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RSRS > CPAP > Flashcards

CPAP Flashcards

1
Q

indication of CPAP?

A 
Treatment of 
- obstructive sleep apnea (OSA)
- Post-Op atelectasis
CHF
- severe
hypoxia
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2
Q

what is snoring casued by

A

vibration of the wall of upper airway, preceded by flow limitation or partial obstruction of the airway

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3
Q

what is OSA?

A

when upper airway becomes severly limited or completely obstructed

CPAP responds to apnea by increasing the pressure

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4
Q

What happens during a central sleep apnea

A
  • airway remain open but there is no flow

CPAP will not increase its pressure

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5
Q

What is the contraindication of CPAP?

A 
- Central sleep apnea syndromes
(because its not the airway thats causing the problem) 
- Pneumothorax
• Large bullae
• Low BP
• Dehydration
• Cerebrospinal fluid leak, 
- recent cranial
surgery/trauma
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6
Q

what is the adverse effect of CPAP

A 
Report to MD
- Chest pain – pleural/
non-pleural
– Severe headache
– Increased breathlessness
treatable
– Dry mucous membranes
in upper airway
– Nose bleed
– Bloating
– Ear/sinus discomfort
– Eye irritation
– Skin rashes
– Claustrophobia
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7
Q

what is the circuit used in CPAP?

A

Single-circuit, interface over or in the nose

- exhale Co2 via exhalation port

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8
Q

what is the pressure available on CPAP

A

2.5 - 20 cmh2o

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9
Q

What are 2 adaption to CPAP

A

Cflex

APAP

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10
Q

what is the function of APAP?

A

auto-PAP

increase pressure(which is set early on) to meet inspiratiory needs of the patient during REM sleep

  • need a standard normal CPAP before qualifying for a APAP
  • the difference between REM AND non-rem has to be greater or at least 4 cmh2o to keep the saturation above 90 in the titration study
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11
Q

how to maintain CPAP?

A
  • Change disposable inlet filter 1/mo
    • Wash reusable inlet filter 1/mo
    • Wash interface, tubing and headgear daily
    • Wash humidifier daily, use only distilled
    water for operation
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12
Q

What are the interfaces options

A
  • Full face
  • Nasal mask
  • Nasal “prong” or “pillows”
  • Total Full Face
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13
Q

what is a Properly Fitted Full Face Mask

A

a) Below lower lip
b) Corners of mouth
c) Bridge of nose

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14
Q

Advantages of Full Face Mask

A
  • More effective for dyspneic patients
  • for pt with nasal obstruction (better for mouth breathers)
  • good for high pressure setting due to wider SA
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15
Q

Disadvantages of Full Face Mask

A 
Claustrophobia
Increased risk of aspiration
Difficulty with speech
Difficulty with secretion clearance
Increased risk of facial pressure sores
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16
Q

Properly Fitted Nasal Mask

A

Sides of nose
Bridge of nose
Above the lip

17
Q

Advantages of Nasal Mask

A 
Less risk of aspiration
Enhanced secretion clearance
Less claustrophobia
Easier speech
- more nature airflow
- optimum for use in high pressure
18
Q

Disadvantages of Nasal Mask

A

Mouth leak
Less effectiveness with nasal obstruction
Nasal irritation and rhinorrhea
Mouth dryness
not suggested for ppl with allergies or cold

19
Q

Advantages of Total Face Mask

A

Claustrophobia
Skin sensitivities
Need for visability

20
Q

how to troubleshoot inadequate flow

A
  1. check power
  2. check device switch on/offf
  3. filter
21
Q

how to troubleshoot airleak

A
  1. mouth open at night–>need a chin strap
  2. mask fit on the face
  3. connection are tight
22
Q

precautions to CPAP

A
  • Skin irritation/redness – try different interface
    • Mask stiffens with age- replace
    • Dry mouth – heated humidity
    • Nasal problems e.g. congestion – nasal saline rinse,
    heated humidity
    • Stomach bloating/discomfort – see MD
    • Air leaks – wash mask and face and use creams, adjust
    mask/straps, accept small leak
    • Difficulty breathing – Ramp or APAP or CFlex
    • Mask removal – adjust mask, head/chin strap
    • Noise - earplugs
23
Q

How does the funding via the assistive device program

A

OSA pts with Level 1 Polysomnography
• Receive ADP package at a cost of $860.00
• ADP will fund a new unit after 5 years if the
current unit requires major repairs
• Most units have a minimum 3 year warranty
(1/3 the original cost then will replace the unit)

24
Q

how does people qualify for ADP funding for CPAP

A 
Dx 
OSA
- presence of significant symptoms
- or medical risk without treatment
and absence of symptoms/risks with treatment
  • Level 1 polysomnography showing evidence of
    OSAS during sleep
25
Q

how to be qualifed for APAP

A

Must have polysomnographically documented
OSA where there is:
- Required change in pressure of a minimum of 4
cmH2O on a prescribed fixed CPAP level of 10
cmH2O or more.
- The change must occur between REM vs.
NREM sleep OR supine vs. recumbent

26
Q

BiPAP

A

Must meet CPAP requirements AND

– who demonstrate one of the following despite CPAP
15cmH2O
• Nocturnal hypoxemia (O2 saturation <88%)

• Nocturnal hypercapnia (PaCO2 >50mmHg) despite three - or more months of sustained CPAP therapy,
- and in the absence of significant underlying COPD which could account for the persistent hypercapnia

• Apnea/hypopnea index > 10

– As above but unable to tolerate ≥15cmH2O

– Continue to demonstrate daytime sleepiness with CPAP
treatment and exclusion of other causes, e.g. narcolepsy,
will be considered on an individual basis

RSRS (16 decks)

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