"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: 15045
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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I have only heard what I can call rumors at this time. I would not want cause an unneeded panic. Hopefully the A.P.P.L.E.S. research results will be open to the public soon.
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Permalink Reply by Rooster on
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Every year in this country, home accidents result in more than 20,000 deaths while an additional 21 million people are treated for injuries, according to the Home Safety Council, a nonprofit safety education and resource group. I have looked and looked for five years now and have yet to find one death, let alone a reported injury, from a CPAP machine.
If you really want to reduce the risk of accidental death or injury to patients, forbid them from going near bathtubs or showers!
But that would not give some in the sleep business the control they want, so don't expect to see them campaigning against bathtubs or showers.
As an aside, my sleep doctor is fully aware of how I optimized my therapy (< 2 AHI) after her sleep lab and my previous sleep lab could not get me titrated below 32 AHI. In fact she expects me to bring copies of my CPAP printouts on every visit and keep her updated on what pressure I am using.
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Permalink Reply by Mike on
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one RT raised the following doomsday scenario: "what about pneumothorax or a bleb on the lung? These are severe contraindications to CPAP therapy at high pressures." Anyone know how common it is for someone to have pneumothorax or a bleb on the lung? why wouldn't it be a good idea to allow the majority of people who don't have such contraindications to do as they please with their CPAPs and provide warnings of the risks for populations potentially at risk?
Rooster said:Every year in this country, home accidents result in more than 20,000 deaths while an additional 21 million people are treated for injuries, according to the Home Safety Council, a nonprofit safety education and resource group. I have looked and looked for five years now and have yet to find one death, let alone a reported injury, from a CPAP machine.
If you really want to reduce the risk of accidental death or injury to patients, forbid them from going near bathtubs or showers!
But that would not give some in the sleep business the control they want, so don't expect to see them campaigning against bathtubs or showers.
As an aside, my sleep doctor is fully aware of how I optimized my therapy (< 2 AHI) after her sleep lab and my previous sleep lab could not get me titrated below 32 AHI. In fact she expects me to bring copies of my CPAP printouts on every visit and keep her updated on what pressure I am using.
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Just remember that a CPAP machine operating at a very high pressure is still applying a very low pressure. 24 cm H2O is equivalent to .34 PSI which is a very low pressure.
I can imagine that is a lower pressure than that quite often exerted in the lungs when sitting down in your sports car or lightly straining on the potty or picking up a gallon of distilled water for your CPAP humidifier or getting a loving hug from your main squeeze.
So does that RT predict doomsday 24x7 for non-CPAP users also?
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Permalink Reply by 99 on
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i did not know you could use a cpap as a door stopper
j n k said:This is my personal take on it, nothing more.
RTs come from a world where they go to school to learn how to take care of seriously ill patients who need ventilators to live. They are trained to look for indications of complications. Doctors bow to their expertise in such matters, and rightfully so. Good RTs take pride in their work and want what is best for patients.
In sleep medicine, RTs want their backs covered, again rightfully so, by working in a system where the doc decides the pressure and the RT makes the adjustment and knows no one else will mess with it, including the patient. That is just good medicine. And it keeps medical professionals involved in the process, which is generally a good thing.
If an OSA patient decides to take into his own hands the tweaking of pressure adjustments, they are shrugging off some of the expertise of the doc and RT, in one sense. BUT, if that is an INFORMED decision by a patient, I have no problem with it--it is a patient's right. I applaud it in that sense. And I've read too many stories of patients getting much better therapy by tweaking pressure to discount the advantages to that approach. Many doctors have no problem at all with patients' tweaking pressures.
Still, it can have some repurcussions. It relieves the rest of the medical team of the responsibility they would have if they were solely in control of pressure. So a patient has to be willing to take that responsibility on himself. It is his body, so he is most interested in the efficacy of his own therapy. If it keeps the pateint involved and interested and makes the patient feel better, it may keep him on therapy instead of giving up and using the thing as a door stop in the basement.
The other side of the coin in all of this is that we now live in the age of auto-titrating machines. Manufacturers claim that it is fine for those machines to be set with pressure ranges wide open, 3 to 25, for simple OSA patients. If that is safe, then questions about the safety of pressure for the simple-OSA patient is already a moot point--the industry has already decided that changes in pressure up to 25 cm are safe. Period.
When I say simple OSA, I mean a patient with no significant central events or other related complications that would limit the range of acceptable pressures.
So, all that is to say, I agree with Farrell on that point, in context.
jeff
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Peter Farrell's notorious quotation on the danger level of CPAPs is also picked up on another Internet forum: http://www.talkaboutsleep.com/message-boards/viewtopic.php?p=109509
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apparently, he was quoted as having said this at a March 2005 ASAA lecture held in Washington D.C. entitled: "Catching Our Breath: Reflections on Diagnosis and Treatment of Obstructive Sleep Apnea.")
j n k said:I've never seen a trascript of the lecture, so I'm not sure he said it, myself. But I don't doubt the sentiment.
Mike said:Peter Farrell's notorious quotation on the danger level of CPAPs is also picked up on another Internet forum: http://www.talkaboutsleep.com/message-boards/viewtopic.php?p=109509
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the quote was also confirmed to me by the ASAA in addition to being reported on cpaptalk at the following URL: http://www.cpaptalk.com/viewtopic.php?f=1&t=9745&start=15
screen shot below:
Mike said:apparently, he was quoted as having said this at a March 2005 ASAA lecture held in Washington D.C. entitled: "Catching Our Breath: Reflections on Diagnosis and Treatment of Obstructive Sleep Apnea.")
j n k said:I've never seen a trascript of the lecture, so I'm not sure he said it, myself. But I don't doubt the sentiment.
Mike said:Peter Farrell's notorious quotation on the danger level of CPAPs is also picked up on another Internet forum: http://www.talkaboutsleep.com/message-boards/viewtopic.php?p=109509
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also take a look at http://www.cpaptalk.com/viewtopic.php?f=1&t=2204&st=0&s...
apparently, the recording was once available through that link (although it didn't work for me)
Mike said:the quote was also confirmed to me by the ASAA in addition to being reported on cpaptalk at the following URL: http://www.cpaptalk.com/viewtopic.php?f=1&t=9745&start=15
screen shot below:
Mike said:apparently, he was quoted as having said this at a March 2005 ASAA lecture held in Washington D.C. entitled: "Catching Our Breath: Reflections on Diagnosis and Treatment of Obstructive Sleep Apnea.")
j n k said:I've never seen a trascript of the lecture, so I'm not sure he said it, myself. But I don't doubt the sentiment.
Mike said:Peter Farrell's notorious quotation on the danger level of CPAPs is also picked up on another Internet forum: http://www.talkaboutsleep.com/message-boards/viewtopic.php?p=109509
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using peter farrells word
no more dangerous than a bowl of cearal
why do we need a script for a cpap
"CPAP is as dangerous as a bowl of cereal. The only way you can get hurt by one is if someone picks the damn thing off the nightstand and hits you over the head with it."
-Peter Farrell, CEO, ResMed
the only thing i can think of is we need a script to hit someone over the head
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"CPAP is as dangerous as a bowl of cereal. The only way you can get hurt by one is if someone picks the damn thing off the nightstand and hits you over the head with it."
-Peter Farrell, CEO, ResMed
(quoted from the March 2005 ASAA lecture held in Washington D.C. entitled: "Catching Our Breath: Reflections on Diagnosis and Treatment of Obstructive Sleep Apnea.")
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