Continuous Positive Airway Pressure (CPAP)

* Practicum Goal: * Prevent further complications in respiratory distress by educating the nurse on the use of CPAP and BiPAP to support the patient population with acute respiratory distress and other chronic respiratory illness.

Thesis: Sleep Apnea is becoming more of a dangerous disease that more people are starting to be diagnosed with. It is extremely important that Sleep Apnea is emphasized so that more people are aware of it.

18 study data were derived from the apnea database (PhysioNet) corresponding to MIT/BIH database. AirFlow, SaO2, Abdominal and Thoracic Movements were obtained from full PSG records. Each record includes a period of nearly eight hours and signals annotation is done minute-by-minute. A minute is labeled as an apnea case if it contains at least one condition of apnea or hypopnea, otherwise labeled as a non-apnea. The patients mean age and weight are between 27 to 63 years (4810.8) and 53 to 135 kg (86.322.2), respectively. PhysioNet data are classified in two categories: Apnea Group (Class A, more than 100 minutes of apnea, mean age: 50 years in range of 29 to 63 years) and Normal Group (class C, less than 5 minutes of apnea, mean age of 33 years

The consequences of undiagnosed and untreated OSA are medically serious and economically costly. Continuous positive airway pressure (CPAP) is considered the gold standard of treatment for OSA along with lifestyle modifications. With CPAP use, patients can reduce their healthcare utilization and save money by reducing the impact of OSA symptoms, comorbidities, and motor vehicle accidents. Direct costs associated with comorbidities include increased medical expenses, emergency room visits, hospital inpatient visits, medication use, and mortality rates (American Academy of Sleep Medicine, 2016).

Sleep apnea is a common sleeping disorder where a person has experiences of not breathing during sleep. Over 20 million Americans, mostly overweight men, suffer from sleep apnea. Despite these numbers, sleep apnea is often not treated directly because its symptoms are thought to be those of depression, stress, or just loud snoring. There may be a genetic component to this disorder as it often occurs within families.People with sleep apnea stop breathing for at least 10 seconds at a time; these short stops in breathing can happen up to 400 times every night.

The population who are diagnosed with obstructive sleep apnea (OSA) often experience daytime drowsiness and are at risk for ischemic heart disease, arrhythmias, hypertension, and other vascular related problems (Hsu et al., 2007). There are several treatment options for people with OSA, which are weight loss, continuous positive airway pressure (CPAP), dental appliances, and surgical procedure. This study evaluates patients who have

This relaxation goes even further when the soft palate muscles and uvula (fleshy tissue) sag over the airway as well, creating the "labored and noisy" (Sleep Apnea) so readily associated with the condition. It is important for the student to know that there are times when this blockage causes breathing to stop entirely. Interestingly, those who suffer with sleep apnea do not realize it, inasmuch as another person typically hears the startling noises and suggests that there is a problem. The sufferer may display frequent episodes of falling asleep on the job, giving work associates the clue, as well. "People with sleep apnea usually aren't even aware they have a problem and may not believe it when told" (Sleep Apnea). Inasmuch as sleep apnea is potentially life threatening, it is imperative that the sufferer seeks immediate diagnosis and treatment. Early recognition and treatment of obstructive sleep apnea is a critical step not only in getting a more restful night's sleep, but also in avoiding the potential complications of irregular heartbeat, high blood pressure, heart attack and stroke. Sleep apnea is more prevalent in men and young African-Americans; however, it has been diagnosed during all life stages. It is important for the student to know that attaining proper diagnosis of obstructive sleep apnea includes consultation with a primary care physician, pulmonologist, neurologist

OSA is characterized by repeated episodes of either partial or complete obstruction of the upper airways during sleep due to excessive relaxation of airway musculature, which leads to cessation

