NHS Clearway User manual

Leaflet Name: Clearway/ Clearway 2 cough assistor
Leaflet Lead Name: Verity Ford
Date Leaflet Developed: January 2021
Date Leaflet Approved: 15/04/2021
Issue Date: April 2021
Review Date: April 2024
Page 1 of 5
Ref: 1412
Version No: 5
Clearway and Clearway 2
Cough Assistor for Home Use
[
Liverpool Ventilation Service
Aintree Site
Lower Lane, L9 7AL Tel: [phone]
Royal Site
Prescot Street, L7 8XP
Broadgreen Site
Thomas Drive, L14 3LB
Royal & Broadgreen Tel: [phone]
What is a Cough Assistor?
A mechanical cough assistor is a machine
which can help you clear secretions or
phlegm from your lungs.
The aim of the treatment is to help you
breathe in and out deeply and quickly. This
can help when your own cough is not strong
enough.
The cough assistor is usually given by a
mask overyour mouth and nose.
It helps you take a big breath in then helps
you breathe out quickly; you would feel a
gentle sucking sensation.
What is it used for?
There are many different reasons why a
cough assistor may be needed including:
muscle problems that make breathing
and coughing difficult.
bone problems that make the chest small
and coughing difficult.
What are the benefits of using a
cough assistor?
It may help you clear mucus from your
chest and may help prevent chest
infections.
It can be used alongside other
treatments to prevent breathlessness
when you are lying down and shallow
breathing that leads to a strain on your
heart and daytime sleepiness.
If you are unsure about the reason why you
have been given the machine please ask
your physiotherapist or doctor.
Will I be seen by a Doctor, Nurse
or Physiotherapist?
The decision to provide a machine is taken
by the team as a whole, however the
machine will be provided by a
physiotherapist, either during a clinic
appointment, a home visit or whilst you are
an inpatient.
During this time you will have a full
explanation about the machine and its set
up. You and/or any carers or family will be
shown how to use and maintain the
machine. You will also be given a list of
contact numbers should you have any
queries.
What do I need to do before I use
it?
Important: You must CHECK the machine
settings each time before starting treatment.
The cough assistor machine you have
been given operates from the mains i.e.
it must be plugged in when in use. If
necessary a battery can be provided to
allow use when away from mains
electricity.
To turn the machine on, press the switch
on the front of the machine.

Leaflet Name: Clearway/ Clearway 2 cough assistor
Leaflet Lead Name: Verity Ford
Date Leaflet Developed: January 2021
Date Leaflet Approved: 15/04/2021
Issue Date: April 2021
Review Date: April 2024
Page 2 of 5
Ref: 1412
Version No: 5
or
The settings are displayed on the screen
when switched on.
Circuit set up
The circuit for each machine is slightly
different. If you are using the Clearway 1
please set up the circuit as below the mask
will attach to the far end after the filter.
If using the clearway 2 the circuit is below,
the mask will attach to the far end after the
filter.
CHECK that the filter, tubing and mask are
attached to the cough assist and that there
are no holes/splits in the tubing.
What if I am concerned about the
safety checks?
If there are any concerns about the checks
you have performed DO NOT USE THE
MACHINE contact the team that provided
the machine for further advice or the service
engineers.
Are there any risks of using a
Cough assistor?
It is important to check the pressures before
starting treatment to ensure the settings
match the prescription you have. Use of
high pressures could potentially cause a
pneumothorax (hole in the lungs). You will
have been carefully assessed and settings
decided on your clinical need. We will
carefully choose settings to minimise any
risk of harm to you. If you experience any
sudden sharp pain which does not go away,
stop using the device and contact your GP
or visit accident and emergency if you feel
you are seriously unwell.
You may experience bloating in your tummy
from air being pushed into it, or you may
feel a stretching feeling of your ribs and
muscles due to you getting a large breath.
These feelings are nothing to worry about
but talk to your physiotherapist if you are
concerned.
When is a cough assistor used?
You will be advised by your physiotherapist
about how to use the machine. You may be
advised to use the device when you are
struggling to clear mucus or regularly
throughout the day.
How do I use a cough assistor?
Your physiotherapist will write in this leaflet
the recommended settings and use of this
device. Please refer to the instruction
manual provided with your clearway for
detailed operating instructions.

