Using a CPAP machine in hospital

This area is for Sleep Apnea questions and general Sleep Apnea Discussions.


Using a CPAP machine in hospital

Postby Frances » Mon May 07, 2007 12:52 am

This is a cautionary tale about CPAP use in hospital and I decided not to append it to the sticky but keep it as a stand-alone. However, if the management feels it should be with the sticky, please feel free to move it.

My husband, the CPAP user, spent almost 9 weeks in hospital this winter - he has only been home about 3 weeks. It started with a compression fracture of the L1 vertebra, along with edema in his legs which was exacerbated by the immobility that went with the fracture. We were trying to manage at home but he fell and damaged the skin of his legs which became infected. By the time he was seen in the emergency dept., he was very ill, with both the cellulitis infection and with septicemia.

After a couple of days, I took the CPAP machine and mask to his room but he was unable to tolerate it. The hospital was very hot (much too hot - I can't imagine what they were thinking) and the air extremely dry. In addition, my husband was getting supplemental oxygen through those little nasal canulas. Between them, they dried out his nose so that he was getting nose bleeds, and as well, his nose was too congested to breathe through. Also, the edema affected his whole body and not just his legs and his face was too puffy for the mask to fit properly. I encouraged him to keep trying and I urged the medical staff to give him some help and a respiratory technician did come once to see him at bedtime to try to adjust things but the situation was just too difficult for anything to work.

So, for all that time, even as he began to improve and after he had beaten the infections, he didn't get to use the machine. Now that he is home, he is trying again but he can't get the mask to seal properly; I think he needs a new mask. He'll get one but it is still somewhat difficult for him to get around so it is slow going.

The odd thing is, though, that he hardly snores at all in bed and this is a big change. If he falls asleep sitting up in his chair in the living room, he does snore but not in bed. Because it is more comfortable for his back, he is sleeping on 3 pillows and more or less on his back, although he does roll a bit to his right.

And, yes, the vertebra has healed but just barely and he needs some physiotherapy to strengthen the muscles and loosen them up. And also, yes, he is walking, with a walker. And driving.

The hospital didn't worry about the sleep apnea and if they wouldn't take it seriously, there wasn't much I could do. But there was no questioning of the machine or mask.
Otherwise, he got good care although on 2 occasions, concerning somewhat peripheral matters, I had to lose my temper to get some action.

BTW, in the summer of '06, he ended up in the ER of a different hospital for 2 nights with pneumonia and when the doctor discovered that my husband used a CPAP machine, he had me bring it in for the second night. Again, no questioning of the machine or mask.
Frances
 
Posts: 984
Joined: Tue Jan 17, 2006 11:41 pm
Location: Toronto, Ontario, Canada

Postby manuel » Mon May 07, 2007 1:46 am

Frances wrote:In addition, my husband was getting supplemental oxygen through those little nasal canulas. Between them, they dried out his nose so that he was getting nose bleeds, and as well, his nose was too congested to breathe through.


Next time, please ask the respiratory therapist to add a humidifier to the oxygen--it's a simple matter for the RT. You really shouldn't have to ask for this if the RT is doing his/her job. The RT should know patients on O2 for any length of time get nose bleeds.

Frances wrote:The hospital didn't worry about the sleep apnea and if they wouldn't take it seriously, there wasn't much I could do. But there was no questioning of the machine or mask.


This is doctor's fault for not ordering it. If the doctor doesn't include CPAP on your husband's chart no one will follow up on it. When your husband brings in his own cpap the hospital staff knows it necessary--that's why they don't question it. You managed to flag down an RT to assist with the CPAP. If the doctor had ordered the CPAP it would have been included in his treatment without having you bring the matter to someone's attention.

