Breas NIPPY Clearway User manual

NIPPY
®
Clearway
A Patient Guide to
the NIPPY Clearway

2 3
Why do I need to use
a NIPPY Clearway?
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 eective 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 a weakness
in the muscles that we use to take in a deep breath, or in our expiratory muscles, our cough strength
decreases and becomes less eective resulting in a build up of mucus within the lungs.
The NIPPY Clearway is a mechanical insuation-exsuation device. These devices can help improve
your cough strength. Your device will be set up by your physiotherapist/clinician.
The NIPPY Clearway gives a deep breath in (insuation) followed by a rapid suck out (exsuation).
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

Ins
Exs
Ins Exs
Outlet
Mask Pressure
4 5
Navigation of your
NIPPY Clearway
On/O – Press once to
turn device on, press
twice to turn device o
Start/Stop – Press
to start or stop
treatment
Mask Pressure Line Valve
– Attach thin tube from
breathing circuit here
Air Outlet – Attach
large tubing here
Insuation/Exsuation Trigger (for use
in manual mode) – Move the switch to
the left for insuation, hold to maintain
pressure until switch is released, move to
the right to activate the exsuation
Ins Exs
Outlet
Mask Pressure

6 7
Navigation of your
NIPPY Clearway
External Battery –
Twist clockwise to
lock in place
Mains power
connection
Air inlet filter
and cover
Hand control – for use
in manual mode
INS
EXS

Ins
Exs
8 9
Setting up your NIPPY Clearway
1Place the NIPPY Clearway on a clean, smooth, hard surface (not carpet).
2Connect to the mains or battery.
3Attach the breathing circuit to the air outlet and pressure line to the
mask pressure valve on the front of the NIPPY Clearway.
4Attach 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.
ATubing
BPressure monitoring line
CCarbon dioxide leak port.
Do not cover this up during
treatment, especially when
using device in NIV mode
DOxygen supply connection
EAnti-bacterial filter
Interface options
Catheter Mount
Mouthpiece & nose clip
Facemask
Ins
Exs
Ins
Exs
1 2 3 4
A
E
B
D
C

Ins
Exs
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Entraining oxygen to your NIPPY Clearway Information about treatment and settings
If you need supplementary oxygen, it may be entrained via a connector
as shown below:
• Always switch on the NIPPY Clearway before the oxygen supply.
When adding oxygen, attach an entrainment port at the mask or
tracheotomy end of the circuit.
• When treatment is complete, switch o the NIPPY Clearway and
disconnect the oxygen tubing from the breathing circuit.
• Store the breathing circuit in a clean 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 NIPPY Clearway in the automatic modes, a Synchrony Beep will sound prior
to the delivery of the negative pressure, signalling when to cough (if mucus is present),
making the treatment more eective.
• A NIPPY Clearway has dierent modes and therefore can provide dierent treatments.
Treatment usually consists of insuation time (Ti) (length of the breath in), exsuation
time (Te) (length of the suck out), and a pause. These three times 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 to
interface here
Ins
Exs
Ins
Exs
Oxygen
port

12 13
NIPPV
Cough assistor
Ins
Ti
Pause
Mode
Ins
Rpt
Exs
Te
Cycle
Rpt
Help
Set– +
Ext. Batt.
Power
Start
Stop
Menu
Clear
Max on time 30 minutes in any 1 hour period.
Starting treatment Changing the mode on your NIPPY Clearway
When you switch on the NIPPY Clearway, 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 dierent prescription or mode.
1Turn the NIPPY Clearway on by pressing
the On/O button.
2Position 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.
3Use ‘Start/Stop’ button to commence therapy.
4If you use a ventilator in addition to the
NIPPY Clearway, ensure that you only begin
treatment with the NIPPY Clearway when you
are ready and your ventilator is ready for you
to use at the end of treatment.
The NIPPY Clearway has 5 dierent modes.
Your clinician will set up the device with the
most appropriate mode or modes for you.
If you have multiple modes programmed,
change the mode, by pressing the Mode
button to display those available to you.
Use the -and +buttons to highlight the
desired mode. Press the Set button to
select. The individual settings for each mode
will be retained in memory so you do not
need to alter the settings each time you
change mode.
Ins
Exs
1
Ins
Exs
32