Leaflet Name: Clearway/ Clearway 2 cough assistor
Leaflet Lead Name: Verity Ford
Date Leaflet Developed: January 2021
Date Leaflet Approved: 15/04/2021
Issue Date: April 2021
Review Date: April 2024
Page 3 of 5
Ref: 1412
Version No: 5
To use this device hold the facemask tightly
over your mouth/nose or attach
tracheostomy connector to your
tracheostomy.
Press the start button to begin treatment.
Use the device as directed by your
physiotherapist.
Rest between cycles as you may feel tired
or slightly light headed. Repeat cycles of
treatment as directed by your
physiotherapist. Always finish treatment
with a breath in on the device.
Equipment and Machine settings
Model:
Serial no.
Machine settings:
Date
Mode
Insufflation pressure
Exsufflation pressure
Ti
Te
Pause
Cycle repeat
Inspiratory repeat
Vibrations
Recommended usage –
Number of
cycles/treatment and
number of
treatments/day.
(each cycle consists of 4-
6 inhalation/exhalations)
Can I use oxygen with the
machine?
YES: Your physiotherapist can supply
you with the necessary connector
for you to attach oxygen. Please
ensure after use the oxygen is
disconnected immediately.

Leaflet Name: Clearway/ Clearway 2 cough assistor
Leaflet Lead Name: Verity Ford
Date Leaflet Developed: January 2021
Date Leaflet Approved: 15/04/2021
Issue Date: April 2021
Review Date: April 2024
Page 4 of 5
Ref: 1412
Version No: 5
How do I look after my equipment?
Cough Assistor:
It is important that your machine is placed
on a firm, flat surface, e.g. a table. It
should be kept clean and dust-free.
Switch device off after use.
Masks:
A standard mask is provided that should
fit tightly over your mouth and nose. If
your arms are weak you may need help to
hold the mask in place as you use the
machine. It is possible to use the machine
by mouthpiece or tracheostomy tube, this
will be discussed with you by your
physiotherapist.
It is important to take care of your mask,
mouth piece or tracheostomy connector. It
is best to wash your mask/ mouth piece
after every use in warm soapy water.
Replace the tracheostomy connector
daily.
Filters:
The filters provided need changing if they
become visibly soiled or contain trapped
moisture. We would recommend the
round filter attached to the tubing is
changed weekly and the filter at the back
of the machine is checked weekly.
Tubing:
The tubing should be washed in warm
soapy water every 2-3 days. If mucus is
coughed into the tube please wash after
use. Please ensure that the tubing is dry
prior to reconnecting to the cough
assistor. Check the circuit at each use a
replace if damaged.
Machine Maintenance and Repair
If your machine breaks down or has a fault
please contact an Engineer at Deva
Medical on:
24hr emergency number 0772 088 3276
Office hours 0151 529 3808
Your cough assistor should be serviced
yearly by Deva Medical. They will contact
you when the service is due to arrange a
convenient time to visit your home and
carry out the service.
Please tell us if there are any problems with
the machine or if it alarms with a fault.
If you have any queries regarding the
service of your machine, contact the NIV
Co-ordinator, on the number shown below.
Replacement Equipment
If you require any replacement equipment
e.g. tubing, masks, filters etc. please phone
the Physiotherapists or NIV Co-ordinator on
the numbers shown below.
We will post replacement equipment out to
you, or you can arrange a convenient time
to collect any equipment required.
Contact numbers:
For any queries or require advice regarding
the use of your machine or the equipment
you have been given, please contact the
department on the numbers below:
Ventilation Team Physiotherapists
Telephone switchboard: 0151 525 5980
Ask for BLEEP 3334

Leaflet Name: Clearway/ Clearway 2 cough assistor
Leaflet Lead Name: Verity Ford
Date Leaflet Developed: January 2021
Date Leaflet Approved: 15/04/2021
Issue Date: April 2021
Review Date: April 2024
Page 5 of 5
Ref: 1412
Version No: 5
NIV Co-ordinator
Tel: [phone]
Available: Mon –Fri, 9 am - 2 pm.
Feeling Unwell?
If you are feeling unwell and need medical
advice please contact your own G.P. who
will be able to assess and advise you.
If you are taken acutely unwell and require
admission to your local hospital please
take your cough assistor and this booklet
with you.
Travelling abroad with your cough
assistor
Most machines can be used abroad if
using a plug adaptor.
You must ensure that your machine is
taken as hand luggage. The ventilation
team can provide you with a letter to allow
this.
Tel [phone]
If you are unsure about travelling please
contact the physiotherapists for advice.
Are there any alternatives?
Your physiotherapist may be able to teach
you exercises, positions or supported
cough techniques which may help you to
clear mucus.
There is also a simple device called a
breath stacker which may help people
with weak coughs to clear mucus.
Please ask your physiotherapist if you
require any more information about these
alternatives.
Useful resources
www.educationbybreas.com
If you require a special edition of
this leaflet
This leaflet is available in large print,
Braille, on audio tape or disk and in other
languages on request. Please contact:
Tel No: 0151 529 2906
Email: interpretationandtranslation
@liverpoolft.nhs.uk