Today I traveled to Portland, where the weather was very pleasant to visit the PDH sleep centre. During the morning we spent some time refreshing or for some newer staff members learning how to fit a cpap mask.
I was one of the ‘refreshers’ and thought I was quite experienced when it came to fitting masks but there were a few useful pieces of information that challenged my way of thinking.
Different people, places and companies all have their own ideas, routines or procedures when fitting cpap masks but the main two points are find a mask the minimizes leak and maximizes patient comfort.
I veered toward being a nasal mask advocate, always letting the patient try a full face as a comparison but was of the belief that nasal if they fitted well, the patient was able to tolerate it and there were no leaks it was a good choice. My reasoning being full faces having more surface area seemed to provide more opportunities to leak.
Nasal pillows were on my last resort list, although on many occasions I have seen them be very effective in managing OSA. If a patient arrived armed with some research and wanted to try them of course I would oblige but other than that I did not always offer patients the choice to try these on. My reasoning this time was nasal pillows can be very fiddly, difficult to fit and less tolerant of higher pressures.
The advice given today was always allow the patient to try on the three different sorts of masks. Unless they try them on we cannot make a judgment as to what fits them, what the patient finds the most comfortable and ultimately it is the patient who chooses the mask.
For the record I had on a nasal mask for a while today at 10cmH20. It was more comfortable than I remember and I think it is important to periodically wear different mask to give an insight into what the patients are experiencing. Kath tried on nasal pillows at 20cmH20. The mask tolerated this pressure and so did Kath! Raelene fitted her first mask on Gerri and also experienced cpap for the first time.
Pictured above are the three different types of masks mentioned. Our trainer today suggested we try to use cpap for a week to gain an even greater understanding of what our patient’s experience. Maybe I will blog about this at a later date.
Jessica
I was one of the ‘refreshers’ and thought I was quite experienced when it came to fitting masks but there were a few useful pieces of information that challenged my way of thinking.
Different people, places and companies all have their own ideas, routines or procedures when fitting cpap masks but the main two points are find a mask the minimizes leak and maximizes patient comfort.
I veered toward being a nasal mask advocate, always letting the patient try a full face as a comparison but was of the belief that nasal if they fitted well, the patient was able to tolerate it and there were no leaks it was a good choice. My reasoning being full faces having more surface area seemed to provide more opportunities to leak.
Nasal pillows were on my last resort list, although on many occasions I have seen them be very effective in managing OSA. If a patient arrived armed with some research and wanted to try them of course I would oblige but other than that I did not always offer patients the choice to try these on. My reasoning this time was nasal pillows can be very fiddly, difficult to fit and less tolerant of higher pressures.
The advice given today was always allow the patient to try on the three different sorts of masks. Unless they try them on we cannot make a judgment as to what fits them, what the patient finds the most comfortable and ultimately it is the patient who chooses the mask.
For the record I had on a nasal mask for a while today at 10cmH20. It was more comfortable than I remember and I think it is important to periodically wear different mask to give an insight into what the patients are experiencing. Kath tried on nasal pillows at 20cmH20. The mask tolerated this pressure and so did Kath! Raelene fitted her first mask on Gerri and also experienced cpap for the first time.
Pictured above are the three different types of masks mentioned. Our trainer today suggested we try to use cpap for a week to gain an even greater understanding of what our patient’s experience. Maybe I will blog about this at a later date.
Jessica
.jpg){kind=link}
No comments:
Post a Comment