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What does the therapy tracking screen mean? Cleaning and maintenance
Ti - Breath in
P - Pause
Te - Cough phase.
You will hear a ‘beep’ just before it delivers
the negative pressure, at this point you
should cough if mucus is present.
The number in the top right corner shows
the current cycle being performed by the
Clearway. In this example, the device is on
cycle number three out of a total of 20.
The vertical white line tracks where you are
in the treatment cycle on the screen.
The NIPPY Clearway works through the
programme of therapy, and when it beeps
and ‘auto sequence complete’ appears on
the screen, the treatment is finished. You
may need to repeat the sequence if you
feel it is necessary.
The device:
• The device and power cord should be checked
for signs of external damage weekly. If any
damage is evident, contact your clinician.
• To clean the device, make sure it is switched
o and disconnected from the mains or
external battery.
• Using a clean, damp cloth, wipe down
the exterior of the device. You may use a
mild neutral detergent or soapy water or
an antibacterial wipe. Do not immerse the
machine in or spray with water or use any
solvent cleaning solutions.
• Wash the interface. You may use a mild neutral
detergent or soapy water or an antibacterial
wipe after use and dry it with a clean cloth.
Filters, breathing circuit and interface:
• The air inlet filter, located on the back of the
machine, should be checked weekly and
replaced when grey or visibly soiled. To remove
the filter, grip the black plastic filter housing
across the top corners and pull away. Remove
the filter and replace it only with a spare
provided by Breas Medical Ltd or reputable
distributor. Push the filter cover back in place
when the filter has been replaced.
• The breathing circuit, bacterial filter and
interface will also need replacing. If visibly
soiled, these should be replaced before
continued use, otherwise your clinician will
advise how often you should replace each item.
NIPPV
Cough assistor
Ins
Ti
Pause
Mode
Ins
Rpt
Exs
Te
Cycle
Rpt
Help
Set– +
Ext. Batt.
Power
Start
Stop
Menu
Clear
Max on time 30 minutes in any 1 hour period.
Pressure
0.0
Active Treatment Display
Ti
Te
P
1.0
cmH2O
3/20
30
25
20
15
10
5
0
-5
-10
-15
-20
-25
-30
2.1 3.1 4.2

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Troubleshooting Your prescription settings 1
Your NIPPY Clearway device will alarm or display a message when it requires attention. Below is a list of
common alarms or information messages and what to do if these occur while you are using the device.
Alarm/Information Message User Action Required
Power Disconnect If electrical power is interrupted, an audible alarm will sound and
a message will appear on screen.
Action: check the power cable is plugged into the mains, secured in the
back of the device and isn’t damaged. If you are using the external battery,
check it is connected correctly.
Pressure Line Disconnect Proximal pressure line has become disconnected. Device still functions
with possible reduced eectiveness.
Action: reconnect tube and inspect for any damage.
Breathing Circuit Disconnection Patient breathing circuit has become disconnected.
Action: reconnect circuit and inspect for any damage.
Low External Battery When the device is running on the external battery, an alarm will sound
when the battery power is low.
Action: either recharge or replace battery, or switch to mains power.
Spanner symbol If your device is due a service, it will display a black flashing spanner symbol.
The device will continue to function as normal.
Action: contact your clinician or Breas Medical directly to organise a service.
Mode
Insuation Pressure cmH2O Exsuation Pressure cmH2O
Insuation Trigger Te Sec
Ti Sec Cycle Repeat
Pause Sec Device locked Yes/No
Insuation Repeat Interface
Advance Settings:
Insuation Oscillations Flow Profile
Exsuation Oscillations Oxygen L/min
Post Exsuation Breaths

18 19
Your prescription settings 3Your prescription settings 2
Mode
Insuation Pressure cmH2O Exsuation Pressure cmH2O
Insuation Trigger Te Sec
Ti Sec Cycle Repeat
Pause Sec Device locked Yes/No
Insuation Repeat Interface
Advance Settings:
Insuation Oscillations Flow Profile
Exsuation Oscillations Oxygen L/min
Post Exsuation Breaths
Mode
Insuation Pressure cmH2O Exsuation Pressure cmH2O
Insuation Trigger Te Sec
Ti Sec Cycle Repeat
Pause Sec Device locked Yes/No
Insuation Repeat Interface
Advance Settings:
Insuation Oscillations Flow Profile
Exsuation Oscillations Oxygen L/min
Post Exsuation Breaths

Notes Notes

*NIPPY Clearway is a trademark of Breas Medical AB
© 2017 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.
Breas Medical Ltd is registered in England and Wales: Reg No 07190611.
Breas Medical Limited, Unit A2, The Bridge Business Centre, Timothy’s Bridge Road,
Stratford-upon-Avon, Warwickshire CV37 9HW United Kingdom ∙ Phone [phone] ∙ www.nippyventilator.com
Breas Medical AB/2017/DOC2610