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CPAP use in the hospital - PaulaO2 - 09-04-2016
I recently had surgery and had to use my CPAP in the recovery room and in my overnight stay.
Or I was supposed to.
The surgery was scheduled quickly due to a lot of openings. I tried contacting the hospital first (about the CPAP) and their contact person said it was up to my surgeon if I could use it while in the hospital. I decided she was incorrect and would wait until the pre-op appt. The Pre-Op nurse gave me a form to sign saying I was bringing my own already set to my treatment pressure. She also said she would send an email out to remind everyone that the form exists. She told me that if I did not bring my own machine, it would cost me $800 to rent one from the hospital. I didn't ask if that was per day or per visit.
We arrived the morning of the surgery with the CPAP and was told to give it to the actual surgical staff who would make sure it was used in post-op recovery. Due to a meeting that ran over and a surgery that ran over, my 10:15 surgery did not happen until 1pm. When I woke, I was not wearing the CPAP. I was in too much pain to complain about it at the time.
When we got to my room, it was the floor nurse that asked why I was not attached to it. She set it up and got me hooked up but could not get the oxygen attached to it. I had the adapter but their hose was one piece or something. Without the CPAP, my O2 jumped between 95 and 80%. But I kept snoring, twitching, and jerking awake. With it but without O2, my O2 dropped to 76. The nurse muted the O2 sensor and got a call into the Respiratory crew to come and do the hose. If I was awake, we put on the O2. When I dozed off, they put on my mask.
Many hours later, when she finally came, she was pleased to see that the CPAP was attached (she thought she was going to have to set it up and all that) but displeased that the correct hose had not been provided. It was in her notes that I had the CPAP but whatever Respiratory crew was supposed to ensure the correct hose was in there for me, failed. She quickly made the hose adjustment, hooked it into my adapter, and viola, my O2 jumped to where it was supposed to be.
The staff all worked around it. Mason, the night nurse, adjusted it for me at one point because it was leaking and I couldn't reach it to fix it. He then moved the hose around to take the weight off the mask.
What will I do in response or for the next time?
1- not sure I will have surgery on such short notice again.
2- and I will stop the rushing staff and say "what about this?" as I point to the CPAP. I don't know why I was not attached to it in the recovery room like I should have been
What can YOU do?
1- find out the hospital's policy. The most likely path is to go through their Pre-Op or Day Surgery department. You can also contact the Respiratory Department.
2 - Ask if there is anything you can do to make it easier. My adapter for my CPAP hose was a good thing. But did I also need the adapter for their hose? I think it was just a matter of it was round without an obvious end.
3 - be assertive but not obnoxious.
4 - one thing we practiced ahead of time is her putting the mask on me without any help from me at all. Because we knew I wouldn't be able to help. It took a while, but she got the hang of it. I think seeing my nose stretch helped! She still keeps putting the top strap of the Nuance on my forehead though. Then she looks at it, mumbles, and moves it to the top. Turning the machine on and off is easy enough but keeping the hose untangled has been a challenge! I got a new hose but couldn't afford a new SlimLine. She hates it. We switched back to an old Slimline and now doesn't threaten to kill me with it. So practice with all the parts. Repeat it over and over. Practice putting the mask on with you laying down on a pillow.
RE: CPAP use in the hospital - PaytonA - 09-04-2016
Whew! Glad you are done with that. Take care of yourself, Paula.
RE: CPAP use in the hospital - srlevine1 - 09-04-2016
(09-04-2016, 02:12 PM)PaulaO2 Wrote: What can YOU do?
I would add ...
5. Make sure all of your equipment is marked clearly with your name and birthdate for disambiguation.
6. Bring a 12-foot piece of plastic tubing in the correct size to interface with your mask. Also an extension cord. This makes sure that everything reaches properly. I also carry a plastic tubing connector -- a little plastic piece with barbs on both ends.
7. Bring your own mask wipes. (Bacterial wipes if you have them)
8. Be prepared to toss the mask cushion, hose, oxygen line, and sterilize everything well after your stay as hospitals have their own biological contaminants . I use Control III as a soak for the water chamber and mask frame when returning home.
9 Be prepared to be billed by the respiratory department for a set-up and periodic visits. Even if all they do is stop by and ask how things are going.
10. Be prepared to sign a waiver absolving them of all responsibility when using your own equipment.
11. I would also check that any damage to the equipment in the facility is covered by my homeowner's insurance and that your DME can provide a replacement machine within 24-hours if necessary.
I have a travel checklist that I use to make sure that I take everything and that there are no surprises. I also carry an end-cap for my ResMed S10 because some physicians do not want you to use a humidifier under certain conditions.
RE: CPAP use in the hospital - Sn00zeAlarm - 09-04-2016
I am amazed how poor communication is between departments in hospitals. Your story could have happened in my local hospital. Each individual person appears very competent but collectively they ... are not.
RE: CPAP use in the hospital - PaulaO2 - 09-04-2016
Yes, each place I went, the staff were freakin' fantastic. But communication between them were non-existent. Like, at the pre-op, I was given a white folder full of paperwork I had signed and some other stuff pertaining to my registration. I was told to bring it back the morning of the surgery. That it was very important to do so. I did. No one asked for it.
I was told to bathe twice. Once the night before and once the morning of, using special soap. Pre-op really stressed this multiple times. No one the day of surgery confirmed that I did. And we went through a lot of trouble to get the special soap!
But again, the staff were all exceptional. I was treated with respect. My assigned nurse or the CNA would come in often to make sure I had everything within reach. No one reeked of perfume or cologne (problems I have had on previous visits). It was looking like I may have to stay another day because I was not moving as well as PT thought I should be. PT and the doc had a "discussion" apparently. I couldn't convince PT that I was a crip before I came in but apparently the doc was able to. Bless their hearts.