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Airway Clearance Assessment CF Teen


There are no right or wrong answers to this survey. Please answer as truthfully as possible so we can work together to find the best airway clearance treatment(s) for you and your lifestyle.

Name

1. Which treatment methods are you currently using?

Please select the device(s)/methods you use and how frequently you use them.

Airway Clearance Techniques

Treatment Name

Huff Coughing

Percussion and Postural Drainage

Active Cycle of Breathing Techniques (ACBT)

Autogenic Drainage

Intrapulmonary Percussive Ventilation (IPV)

2. To what extent is each statement true for you?

Check the box that applies to each statement.
I can explain the benefits of airway clearance.(Required)
I am confident I know how to do my airway clearance correctly(Required)
I am satisfied with my current airway clearance routine(Required)
I know about all of the airway clearance options that are available to me(Required)
I do my airway clearance routine every day(Required)
I do my airway clearance routine when I am away from home(Required)
I know the correct order in which to do my respiratory treatments, including airway clearance(Required)
I know how to clean/disinfect my airway clearance equipment(Required)
I am comfortable doing airway clearance in front of friends/family(Required)

3. Which of these might get in the way of your child doing their current airway clearance therapy (ACT) and/or might prevent your child from adding a new ACT?

Check all items that apply to your situation.(Required)

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