NIPPY Clearway Clinical User Guide

Published: September 11, 2019

The NIPPY Clearway is a versatile airway clearance device that combines powerful performance with advanced mode options.

This enables specific and effective treatment options for secretion clearance, lung volume recruitment and cough augmentation in patients.

The NIPPY Clearway provides you with a range of modes and features to enable the prescriber/therapist to customise the treatment for individual patient needs to maximise efficacy and synchronisation.

ModeManual
UseAcute use, titration of automatic and programmable modes to gain optimal settings & LVR +/- secretion clearance techniques.
About the ModeThis mode allows the clinician to deliver the required sequence of insufflations +/- exsufflations and timings manually via the remote hand control or the insufflation/exsufflaton switch on the front of the NIPPY Clearway.
What to set?Insufflation & Exsufflation pressures are set, the times and sequence of treatment are controlled manually by the therapist/carer using the remote hand control or switch on the front of the NIPPY Clearway. To maximise synchronisation, you are also able to adjust the flow profile in the advanced menu. The flow profile alters the time taken to reach insufflation pressure.
ModeBasic Auto
UseCan be used as an MI-E mode for acute use or for longer term management of patients requiring cough augmentation and secretion management.
About the ModeThis mode delivers one insufflation, followed by one exsufflation followed by a pause. This is one cycle. The number of cycles is determined by pressing start/stop (Max of 20 cycles). If you wish to set a specific number of cycles, without relying upon stopping the device manually, you can set this in the timed auto mode (please see below).
What to set?Insufflation & Exsufflation pressures are set, as well as inspiratory time / expiratory time (Ti / Te and pause times. The flow profile can also be set to allow maximum synchronisation. To maximise synchronisation, you are also able to adjust the flow profile in the advanced menu. The flow profile alters the time taken to reach insufflation pressure.
ModeTimed Auto
UseSpecific MI-E treatment programme with repeated insufflations and or a specific amount of cycles where required, secretion clearance techniques (+/- Exsufflation).
About the ModeThis mode allows the clinician to set a number of repeated insufflations prior to the exsufflation. You can also repeat the cycle. This enables a specific programme to be set for the individual patient (optimising their airway clearance session as necessary). This will enable consistent therapy for the patient in the community or sub-acute setting, allowing the therapist or carer to also carry out manual techniques if required. You can also set a limited number of basic auto cycles in this mode if required by setting one insufflation, the exsufflation and the number of repeat cycles you require. Exsufflation pressure can be set to zero to allow purely repeated insufflations for LVR/secretion clearance techniques.
What to set?Insufflation & Exsufflation pressure. Ti /Te, and Pause times are all set. Then the number of insufflation repeats and number of cycles are programmed. To maximise synchronisation, you are also able to adjust the flow profile in the advanced menu. The flow profile alters the time taken to reach insufflation pressure.
ModeTriggered Mode
UseCan be used in patient groups who have sufficient inspiratory effort, to allow maximal synchronisation. Can also be used in patients who do not require negative pressure, as Intermittent Positive Pressure Breathing (IPPB) or secretion clearance techniques in combination with the positive insufflation breaths.
About the ModeThe device will trigger each insufflation as the patient’s inspiration effort is detected. Trigger sensitivity is able to be altered from 1 (easiest) to 10 (hardest), to help synchronise the therapy with the patient’s effort.
In this mode the pause should be extended to allow the patient enough time to trigger, it is increased in this mode to 9 seconds to allow this. If they do not trigger by the end of the pause, a timed insufflation is delivered.
What to set?Insufflation & Exsufflation pressure (0cmH20 exsufflation pressure can be set for airway clearance or IPPB use). Ti /Te and Pause times are set. Then the number of insufflation repeats and number of cycles are set. The trigger sensitivity (1-10) and flow profile can also be adjusted in the advanced menu. The flow profile alters the time taken to reach insufflation pressure. If you require more than 10 insufflations, you can repeat the cycles also.

If you wish to set up more than one mode for your patient you can set the modes up with varying settings. For example you can use Basic Auto for cough augmentation and a programmed mode for LVR.

During all programmed modes, it is possible to override the programme at all times with the manual hand control or the front switch on the NIPPY Clearway.

It is possible to turn other modes off so they are not available. This option is found in the advanced menu.

Whilst a patient is using the device it is possible to adjust the settings in order to optimise the therapy during use.

For further assistance with setting the device, please contact your local representative.

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