Need guidance for a patient

IllinoisRRT · Post by **IllinoisRRT** » Thu Dec 02, 2004 3:29 pm

I have a patient on BiPAP who has been very difficult to find a mask for. He will not use a nasal mask or cannula/pillow type device because he is a mouth breather. He has tried just about every full face mask that I know of, and I am going to set him up with a F-P Oracle next week. If, for whatever reason, he doesn't like it, what other options do I have? Are any of you in similar situations? What is another option for me to give him?

Titrator · Post by **Titrator** » Thu Dec 02, 2004 4:26 pm

Hi RT,

Sounds like you have tried the kitchen sink on this patient. There is a full face mask made by Fisher Paykel. It is called the Flexfit 431. It seals just under the chin, instead of just below the lower lip. This may be something that he would like. I recommended it to a woman whos mother had a very hard time with all masks tried, and she loved it..

Here is the link to the HC 431 on cpap.com's website.

https://www.cpap.com/productpage/1410

Regards,

Ted

wading thru the muck! · Post by **wading thru the muck!** » Thu Dec 02, 2004 6:55 pm

Is your patient a mouth breather because of difficulty breathing through his nose?

If not, he may want to try some of the mouth closure schemes devised by some of the forum members. I use one devised by rested gal. I use a silcone scar therapy patch to seal my lips shut over night. Rested gal also wraps an ace bandage over hers to assist in the closure. I've found the adhesive on the ones I use (curad) keeps the patch on all night without any help. It comes off in the morning just fine and I can reuse the same patch for days.

Good luck!

chrisp · Post by **chrisp** » Mon Dec 06, 2004 9:03 pm

I've got a FP 431. All I can say is it is loud. The rush of air and it amplifies the sound of the 420E . I stopped using the mask for now.

rested gal · Post by **rested gal** » Mon Dec 06, 2004 11:44 pm

IllinoisRRT, this is a real long shot, but if the Oracle doesn't work out for your patient, you might try an Activa nasal mask (size shallow because it will be wider and blunter at the top) placed over his mouth instead of over his nose. Since you say he's a mouth breather, it won't matter that the mask doesn't cover his nose. With a bit of luck, the top of the shallow cushion will block off his nostrils, preventing any nose air leaks. If it doesn't fully block his nares, add nose plugs. Sounds crazy, I know...the idea of using a nasal mask as an oral mask, but I can use the Activa like that just fine. Since the straps can be worn very loosely, he might find that more comfortable - if his facial features let it work that way at all. Might be worth a try since you say you've tried just about everything.