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49er wrote:And once again, they are feeding the myth that oxygen is the answer when if the patient can't breath, it is useless.

Meanwhile, can you specifically explain what you mean here?

Thanks.

49er wrote:I had a 33 AHI although I think half were false centrals. Maybe the key is I need to be upright more?

Were the other half scored on the basis of desaturations or arousals?

Morbius wrote:

49er wrote:I had a 33 AHI although I think half were false centrals. Maybe the key is I need to be upright more?

Were the other half scored on the basis of desaturations or arousals?

Sorry I wasn't clear. This happened when I was taking a nap at home. The reason I believe the centrals were false is I noticed when I am trying to fit the Full Face Fit Life mask so it doesn't leak that there are occasional breathing pauses. Similar to what happens when I have used a nasal pillow mask in the past. Of course, I could be totally off base.

I realize one occurrence doesn't prove anything but in the past, when I slept on the wedge, my AHI seemed to be higher than normal even with the elan nasal mask.

Morbius wrote:
Further, OSA is frequently positional, and the one position nobody talks about around here is upright (for obvious reasons)(or maybe not). Consequently, the recommendation is to place patient in a semi-upright position (because they are, in fact, not there to sleep, they are there to wake up):

http://www.aaahc.org/Documents/Institut ... %20pdf.pdf

Ha, the one time I ended up in ER and was dozing off sitting up my SPO dropped to mid 70's.

Morbius wrote:

49er wrote:And once again, they are feeding the myth that oxygen is the answer when if the patient can't breath, it is useless.

Meanwhile, can you specifically explain what you mean here?

Thanks.

If you are not breathing in then all the O2 in the world won't reach the lungs, it will just feed the room.

BlackSpinner wrote:

Morbius wrote:

49er wrote:And once again, they are feeding the myth that oxygen is the answer when if the patient can't breath, it is useless.

Meanwhile, can you specifically explain what you mean here?

Thanks.

If you are not breathing in then all the O2 in the world won't reach the lungs, it will just feed the room.

Nor will a CPAP help that.

BlackSpinner wrote:

Morbius wrote:
Further, OSA is frequently positional, and the one position nobody talks about around here is upright (for obvious reasons)(or maybe not). Consequently, the recommendation is to place patient in a semi-upright position (because they are, in fact, not there to sleep, they are there to wake up):

http://www.aaahc.org/Documents/Institut ... %20pdf.pdf

Ha, the one time I ended up in ER and was dozing off sitting up my SPO dropped to mid 70's.

Probably artifact. Only a skilled HCP would be able to discern that.

Morbius wrote:

BlackSpinner wrote:

Morbius wrote:

49er wrote:And once again, they are feeding the myth that oxygen is the answer when if the patient can't breath, it is useless.

Meanwhile, can you specifically explain what you mean here?

Thanks.

If you are not breathing in then all the O2 in the world won't reach the lungs, it will just feed the room.

Nor will a CPAP help that.

That is exactly what a cpap machine does - keep your airways open so you can breathe. Have you ever seen a person having an apnea? They are trying to breathe but can't because their airway is collapsed, their hole abdomen is straining to attempt to breathe in.

Morbius wrote:

BlackSpinner wrote:

Morbius wrote:
Further, OSA is frequently positional, and the one position nobody talks about around here is upright (for obvious reasons)(or maybe not). Consequently, the recommendation is to place patient in a semi-upright position (because they are, in fact, not there to sleep, they are there to wake up):

http://www.aaahc.org/Documents/Institut ... %20pdf.pdf

Ha, the one time I ended up in ER and was dozing off sitting up my SPO dropped to mid 70's.

Probably artifact. Only a skilled HCP would be able to discern that.

Every time I dozed off? Really? Oh and I would wake up choking and gasping for breath.

BlackSpinner wrote:

Morbius wrote:

BlackSpinner wrote:

Morbius wrote:

49er wrote:And once again, they are feeding the myth that oxygen is the answer when if the patient can't breath, it is useless.

Meanwhile, can you specifically explain what you mean here?

Thanks.

If you are not breathing in then all the O2 in the world won't reach the lungs, it will just feed the room.

Nor will a CPAP help that.

That is exactly what a cpap machine does - keep your airways open so you can breathe. Have you ever seen a person having an apnea? They are trying to breathe but can't because their airway is collapsed, their hole abdomen is straining to attempt to breathe in.

