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MI-E Cough Assist: A Course for Clinicians


Description


Mechanical Insufflation-Exsufflation (MIE) Cough Assist: A Course for Clinicians

What's included in this course?

This course reviews theoretical and practical components of adult MI-E prescription and application in the format of mixed media. It includes theory, videos, links to resources and webinars, recommended readings and quizzes.


What will I learn in this course?

After completing this course, you will have a greater understanding of:

  • The history, rationale and evidence for MI-E
  • Assessing cough
  • Patient selection
  • MI-E equipment
  • Titration of MI-E settings
  • Assessing efficacy and waveform analysis
  • Barriers to effective MI-E and problem solving
  • Considerations for domiciliary MI-E use.

Who is this course for?

Clinicians responsible for the prescription and delivery of mechanical in-exsufflation 'cough assist' devices.


What's the benefit of completing this course?

The content of this course has been developed based on the cited research and has been reviewed by clinical experts in the area of cough augmentation. This course has been shown to be effective in improving confidence and competence in delivering MI-E: 

https://rc.rcjournal.com/content/69/1/91


How long will this course take to complete?

The course should take around 6-hours to complete.


Acknowledgements

This online training was written by Elizabeth Lambrinos Senior Physiotherapist at Royal Prince Alfred Hospital, Sydney Local Health District. The course was facilitated by MND Victoria and MND NSW with Grant Funding from FightMND.

 

The online training modules were created in February 2025 and information included is accurate as of this date. 


Content
  • Welcome
  • Course Outline
  • MI-E History and Devices 
  • Definitions/Abberviations
  • Section 1 – MI-E fundamentals
  • MI-E Table
  • MI-E Physiology
  • MI-E Evidence
  • Section 2 - Patient selection
  • Assessing Cough
  • Effective Cough Volume (ECV) vs Peak Cough Flow (PCF)
  • Indications/Patient Populations
  • Contraindications/Precautions/Adverse Events
  • Quiz: Contraindications/Precautions/Adverse Events
  • Section 3 - Initial setting up for titration of MI-E
  • Choosing an interface and assembling a circuit
  • Quiz: Choosing an interface and assembling a circuit
  • Insufflation Pressure
  • Quiz: Insufflation Pressure
  • Insufflation Time (Ti)
  • Inspiratory Flow/Rise Time
  • Quiz: Inspiratory Flow/Rise Time
  • Trigger 
  • Quiz: Trigger
  • Exsufflation Pressure
  • Quiz: Exsufflation Pressure
  • Exsufflation Time (Te)
  • Quiz: Exsufflation Time (Te)
  • Pause Time
  • Quiz: Pause Time
  • Oscillations
  • Pre therapy Insufflation/Recruitment
  • Post-therapy Insufflation/Recruitment
  • Section 4 – Cough Assist E70 Philips
  • CoughAssist E70 - PHILIPS - Part 1
  • CoughAssist E70 - PHILIPS - Part 2
  • CoughAssist E70 - PHILIPS: Resources
  • Section 5 – Clearway 2 Breas
  • Clearway 2 - Breas - Part 1
  • Clearway 2 - Breas - Part 2
  • Clearway 2 - Breas: Resources
  • Section 6 – MI-E Titration continued
  • Programs
  • Instructions to Patients 
  • Manually Assisted Cough (MAC)
  • MI-E Titration Summary 
  • Section 7 - Assessing MI-E treatment
  • Assessing MI-E Treatment: MI-E Assessment
  • Download Device - Analysis of Waveform
  • Quiz: Assessing MI-E Treatment Waveform Analysis
  • Section 8 – MI-E problem solving
  • Interface Issues
  • Progressive Disease and Airway Patency
  • Aerophagia
  • Managing Medical Complications with Case Study
  • Other considerations
  • Section 9 - Domiciliary MI-E use
  • Domicillary Use
  • Caring for the Device
  • Section 10 – Case studies
  • Quiz: Case Study 1
  • Quiz: Case Study 2
  • Section 11 – References
  • References
Completion rules
  • All units must be completed
  • Leads to a certificate with a duration: Forever
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