may be entrained via aconnector
as shown below:
•Always switch on the Clearway 2before the oxygen supply.
When adding oxygen, attach an entrainment port at the mask or
tracheotomy end of the circuit.
•When treatment is complete, switch off the oxygen supply then
the Clearway 2and disconnect the oxygen tubing from the
breathing circuit.
•Store the breathing circuit in aclean bag or other suitable container.
•If you need a caregiver to assist with treatment, you may want to agree on a signal with
them to alert them that you want to stop treatment. This maybe a thumbs up, looking up
or shaking your head.
•Treatment is usually carried out in the position you cough best in.
Your clinician will advise you on this.
•Treatment settings are prescribed like medicine; therefore, they should only be set
by a clinician. Your device will be programmed with the appropriate settings for you.
•If possible, try to avoid treatment immediately after a meal or food.
•When using the Clearway 2in the automatic modes, a Synchrony Beep®will sound prior to
the delivery of the negative pressure, signalling when to cough, making the treatment
more effective.
•A Clearway 2has different modes and therefore can provide different treatments. MI-E
(cough) treatment usually consists of one or more insufflation time (Ti) (length of the
breath in), exsufflation time (Te) (length of the suck out), and a pause. These together
are called a cycle. The number of cycles you should do in each treatment will be advised
by your physiotherapist or clinician. After each treatment, you may need to have a short
rest (30 seconds or longer). Any secretions can then be cleared.
Attach
interface to
here
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Starting treatment Changing the mode on your Clearway 2
When you switch on the Clearway 2, it will remember the last settings that were used, so you will not
need to set up the device each time, unless you are changing to a different prescription or mode.
1
2
Turn the Clearway 2on by pressing the
On/Off button.Check and confirm that
you are using the correct circuit type.
Position the interface. If using a mask, ensure
it is firmly against your face to prevent air
leakage. Your carer may need to support the
back of your head to ensure a steady seal of
the mask.
3
4
Use ‘Start/Stop’ button on the Clearway 2 or
hand controller if you are using one, to
commence therapy.
If you use a ventilator in addition to the
Clearway 2, ensure that you only begin
treatment with the Clearway 2when you are
ready and your ventilator is ready for you to
use at the end of treatment.
The Clearway 2 has different modes and
can save settings from a mode in a
profile. Your clinician will set up the
device with the most appropriate mode
or modes for you.
If you have multiple modes or profiles
programmed, change the mode or
profile,by pressing the Mode button
on the touchscreen, to display those
available to you.
Using the touchscreen display, press the
Mode button then select the Mode or
Profile you want to use -the individual
settings for each mode and profile will be
retained in the device memory and so
you do not need to alter the settings
each time you change the mode or
profile you are using.
2
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1. Turn off the Clearway 2 and disconnect the
mains supply.
2. Remove the patient circuit.
3. Disconnect all electric cables.
4. Clean the outside of the Clearway 2using
disinfection wipes containing ethanol 70%.
5. Reconnect the patient circuit.Make sure all
parts are dry before the Clearway 2is put
into operation.
Inspect the device, power cord and patient circuit
for damage whilst cleaning. If the is any damage
noticed, do not continue to use the device, and
contact your care provider, hospital or referring
clinician immediately.
For more detailed information please consult the
Clearway 2 User Manual.
What does the Active Treatment Display mean?
Ti -Breath in
Te -Cough phase
P -Pause
You will hear a ‘beep’ just before it delivers the
negative pressure, at this point you should
cough.
The number in the top right corner shows the
current cycle being performed by the
Clearway 2. In this example, the device is on
cycle number three out of atotal of twenty.
The vertical white line tracks where you are in
the treatment cycle on the screen.
The Clearway 2 works through the programme
of therapy, and when it beeps and ‘Treatment
has Ended’ appears on the screen, the
treatment is finished. You may need to repeat
the sequence if you feel it is necessary.
Cleaning and maintenance
The device: Filters, breathing circuit and interface:
The air inlet filters are located on the back of the
device and accessed by simply removing the filter
housing. There are two types of filter to be used:
1. Cleanable filter (grey)
2. Disposable filter (white)
The filters should be inspected weekly, and changed
if discoloured, or more frequently if advised by your
referring clinician. Clean the cleanable filter at least
once a week and replace once a year.
1. Remove and separate the two filters.
2. Carefully vacuum the cleanable filter to remove
any build-up of dust.
Replace the white filter at least every 4th week, or
more frequently when used in high pollution or
pollen-rich environments.
Please check the User Manual for more information.
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Active Treatment Display 3of 20