Sorry sweetie. The (a) risk in the PACU is respiratory depression/arrest, and all the CPAP in the world won't help that.

BlackSpinner wrote:

Morbius wrote:

BlackSpinner wrote:

Morbius wrote:
Further, OSA is frequently positional, and the one position nobody talks about around here is upright (for obvious reasons)(or maybe not). Consequently, the recommendation is to place patient in a semi-upright position (because they are, in fact, not there to sleep, they are there to wake up):

http://www.aaahc.org/Documents/Institut ... %20pdf.pdf

Ha, the one time I ended up in ER and was dozing off sitting up my SPO dropped to mid 70's.

Probably artifact. Only a skilled HCP would be able to discern that.

Every time I dozed off? Really? Oh and I would wake up choking and gasping for breath.

Have you ever see a patient having an apnea? They do not

wake up choking and gasping for breath.

It was probably one of those diseases you people get.

Morbius wrote: Have you ever see a patient having an apnea? They do not

wake up choking and gasping for breath.

It was probably one of those diseases you people get.

Yes actually they do. I have done massage on people that have diagnosed OSA and they fell asleep under my hands and that is exactly how they behaved when woken up.

Have more fun nitpicking.

That is exactly what a cpap machine does - keep your airways open so you can breathe. Have you ever seen a person having an apnea? They are trying to breathe but can't because their airway is collapsed, their hole abdomen is straining to attempt to breathe in.[/quote]
Sorry sweetie. The (a) risk in the PACU is respiratory depression/arrest, and all the CPAP in the world won't help that.[/quote]

Morbius, please explain this comment. I fear having surgery (GA) and waking in the recovery room gasping with the feeling of suffocating. Why will cpap not help?
I have to add from experience that just giving a patient oxygen may improve their oxygen saturation but it does not help with the suffocating,gasping for breath. Been there done that.

In a PACU and there are many activities going on in the short amount of time a patient is there. The reason for a PACU is to monitor a patient until they are recovered from anesthesia (this means frequent awakings) and to be able to maintain their airway on their own. Unless it is contraindicated, the head of the bed will be elevated so you don't have to worry about a wedge pillow in an adjustable bed. I was always within a few feet from my patient's (no more than 2 at a time) where I could see and hear everything going on. Usually you are in the PACU from less than an hour to one and a half hours unless they are having a bed shortage but that's a different discussion. http://www.ncbi.nlm.nih.gov/pubmed/9728843
As far as the training of staff on machines, you have to take into consideration the number of different brands and types of machines if every patient brought their own. The hospitals would probably pick one machine to train staff on and let the patient bring their mask.
From my perspective, and I've been a patient also, I don't see the benefit of CPAP in PACU,for most patients, since we don't want you to sleep for long periods in the limited amount of time you are in the PACU.
Now when you are in a room, ICU or regular floor, where you are going to be sleeping for longer periods, by all means your CPAP machine is appropiate.

OkyDoky wrote:In a PACU and there are many activities going on in the short amount of time a patient is there. The reason for a PACU is to monitor a patient until they are recovered from anesthesia (this means frequent awakings) and to be able to maintain their airway on their own. Unless it is contraindicated, the head of the bed will be elevated so you don't have to worry about a wedge pillow in an adjustable bed. I was always within a few feet from my patient's (no more than 2 at a time) where I could see and hear everything going on. Usually you are in the PACU from less than an hour to one and a half hours unless they are having a bed shortage but that's a different discussion. http://www.ncbi.nlm.nih.gov/pubmed/9728843
As far as the training of staff on machines, you have to take into consideration the number of different brands and types of machines if every patient brought their own. The hospitals would probably pick one machine to train staff on and let the patient bring their mask.
From my perspective, and I've been a patient also, I don't see the benefit of CPAP in PACU,for most patients, since we don't want you to sleep for long periods in the limited amount of time you are in the PACU.
Now when you are in a room, ICU or regular floor, where you are going to be sleeping for longer periods, by all means your CPAP machine is appropiate.

I understand the purpose of the PACU is to wake patients up but to achieve that takes time. Even after you have opened your eyes you can drift off to sleep again. I can tell you that as soon as my eyes closed I stopped breathing. Having a nurse right there shaking me awake will not diminish the horrible feeling of suffocation.