HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE
Respiratory: References
PURPOSE:
To safely maintain a patient diagnosis with sleep apnea
PROCEDURE:
1. Adhere to Universal Precautions.
in the home setting utilizing CPAP or BIPAP. 2. Check equipment – make sure all connections are
tight and equipment is plugged in.
CONSIDERATIONS: 3. Check settings with physician orders
1. CPAP is the use of positive airway pressure to the
airways via a mask or nasal pillow to maintain
patency and prevent pharyngeal collapse.
CPAP – amount of resistance (measured in cm of
H20) Pressure from 2-20cm H 20
BIPAP – Inspiratory resistance pressure Expiratory
resistance pressure Possible use of humidifier
2. CPAP is indicated in use for treatment of sleep
apnea. 4. Instruct patient to wash and dry face prior to placing
mask on.
3. Side effects of CPAP include:
a. Claustrophobia 5. Place mask or nasal pillows on patient. Assess fit.
b. Drying of nasopharyngeal mucosa 6. Turn flow generator on.
c. Skin irritation and potential breakdown of skin
under mask
d. Pain from sinus or inner ear infection
4. BIPAP is the use of positive airway pressure at two
different settings; a higher one for inspiration and a
lower one for expiration.
5. BIPAP is indicated for treatment of sleep apneas
that require higher levels of CPAP (>10cm H20) to
resolve apneic periods.
7. Patient can be instructed to leave mask on and
disconnect tubing to get up during night.
AFTER CARE
1. Mask or nasal pillows, tubing, valves and filters
must be cleaned according to manufacturer’s
recommendation.
6. Side effects are the same as those associated with 2. Document in patient’s record:
CPAP. a. CPAP/BIPAP settings
b. Skin integrity including mucous membranes
7. The respiratory equipment company does initial
c. Evidence of pain, if any
setup including demonstration, instruction, and
d. Respiratory status
written instructions on care settings and use of
e. Instructions given to patient/caregiver.
equipment.
f. Patient/caregiver understanding of instructions.
EQUIPMENT:
CPAP or BIPAP flow generator
CPAP mask or nasal pillows with straps marked for
adequate fit
Gloves
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