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Troubleshooting Your prescription settings 1
Below is a list of common alarms or information messages and what to do if these occur while you are
using the device.Please check the User Manual for a comprehensive list of alarms and troubleshooting.
Further information and tutorial videos can also be found at www.EducationByBreas.com
Alarm/Information Message User Action Required
Power Fail All power sources have been lost –mains power has become
disconnected and the batteries do not have enough charge to
power the Clearway 2. Check all of the power connections,
change to a new power source if possible.
High Pressure 120% of set pressure is detected for >2 seconds. This could be as a
result of coughing into the breathing circuit during the insufflation
phase. Acknowledge the alarm using the touchscreen and re-start your
Clearway 2 by switching the power off then on again.
Incorrect Circuit in Use No exhalation port is detected in the breathing circuit. This could be because
the incorrect circuit is being used or that the exhalation port is blocked. Ensure
the correct circuit type is being used and that it he exhalation port is not blocked
during treatment.
Internal Over Temperature Internal temperature of the Clearway 2 is >60°C –this could as a result
of high ambient temperature or that the device is placed in direct
sunlight or close to a heat source. It could also be as a result of the air
inlet filters being blocked with dust and dirt. Check for these things.
Mode Interface Type
INS. Pressure EXS. Pressure
INS. Trigger Te (seconds)
Ti (seconds) Treatment Cycles
Rise Oscillation Frequency
INS. Breaths INS. Osc. Pressure
Stepped INS. EXS. Osc. Pressure
Pause Time (seconds) Recruitment Breaths

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Your prescription settings 3Your prescription settings 2
Mode Interface Type
INS. Pressure EXS. Pressure
INS. Trigger Te (seconds)
Ti (seconds) Treatment Cycles
Rise Oscillation Frequency
INS. Breaths INS. Osc. Pressure
Stepped INS. EXS. Osc. Pressure
Pause Time (seconds) Recruitment Breaths
Mode Interface Type
INS. Pressure EXS. Pressure
INS. Trigger Te (seconds)
Ti (seconds) Treatment Cycles
Rise Oscillation Frequency
INS. Breaths INS. Osc. Pressure
Stepped INS. EXS. Osc. Pressure
Pause Time (seconds) Recruitment Breaths

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Your prescription settings (NIV/ IPPB Modes)Your prescription settings 4
Mode Interface Type
INS. Pressure EXS. Pressure
INS. Trigger Te (seconds)
Ti (seconds) Treatment Cycles
Rise Oscillation Frequency
INS. Breaths INS. Osc. Pressure
Stepped INS. EXS. Osc. Pressure
Pause Time (seconds) Recruitment Breaths
Non-Invasive Ventilation (NIV) Mode
IPAP Pressure Ti (seconds)
EPAP Pressure Trigger Level
Back-Up Rate (BPM) Interface Type
Intermittent Positive Pressure Breathing (IPPB) Mode
Flow (L/min) Maximum Ins. Pressure
Plateau (seconds) Trigger Level
Interface Type

Clearway 2is atrademark of Breas Medical AB
©2021 Breas Medical –All rights reserved.
Breas Medical reserves the right to make changes in specifications and features shown
herein, or discontinue the product described at any time without notice or obligation.
Contact your Breas representative for the most current information.
Breas and the Breas logo are trademarks of Breas Medical AB.
COR-MAR-MAR-007820 Rev_0
Breas Medical AB, Företagsvägen 1
SE-435 33,Mölnlycke
Sweden
Phone: [phone]
Email:[e-mail]
Breas Medical Limited, Unit A2, The Bridge Business Centre, Timothy’s Bridge Road,
Stratford-upon-Avon, Warwickshire CV37 9HW United Kingdom ∙ Phone [phone] ∙www.breas.com
Company Registered in England and Wales. Company number 07190611 Registered office: Barclays Bank
Chambers, Bridge Street, Stratford upon Avon, Warwickshire. CV37 6AH United Kingdom