cpap pressure setting

neversleeps · Post by **neversleeps** » Tue Jun 21, 2005 10:52 pm

When I attempt to access the website you referenced: http://www.in.gov/legislative/ic/title25/ar34.5
I get the following response from Access Indiana:

The web page you have requested could not be located on our server. If you provided the web address yourself, please verify that what you've typed is correct.
Thank you for using accessIndiana

rested gal · Post by **rested gal** » Tue Jun 21, 2005 11:49 pm

After some digging backward into the URL that didn't work, I finally worked my way to what I think the person meant to link in Indiana's code:

IC 25-34.5-3 Chapter 3. Violations and Sanctions

momexp5 · Post by **momexp5** » Wed Jun 22, 2005 6:22 am

I read the material at the link RG figured out. I don't think it applies to people treating themselves, I think it's meant to prohibit second parties from practicing for money on others.

Shoot, there's lots of parallels. You can do anything you want to yourself, pretty much, that it'd be illegal for someone else to make money doing on you without training.

All those breastfeeding mothers in the 50s who ignored the advice of pediatricians... practicing medicine on their poor little babies, tsk tsk

Well, hang the consequences, I lowered my pressure one point. I also got a petite mask to replace the small one the DME gave me. I had a much better night of sleep last night.

3isles · Post by **3isles** » Wed Jun 22, 2005 7:22 am

[quote="Anonymous (snip) I understand the logistics behind wanting to take matters in your own hands when the therapy that everyone said would make you feel great doesn't, but I have also seen first hand the irreversible damage that overexpanding your lungs can do to a person.
,,,,,,,,,snip,,,,,,,,,,,,,,,,
I would hate for someone to damage their lungs so badly, that they ended up ventilator dependant and stuck in an ICU for months. All because they thought that turning up their CPAP a "little" would be okay. Most people are shaking their heads right now saying, 'A little bit won't hurt me', but everyone's body is different and everyone's airway muscles have their own compliance issues. One person who might say that 14cwp isn't very much pressure for them, might pass that along to someone who's airway is already damaged by 20 years of continued smoking. That person might turn their CPAP from 8 to 14cwp because so-and-so said that it wasn't very much pressure for them, and end up with a pneumothorax that leads to hospitalization or even death. I know that sounds far fetched, but the reality is that it could happen.

Sorry to have caused such a ruckus! Happy Sleeping![/i]

Ok, so you are saying that xpap can damage a person's lungs? And from a slight adjustment in pressure? I am sure glad you didn't want to create a ruckus, but if you ever do, I know where you can post this that would create a real frenzy...

In my experience doctors and experts can make mistakes too. For instance (very fresh in my mind) I was SURE that my daughter's seizure med was causing pancreatitis, (it is a known though very rare side effect) I just didn't know how to prove it. All her docs said it was impossible because she had been on it without problem for 8 years. It took me 6 months of badgering all her docs(pedi/neurologist/gastroenterologist/endocrinologist) until finally the gastroenterologist ordered the necessary tests. As soon as he saw the results he pulled her off the med immediately even though there would be withdrawal issues. I was right and they were wrong. We have can't just blindly trust that what we are told is true. I do not advocate just going off the deep end and taking your treatment into your own hands, but do keep pushing for answers and action. And make them let you try things to make it work for you.

ozij · Post by **ozij** » Wed Jun 22, 2005 7:22 am

Information Maintained by the Office of Code Revision Indiana Legislative Services Agency wrote: IC 25-34.5-3-5
Conditions for operation of equipment by health care nonprofessional
Sec. 5. An individual who is not licensed, registered, or certified as a health care professional may deliver, set up, calibrate, and demonstrate the mechanical operation of respiratory care equipment in a residential setting only when the following conditions are met:.....<snipped>...

(3) The individual does not attach the respiratory care equipment to the patient

(my emphasis)

Guess who attaches the equipment to the faces of xPAP users in their residences in Indiana every evening.
Bunch of crimnals, all of them.

O.

neversleeps · Post by **neversleeps** » Wed Jun 22, 2005 7:45 am

momexp5,

You crack me up!!! I came to the same conclusion you did after reading it last night. If it applied to the patient, it would be illegal for us to attach ourselves to our own cpap machines at night!!! (IC25-34.5-3-5 number 3.)

Certainly is a relief to know none of us are doing anything illegal! Well, with our CPAP therapy anyway... .

neversleeps · Post by **neversleeps** » Wed Jun 22, 2005 7:50 am

OOOPS!

