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Rock Hinkle: Bi-level Titration
You are titrating a patient on bi-level. The patient has slept well and you've found what seems to be the IPAP and EPAP needed for this patient. The patient has COPD. Can you adjust for Rise Time, Ti Maximum and Ti Minimum, Exhalation, Trigger and Cycle Sensitivity to improve therapy any further? Or is IPAP and EPAP need the extent of your titration?
Betchya this one "ain't" on the exam!!!! *wicked grin*
Views: 238
Replies to This Discussion
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Permalink Reply by D. W. Conn on
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Judy thats evil.....I like it
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Permalink Reply by RockRpsgt on
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This would be a question of protocol. For which I would refer first to my P&P. I do not to believe it to have a policy on these types of comfort adjustments. Which would leave to clinical judgement. Clinical judgement tells me that I can adjust for any theory that I can validate. I would say that yes I could if it looked beneficial to the pt. Documentation of the changes made along with the results could be crucial for this pt.
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Keep them coming guys! Thank you so much Judy. Ask anything you want. It does not matter if it is on the test or not. Put me in any situation you like as I am bound to answer based on the same set of rules.
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You could very well be right jnk. I have never been in this situation. Those settings are hardly ever discussed.
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Permalink Reply by Judy on
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The two major manufacturers have similar "comfort features" but use somewhat different terminology. Since determining the settings for these "comfort features" require that the patient be sleeping how on earth is the local DME RRT going to come up w/the desirable settings?.
CAN an in-lab titration be done with a patient's personal bi-level? How could this be accomplished? How can a personal bi-level be remotely adjusted and titrated?
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I know. I rather like it too. *wicked grin*
D. W. Conn said:
Doggone jnk is just too darn level headed. Come on, jnk, you really think there are any sleep doctors out there that have the smarts or experience to script comfort feature settings??? Much less the interest. Snort!Judy thats evil.....I like it
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Yeah, well, jnk is one sharp cookie for all his protestations he is "only" a patient!! And his comment planted the question in my head. Blame him!!
Dontcha just love that guy??
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So which one of us got it right?
Judy said:Yeah, well, jnk is one sharp cookie for all his protestations he is "only" a patient!! And his comment planted the question in my head. Blame him!!
Dontcha just love that guy??
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How the hey do I know?? WHY on earth do you think I asked the question??!!!! "I" would like to know the answer!!!
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According to binary those are comfort levels to set up after titration. The best time to do it to show the doctor the possible outcome would be during the titration. Also It is the techs job to show the doc samples of the pts sleep at a variation of settings so that he can best prescribe the proper therapy. Until someone shows me otherwise I stand by my answer. We are allowed to change biflex, which could change a great many of those settings. So yes if I had a good argument to base my decision off of I would change those settings.
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