Term
| what is the major non-surgical, long term treatment of OSAS? |
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Definition
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Term
| What are indications someone needs CPAP? |
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Definition
| Sleep-related upper airway obstruction, chronic lung disease |
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Term
| What are symptoms that someone may need VPAP? |
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Definition
| CPAP does not treat their CSA or cheynes stokes breathing, chronic heart failure, |
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Term
| What are signs someone may need bi-pap? |
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Definition
| Does not tolerate CPAP well, Needs to be at a high pressure on CPAP, |
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Term
| What are some complications of CPAP? |
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Definition
| Congestion, nasal dryness, rhinorrhea (runny nose), chest discomfort, induced central apnea, conjuctivitis (eye infection), skin rash, pressure sores |
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Term
| What are some complications that can occur the first night of CPAP therapy |
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Definition
| Nasal congesion, mouth breathing, REM rebound with decreased arousability, potentially dangerous hypoxemia, panic awakening |
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Term
| What are solutions to problems that can occur the first night of CPAP therapy? |
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Definition
| Humidification, chin strap, attended study, vigilant tech, pt preperation education |
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Term
| What are some mask related complications that can occur with CPAP? What are there solutions? |
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Definition
| Skin rash, pressure sores and conjuctivitis-having the right mask fit or type, also can use a protective skin covering such as vitamin E |
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Term
| What are some pressure related complications that can occur with CPAP? |
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Definition
| Difficulty exhaling, Aerophagia, Chest discomfort, Sinus Discomfort- ramp the pressure up, bi-level pressure, nasal strips |
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Term
| What are some nasal complications that can occur while using CPAP and how can they be managed? |
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Definition
| Rhinorrhea (runny nose), congestion, dryness, epistaxis-humidification, nasal spray, topical application |
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Term
| What are pulmonary barotrauma, pneumonmediastinum and pneumothorax? |
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Definition
| Unusual CPAP complications |
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Term
| What are the 6 goals during titrations? |
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Definition
Eliminate apnea
Eliminate hypopnea
Eliminate snoring
Eliminate desaturation
Eliminate arousals
Increase compliance |
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Term
| What are 4 things that can prepare a pt for compliance during a study and for there future home therapy? |
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Definition
| Physician explantion, mailed information, video, CPAP "acclimation" |
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Term
| What pressure should a titration typically begin at? |
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Definition
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Term
| How many cm of H2O are you allowed to raise the pressure at a time? |
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Definition
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Term
| Once the pressure is between 10-12 cm what are things you should and should not do? |
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Definition
| Raise the pressure more than one cm. Also may need to do bi-level |
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Term
| What is the most important stage and position to titrate during? |
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Definition
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Term
| How do you know when CPAP pressure is insufficient? |
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Definition
Residual upper airway resistance
EEG arousals
Post-treatment hypoventilation with CO2 retentiona and hypoxemia |
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Term
| How do you know when the CPAP pressure is to high? |
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Definition
Arousals, awakenings
Pt intolerance
Central apnea
Oral air leak |
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Term
| What are indications of a mouth breather? |
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Definition
decrease in CPAP flow signal
Increase in CPAP leak # |
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Term
| What can you do for someone who is a mouth breather? |
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Definition
| Increase CPAP pressure, humidification, full face mask, chin strap |
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Term
| What do you do if central apneas appear during titrations? |
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Definition
| Raise the pressure 1-2 cm, if the CAs persist or lengthen lower pressure until they disappear |
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Term
| Can you lower a pressure in a titrations study? |
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Definition
| Yes for centrals or pt comfort. |
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Term
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Definition
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Term
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Definition
| To eliminate hypopneas and snoring. |
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Term
| How long should a pt have on CPAP for a split night study? |
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Definition
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Term
| How long does the pt need to have a baseline for before a split night? |
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Definition
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Term
| What does EPAP stand for? |
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Definition
| Expiratory positive airway pressure |
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Term
| What does IPAP stand for? |
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Definition
| Inspiratory positive airway pressure |
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Term
| What are indications to put a pt on Bi-Pap |
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Definition
| Non-tolerance of CPAP, History of CO2 retention |
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Term
| When should O2 be applied? |
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Definition
When the baseline is below 88-90% however not on the baseline unless it is lower it will mask events
After obstructive events have been eliminated
Should be on low flow levels .5-2 l/m |
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