Diagnostic Polysmnogram Protocol

* Depression & Irritability* * Loud snoring* * Morning headache* * Difficulty staying asleep* * Difficulty concentrating during the day* * Observed episodes of breathing cessation during sleep* * Having high blood pressure* 4. What tests help the provider diagnose OSA? * Electrocenphalogram- Detects electrical activity in the brain while awake or asleep. The brain cells communicate 24/7 via electrical impulses.

Mr. GL’s sedation was paused thirty minutes prior to performing assessment. The patient was unresponsive throughout the entirety of the head-to-toe assessment with a GCS of 3. The patient’s pupillary response was sluggish. He was on mechanical ventilation set to assist control with a respiratory rate of 26, FiO2 of 80%, PEEP of 5, and tidal volume of 500. His endotracheal tube remained at 23 inches. His chest rise was equal. Wheezing was heard in all lung fields. Heart sounds were muffled, but S1 and S2 were present. EKG revealed sinus tachycardia with a heart rate of 106. The patient’s abdomen was soft and non-distended with hypoactive bowel sounds in all four quadrants. The patient’s foley catheter was intact and patent with dark yellow, clear urine output. A

Cardiovascular Assessment: No visible pulsations, no heaves or lifts. Apical pulse present in the fifth intercostal space at the left midclavicular line. Auscultation of apical rate 62 beats per minute, normal rhythm regular S1 - S2 heart sounds present. Pulsations present when supine and disappear at a 45 degree angle position. Extremities are brown color without redness, cyanosis, lesions or varicosities bilaterally. Temperature warm bilaterally, Allen test was negative. Homan’s sign negative. Carotids: +2 and present bilaterally. Right Radial +2, left radial +1 , Right Brachial: +2

The factors used for diagnosing OSA were limited to overweight males in there 40’s; it is now known that OSA affects men and women of any age and children. The first sleep disorder was identified in 1956. The disorder was named “Pickwickian Syndrome” patients that suffered from this syndrome were all overweight and experiencing daytime sleepiness. The name Pickwickian comes from a Charles Dickens play “Pickwick Papers” one of the characters-Joe the fat boy-was so sleepy he fell asleep standing up (Dement 175). OSA was not discovered in the United States until 1970 when Dr. William C. Dement was asked by a colleague at the Stanford University Medical School to do sleep recordings on a group of Pickwickian Syndrome patients. The results of the all-night sleep study concluded that there was a significant amount of disruptive breathing through out the night. In 1965 a group of European researchers did a similar sleep study. At that time all of the studies of Pickwickian Syndrome were conducted on subjects during the daytime while the patients were awake and experiencing their daytime sleepiness. The European sleep study had found that patients stopped breathing for several seconds, many times a night, Dr. Dements had reached the same conclusions after his study showing that some patients stopped breathing for as long as 90 seconds per apneic episode this was a potentially deadly disorder. Unfortunately the Europeans discovery of this condition went

OhioHealth Sleep Services can diagnose a variety of sleep disorders, including sleep apnea, narcolepsy, insomnia, and restless leg syndrome. Sleep apnea is a frequently occurring disorder involving the collapse of the airway during sleep, causing snoring and cessation of breathing. Sleep disorders can contribute to several health risks such as hypertension, obesity, heart attack, diabetes, and stroke. Our caring and experienced sleep specialists provide you with the high quality and comprehensive medical care you deserve.

Obstructive sleep apnea: Obstructive sleep apnea (OSA) is a sleep–breathing disorder characterized by momentary episodes of either complete breathing cessation for periods of ten seconds or more (apnea) or significant reductions in breathing amplitude (hypopnea) caused by a collapsed or obstructed airway; these two conditions can lead to hypoxemia (low levels of oxygen in blood) and hypercapnia (high levels of carbon dioxide in blood). Patients are categorized as having mild, moderate or severe OSA depending on the apnea/hypopnea index (AHI), which is defined as the total numbers of apnea/hypopnea episodes per hour of sleep. In normal individuals the index is usually 5 or lower, 5-15 in mild, 15-30 in moderate and 30 or more in severe OSA patients (1, 2). In patients with mild OSA the oxyhemoglobin saturation drops to 95% and can drop below 80% in severe cases. Obstruction of the airways results in greater breathing effort and fluctuations in intrathoracic pressure, resulting in arousal, sleep interruption and reopening of the airway (3).

