"please keep me updated about oximeters "
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How Dangerous are CPAP Machines?
Peter Farrell, the Founder of ResMed, is notorious in the Sleep Medicine establishment for saying “The only way you can get injured by one of our machines, at least the low level ones, is if somebody picks the goddamn thing up and slams you over the head with it.”
But still RTs and other sleep professionals cringe at the idea of letting a patient adjust his or her own pressure settings, based on the notion that high pressures can kill you. Furthermore, they say that no amount of disclosure to the patient of possible risks will justify letting the pressures change without a doctor's say so.
What's the truth?
Views: 14940
Replies to This Discussion
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Permalink Reply by Mike Burns on
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One the reasons it could cause complex sleep apnea with increase pressure
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Permalink Reply by lia deneau on
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Mr. Banyon,
I know you made that comment in general.. still stings because I am the in general...sleep professional that gets to witness the patients that are so miserable...that are never offered alternatives...that the DME does horrible follow up..etc and on and on... like i said we have to work together!!!
Banyon said:
lia deneau said:How dare you insult me by saying that I am a poorly motivated professional, that I do not have my patients best interest at heart...
Calm down. No one said that of you.
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Permalink Reply by Neal Buckner, LRCP on
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Chris,
There is a realtime program for the Resmad and Respironics PAP devices. Reslink/Restrak is a wireless modem attached to the device which allows a remote access to the device while it's in use and records real time data with optional SpO2 tacking. It hasn't taken off as much as it should. But, it is availible and useful.
chris h said:First of all , ALL whom are on this forum are first person witnesses to what is and is not happening with sleep.From gasping newbie to advanced professionals in the field. Machines and people are only as good as the info they are programed with.A lack of communication from machine to professional to patient has been and still remains poor. I saw my new sleep doctor today and he said having real time acess to data would be helpful but then he said how would we make that happen?Some computer geek could wright a program to give a redlight warning if data is out of peramiters to upload to some one who know what they are doing to fix it. That missing link and support staff are just a dream at this point. Good Sleep, Chris
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Permalink Reply by RockRpsgt on
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Great explanation Neal. Thank you for your input. You too Lia.
lia deneau said:Gosh Neil.... you poorly motivated , fear mongering person you!....No, for real Neil great answer...
I also wanted to say to anyone out there...
How dare you insult me by saying that I am a poorly motivated professional, that I do not have my patients best interest at heart... you know nothing about me, my practice and how IMPORTANT helping people are... those words that you spew feel like hate to me... after watching patients sleep for many years, and working with the worst of the worst at childrens hospital and then seeing idiot parents "DECIDE" to play with their childrens pap therapy becuase they think they dont need it and end up with a coded or dead child....shame on you...
I Highly advocate patients get educated, and I am the first one to tell patients that if the are not feeling any better or having a hard time lets discuss the issues and if this doesnt resolve your problem...please, please, please, compain, howl, or whatever you have to do to get attention...lets face it the DME's followup can be abysmal.... I think that if we all have to work together, physician, patient, and techs and the DME's to make this all work!
Neal Buckner, LRCP said:Ok. A practitioners 2 cents here.
For the most part. Simple OSA is just that. Simple. As we age and medical conditions change, changes in PAP may need to occur. Either increase or decreased. For those who are proactive about their treatment and understand what kind of sleep apnea they have, making small changes is probably no big deal.
However, having said that. There is some danger in making changes to your PAP pressure if you don't have a clear understanding of the possible outcomes. Too high of a pressure can be just as bad as a pressure that is too low. More so in some cases.
Central sleep apnea's can be worsened if too much CO2 is blown off due to the increase in ventilation when pressures are too high. Plus the number of sleep disturbances can increase from mask leak and swallowing air. Increasing CPAP pressure in turn creates a higher PEEP. Positive end expiratory pressure. Increased PEEP increases the lung surface area participating in respiration. This increased respiration can lower CO2 levels causing the central chemoreceptor to delay sending a signal to the diphragm to contract. This can cause increased central apneas and hypopneas in turn causing O2 sats to drop due to the decrease in ventilation. Desats cause disturbances.
In patients who have later stages of COPD the increase will increase the oxygen levels. Advanced stage of COPD the central chemoreceptor is no longer the receptor used in regulating the respiratory rate. The peripheral chemoreceptor takes over. The peripheral receptor measures blood oxygen. Increasing the O2 levels by way of increased ventilation and respiration also tells the brain the diaphragm does not need to contract. Hyponeas and central apneas increase thus causing the blood CO2 levels to increase.