Upon arriving at the scene, the advanced care paramedic would begin the primary survey. All dangers would be assessed, including environmental dangers, animals, agitated bystanders and any other alarming cues. Once all dangers have been assessed the ACPs begin investigating the patient’s responsiveness using the acronym AVPU (QLD.gov.au, 2016). An assessment of their alertness, verbal response, response to painful stimuli or unconsciousness is completed. Once assessed, the patient’s airway is then checked to be clear of any obstructions to ensure proper respiration can occur, at this point, the triple airway manoeuvre would be adjusted to only the opening of the mouth and the jaw thrust (QLD.gov.au, 2015). If the patient complains of neck and back tenderness, neurological deficit, evidence of intoxication or a distracting injury (QLD.gov.au, 2016. 2) spinal immobilisation is required to ensure no further damage to the spinal cord occurs or an aid to keep the patient as calm as possible if a distracting injury (Hodegetts et al., 2011). The patient's breathing should then be assessed now that the spine in immobilised to ensure the depth, rate and rhythm of the breaths are adequate. If needed an oropharyngeal airway may need to be inserted into the mouth to keep the tongue from blocking the airway if it is tolerated (Higginson et al,. 2013). Lastly, in the primary survey, the

ation that I will be discussing is Airway Pressure Release Ventilation (APRV). I have not had an opportunity to use this mode, so I thought I would research it for this assignment. “The degree of ventilator support with APRV is determined by the duration of the two CPAP levels and the mechanically delivered tidal volume. Depends mainly on respiratory compliance and the difference between the CPAP levels. By design, changes in ventilatory demand do not alter the level of mechanical support during APRV. When spontaneous breathing is absent, APRV is not different from conventional pressure-controlled, time-cycled mechanical ventilation”( Putensen, C. )APRV is a form of improved pressure ventilation allowing unrestricted spontaneous breath at an

Sleep apnea is a medical condition that should never be ignored. When a person suffers from this disorder, he or she repeatedly starts and stops breathing when they are sleeping, and this may occur hundreds of times each night. Sleep apnea comes in many forms, with the most common being obstructive sleep apnea. This type of apnea occurs when the muscles of the throat relax. A dentist may need to be seen to assist in the treatment of this condition, one which is often marked by drowsiness during the day and loud snoring at night. What do individuals need to know about this condition?

Continuous Positive Airway Pressure or CPAP as it is known, uses forced air to keep a patients airway open. It has common uses that most people are familiar with such as sleep apnea. But it also used in emergency and hospitals routinely to treat sicknesses such as congestive heart failure. In this essay I will give a brief history on CPAP, a basic overview of its anatomy and the some of the many uses of CPAP and health benefits.

Sleep apnea is characterized in a similar manner to hypopnea, a lack of airflow and oxygen levels at night whilst sleeping. However there are some key differences. Sleep hypopnea is a part of the obstructive sleep apnea family, and therefore has to deal with any obstructions that occur in the airways whilst sleeping (Phillips, 2015). Central sleep apnea, is another type of sleep apnea that can occur in people. This apnea is very different from obstructive sleep apnea. This apnea is caused because the brain temporarily fails to signal to the muscles that are in charge of controlled breathing. Obstructive sleep apnea is referred to as a mechanical problem, whereas central sleep apnea is referred to as a communication problem (Phillips, 2015). Central sleep apnea is much less common than obstructive sleep apnea and it can be caused by medical conditions that affect the brainstem. The symptoms of central sleep apnea are very similar to obstructive sleep apnea: stopping breathing or irregular breathing during sleep, shortness of breath leading to awakenings, chronic fatigue, excessive daytime drowsiness, morning headaches, poor/restless sleep, difficulty concentrating, mood changes, and snoring (Phillips, 2015). The treatment for central sleep apnea is by using a CPAP machine or a BPAP machine (which is very similar to a CPAP), certain medications have also been known to help stimulate proper breathing whilst sleeping (Phillips, 2015). Finally, the last kind of sleep apnea that can occur is complex sleep apnea. This type of sleep apnea is a mixture of obstructive sleep apnea and central sleep apnea. Essentially, this type of apnea occurs because of slight obstruction and the brain failing to properly inform the muscles to breathe (Phillip, 2015). BPAP machines and Adaptive servo ventilators “have shown successful use as the machines are capable of performing a

CPAP systems use mild pressure with a variety of flimsy, light-weight masks that are very fragile and secured to the cranium

of sleep apnea are obstructive sleep apnea (OSA), central sleep apnea (CSA), and complex sleep