They also must withdraw blood to check for any condition. Inappropriate sinus tachycardia is a condition that is presented with similar symptoms of Postural Orthostatic Tachycardia Syndrome (Busmer 19). It may be difficult for medical professionals to differentiate these two conditions. Some techniques have been prone to minimize the risk of falls which consist of avoiding standing for long periods of times and if possible to keep moving. ”Postural Orthostatic Tachycardia Syndrome is a life changing condition, often affecting healthy, young, fit and active people. It affects every aspect of their lives and consequently their physiological wellbeing” (Busmer 20). Some things that could happen because of Postural Orthostatic Tachycardia Syndrome are deconditioning because of poor tolerance of exercise. People who are diagnosed with Postural Orthostatic Tachycardia Syndrome need to go through a support of any kind such as practically and emotional. Some things are made to raise awareness through healthcare professionals. Research is also needed to understand Postural Orthostatic Tachycardia Syndrome and how to approach and manage or cure this

Both of his lung fields appear clear, with normal breath sounds, no signs of pulmonary consolidation and other abnormalities detected. His apex beat show an extra heart sound (ectopic heartbeat) which is due to the narrowing of his blood vessels that connects to the heart and to the lungs, which often occurs without a clear cause and are harmless, with no signs of murmur or split heart sounds. His abdomen is significantly distended with presence of bulging flanks pushed outwards with no signs of pain or rebound tenderness on deep palpation, and when testing for shifting dullness. He was placed in a lateral decubitus position to assess fluid shift and had a positive result. Upon percussion of Frank’s abdomen in the supine position for flank

Split night polysomnogram protocol was explained upon the patients arrival. The patient is currently here to assess for sleep apneas due to symptoms such as daytime sleepiness, snoring as well as a a BMI of 34.37.

Patient was deemed to have reached maximum medical improvement (MMI). It was opined that no treatment is indicated for sleep disorder unless a polysomnogram reveals

Problem/Purpose The problem/purpose of this article is clearly and concisely stated, they discuss how prone sleeping is a major risk factor for sudden infant death syndrome (SIDS), and how some of the associated factors may be signs of cerebral hypoxia. The researchers wants to know whether sleep positions, such as supine

Skomro, R. and Kryger, M. (1999). Clinical presentations of obstructive sleep apnea syndrome. Progress in Cardiovascular Diseases, 41(5), pp.331-340.

The most familiar procedure is electroencephalogram. The EEG is the most completed procedure. EEG’s help with a lot of symptoms. They are used to help in the diagnosis of epilepsy and variation of neurological symptoms. People with head trauma or severe disease are evaluated with EEG’s. EEG monitoring is done during surgeries in the neck or around heart. This helps offer more information about brain function. EEG’s normally take about 90 minutes. Another procedure is PSG, which stands for Polysomnograms. This is a recording during sleep that uses physiologic monitors to evaluate sleep, and sleep disorders. It monitors load snoring, struggle to stay awake during the day, falling asleep at unsuitable times, and insomnia. Physician’s use Polysomnograms to recognize dysfunction in wake and sleep cycles, and breathing disorders. Evoked potentials and Nerve Conduction Studies are two other procedures ENDT’s perform. Evoked potentials are extremely helpful evalulating spinal cord injuries, hearing loss, blurred vison, acoustic neuroma, and blind spots. Nerve Conduction evaluate potentials from peripheral nerves. This test is for patients suffering from nerves that produce tingling, muscle pain, muscle cramping, muscle

The heart is as yet performing at imperfect level; when resting blood hurries to lungs and which causes his heart failure worst; tolerant is additionally encountering paroxysmal nocturnal dyspnea which includes shortness of breath when slaying down resting/sleeping; hoisting the head with pillows helps the patient rest. The term that

A pulsating mass in the abdomen can be visualized and palpated when he is supine. There is a faint palpable dorsalis pedis in the left foot. The dorsalis pedis is absent to palpation and doppler on the right. The right foot is cooler than the left but both have normal color.