In short. Please always inform your physician of any changes you have made and get a download done after 2 weeks at the new pressure to ensure the change didn't make things worse.
It is for these very reasons that a licensed professional should be involved with any changes to a prescribed pressure.
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Hi Neal, I guess cost and lacking infrastructure to monitor data have kept this from becoming the gold standard of treatment. Have any of you professionals out there used these gizmos? if yes what did you think of them?
Neal Buckner, LRCP said:Chris,
There is a realtime program for the Resmad and Respironics PAP devices. Reslink/Restrak is a wireless modem attached to the device which allows a remote access to the device while it's in use and records real time data with optional SpO2 tacking. It hasn't taken off as much as it should. But, it is availible and useful.
chris h said:First of all , ALL whom are on this forum are first person witnesses to what is and is not happening with sleep.From gasping newbie to advanced professionals in the field. Machines and people are only as good as the info they are programed with.A lack of communication from machine to professional to patient has been and still remains poor. I saw my new sleep doctor today and he said having real time acess to data would be helpful but then he said how would we make that happen?Some computer geek could wright a program to give a redlight warning if data is out of peramiters to upload to some one who know what they are doing to fix it. That missing link and support staff are just a dream at this point. Good Sleep, Chris
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I have used the Restraxx system. It was pretty nice. My first lab used them to keep track of our pts in the trucking industry. We used the data not only to monitor efficacy and compliance but also to figure ways to keep cost down for the drivers. In the end we put alot of drivers on PAP for under $2000 total.chris h said:Hi Neal, I guess cost and lacking infrastructure to monitor data have kept this from becoming the gold standard of treatment. Have any of you professionals out there used these gizmos? if yes what did you think of them?
Neal Buckner, LRCP said:Chris,
There is a realtime program for the Resmad and Respironics PAP devices. Reslink/Restrak is a wireless modem attached to the device which allows a remote access to the device while it's in use and records real time data with optional SpO2 tacking. It hasn't taken off as much as it should. But, it is availible and useful.
chris h said:First of all , ALL whom are on this forum are first person witnesses to what is and is not happening with sleep.From gasping newbie to advanced professionals in the field. Machines and people are only as good as the info they are programed with.A lack of communication from machine to professional to patient has been and still remains poor. I saw my new sleep doctor today and he said having real time acess to data would be helpful but then he said how would we make that happen?Some computer geek could wright a program to give a redlight warning if data is out of peramiters to upload to some one who know what they are doing to fix it. That missing link and support staff are just a dream at this point. Good Sleep, Chris
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Hi Rock, Under two thousand dollars that sounds like a reasionable number .Was that for daily or weekly download?Good sleep,Chris
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I am not sure Chris. The 2k covered the study, machine, and first 2 downloads through our company. This was to ensure that we had the pressures right, and that the driver was getting efficient treatment. After this a another company took over.
chris h said:Hi Rock, Under two thousand dollars that sounds like a reasionable number .Was that for daily or weekly download?Good sleep,Chris
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one of those Life alert" I have fallen and cant get up" type companies already has network set up.Instead of emt a pro like you could be alerted.Machine needs tweeking or mask leaks excessivly could be adressed earlier .Good Sleep, Chris
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we really need like buttons...!
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Permalink Reply by Andy on
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Neal Buckner, LRCP said:
There is a realtime program for the Resmad and Respironics PAP devices. Reslink/Restrak is a wireless modem...
Hi Neal-- I have a Resmed with a ResTrax unit attached. I was under the impression that the ResTrax only delivered historical data, the same AI/HI and time data that can bee seen on the unit's LCD.
How can I access the ResTrax data myself?
As usual, the DME is not ccooperative with supplying data from the Resmed, so it would be great to be able to do so myself.
Is the "optional SpO2 tacking" available on the Resmed units? If so, how does it work?
Thanks!
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Permalink Reply by Rooster on
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I guess if you sleep technicians were trained in treating diabetes, you would be putting together a system so that diabetics could send their blood-sugar readings to their doctor's office and avoid having to get stressed out interpreting the readings and adjusting diet, exercise, and medication.
LMAO on a Monday morning!
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