I'm a registered nurse and I know how difficult it is for patients to get simple things taken care of. Hospitals can be frustrating. If the hospital sends out a survey make sure and fill it out. Explain what happened. They should follow up on your complaint.
User avatar
manuel
 
Posts: 133
Joined: Mon Mar 26, 2007 3:47 am
Location: Warren, MI
Machine: S9 Autoset
Mask: Ultra Mirage
Humidifier: YES
Year Diagnosed: 2006

Postby Frances » Mon May 07, 2007 10:19 pm

Manuel, I didn't know that one could add a humidifier to the supplemental oxygen - thanks for that information. The problem was certainly obvious to the nurses so I don't think they knew that either. Heaven forfend that there should be a next time, once in a lifetime is enough for anybody, but I'll remember, just in case.

It didn't help that my husband was too sick to care for several weeks. They did make some effort to deal with the nasal congestion but in the long run no one took it very seriously.

Looking back on my posting, I see that I didn't make the point that I should have. It is all well and good to want to use your CPAP machine in the hospital but circumstances can conspire against it. And these circumstances were definitely unusual.
Frances
 
Posts: 984
Joined: Tue Jan 17, 2006 11:41 pm
Location: Toronto, Ontario, Canada

Postby manuel » Tue May 08, 2007 12:59 am

Frances wrote: Manuel, I didn't know that one could add a humidifier to the supplemental oxygen - thanks for that information. The problem was certainly obvious to the nurses so I don't think they knew that either.


The humidifier is a small bottle water. It takes less than a minute to set up. I’m sure the nurses are familiar with it as well. If it was my patient I would have taken care of it myself. You usually don’t need an order for it—it’s considered a comfort measure.

This might help next time. Many patients come to the ER with a list of their medications (usually typewritten). Make such a list and add “CPAP at 10cm H20 at bedtimeâ€
User avatar
manuel
 
Posts: 133
Joined: Mon Mar 26, 2007 3:47 am
Location: Warren, MI
Machine: S9 Autoset
Mask: Ultra Mirage
Humidifier: YES
Year Diagnosed: 2006

Postby Vicki » Tue May 08, 2007 11:52 am

See the ASAA "Hospital Use of CPAP" draft guidelines. In top stickies.

Vicki
Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Vos Savant

That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.
User avatar
Vicki
Moderator
 
Posts: 6311
Joined: Tue May 31, 2005 8:21 pm
Location: Southern California
Machine: DeVilbiss IntelliPAP
Mask: Fisher & Paykel Flexifit 431
Humidifier: Rarely as needed
Year Diagnosed: 1999



  • Site Supporter

  • Similar topics
    Replies
    Views
    Author

Return to SLEEP APNEA HELP!

Who is online

Users browsing this forum: dqdzfdpxa, drdektdfz, eidcfnegi, fthjcbvqc, fzmjqwatv, gjdhletd, gjeitsqm, gjfufklbv, gjhjfzug, gjhkegdd, gjimzyinb, gjkbgddz, gjkkbzuz, gjlcjxoi, gjljorhqx, gjlmcdkrn, gjmtunbw, gjmxypjz, gjnisugih, gjnljnsq, gjpazzal, gjpqjnjr, gjpvbatk, gjqblebb, gjqhtybe, gjqvfmnkh, gjrercxb, gjshtwpe, gjsuitlo, gjtbijwod, gjtslnwya, gjugrrji, gjwjxdpr, gjwotomj, gjxtuwwep, gkyarvaph, hyjwiaqnl, hzgpklygm, Impubcusetems, juzjfnwwz, jwrzrnada, knkwnrjoa, kxzvdmsik, lbrmwgaza, lrklxcgpw, lwqjmjpuu, mcrzqaoiy, mkosqwjph, nosorimei, ntjxfnnfk, nupxblvkz, ofbbfuwek, oiiikgkvj, pcsubrvdj, qkfygvdrp, rewtsskgz, soppnpkxg, srovtnruo, uggjldtzg, umkgydppm, usuaokzzl, vkeyknrda, vmllxkdft, vxbrwzgvk, watdjgzde, wsmztkopl, wvpkyxhmu, xfmaggtou, ylsqquxph, zcwiejbwn, zggprxbsh and 2 guests

cron