I didn't see your post ozij. I'm being redundant, I suppose!! It's kind of sad an RT would lead cpap patients to believe they were doing something illegal by adjusting their own pressure. That's why we need to see the actual document someone is referencing, so we can point out just such misinformation!

mikemoran · Post by **mikemoran** » Wed Jun 22, 2005 8:50 am

Wait!!!!!!! AutoPAPs are machines that adjust the pressure upward and downwards slightly. Are they killing us making our lungs explode? Or are they illegal because there isn't a practioner doing the adjustment? Guess I better not use mine just in case.

rested gal · Post by **rested gal** » Wed Jun 22, 2005 2:57 pm

I am sure glad you didn't want to create a ruckus,
but if you ever do, I know where you can post this that
would create a real frenzy...

3isles, that was funny!!
Gosh, I hope "2-2" (some of ya'll know who I mean!)
doesn't find this board... or this topic!

3isles · Post by **3isles** » Wed Jun 22, 2005 3:53 pm

I couldn't help myself....(rolling on the floor with evil laughter....)

tomkat · Post by **tomkat** » Wed Jun 22, 2005 4:58 pm

As a recent (one month) APAP user I was curious what the actual PSI (pounds per square inch) pressures were. Using a units conversion handbook I obtained the following results: 1 cm of water = 0.01425 PSI.
4 cm H20 = 0.057 PSI; 8 cm H2O = 0.114 PSI; 12 cm H2O = 0.171 PSI; 16 cm H2O = 0.228 PSI and finally 20 cm H2O = 0.285 PSI. Atmospheric pressure is approximately 14.7 PSI so an increase of only approximately one-quarter of one PSI (at 20 cm H2O) (most of us are at an even lower setting) makes all the difference in the world! The CPAP/APAP produces sufficient volume of air to maintain the preset pressure. When you remove your mask the machine generates the maximum volume (CFM) of air it can in an attempt to maintain the set pressure (it can't do it with no load to work against). When your mask is in place, with even a small leak, the machine usually can generate enough volume to achieve the preset pressure. The extremely low additional pressure (above atmospheric) really surprised me especially when compared to common pressures we are all familiar with such as automobile tires (approx. 30 PSI).

so tired · Post by **so tired** » Wed Jun 22, 2005 7:20 pm

I think you guys were too hard on Guest! He was just trying to help. Personally, as a medical professional myself, I don't think it's that farfetched to think of a physician contacting the insurance company for noncompliance. Sometimes situations call for drastic measures, (and I am NOT talking about adjusting CPAP!) I for one would not adjust mine without consulting the physician first, who would then write the order. Maybe after I have more experience, I will feel differently, after all, I'm a newbie!

neversleeps · Post by **neversleeps** » Wed Jun 22, 2005 8:38 pm

Hi so tired.

I'm not sure which part of Guest's post was an indication to you that he was "just trying to help." Was it the part where he tried to scare cpap users into using only their DME/sleep doctor to change their pressure settings by telling them it was illegal for them to do it themselves?

You wrote:

I for one would not adjust mine without consulting the physician first, who would then write the order.

Certainly that is up to you. The point is, you are aware that it is not illegal for you to adjust it yourself. If you have a lot of time and money to spend on such appointments, then why not. However, in the future, if you should decide to monitor your own therapy by using the software provided by the CPAP manufacturer, you may elect to make your own adjustments. You will see on a nightly basis the number of events that occurred, and be able to track the optimum pressure settings with the least resultant apnea events. Some CPAP users are committed to being proactive in their therapy and find use of the data provided an absolute necessity to obtain the best treatment. Others have no interest in the day to day results, and prefer to stop in at the doctor's office a couple times a year.

What has happened over time, as more and more CPAP users obtain the software and monitor their results, is that many of us have come to realize we are much more involved than our DME's/Sleep docs. Many users have complained that their DME's/Sleep Docs never even download the information, or if they do, they only check for compliance. Even harder to swallow, is that we are paying them for this 'service'! As more users are taking their treatment into their own hands, the DME's/Sleep docs make less money. So you'll find we may seem to be hard on them, but experience has taught us that many are angry that we are taking money out of their pockets. While it's always prudent to verify any information one is given, it is of utmost importance when the information is given by someone who has an agenda.

I think you are absolutely right when you say,

Maybe after I have more experience, I will feel differently, after all, I'm a newbie!

Guest · Post by **Guest** » Thu Jun 23, 2005 12:58 pm

[quote="tomkat"]... The extremely low additional pressure (above atmospheric) really surprised me especially when compared to common pressures we are all familiar with such as automobile tires (approx. 30 PSI).
/quote]

30 psi would blow your lungs apart.

Try blowing against a tire pressure gauge and see where it gets you.

neversleeps · Post by **neversleeps** » Thu Jun 23, 2005 1:16 pm

I believe that is exactly the point tomkat was making...

cpap pressure setting

CPAP/APAP pressures converted to PSI

Re: CPAP/APAP pressures converted to PSI

Humidifier