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[Equipment] Wearing mask without running the machine
#1
Exclaimation 
Wearing mask without running the machine
Quite often we recommend that new members try wearing their mask while reading or watching TV to get used to it. I came across this warning on the Resmed site:

The device should only be used with masks (and connectors1) recommended by ResMed, or by a physician or respiratory therapist. A mask should not be used unless the device is turned on. Once the mask is fitted, ensure that the device is blowing air. The vent hole or holes associated with the mask should never be blocked.
Explanation: The device is intended to be used with special masks (or connectors) which have vent holes to allow continuous flow of air out of the mask. When the device is turned on and functioning properly, new air from the device flushes the exhaled air out through the mask vent holes. However, when the device is not operating, insufficient fresh air will be provided through the mask, and the exhaled air may be rebreathed. Rebreathing of exhaled air for longer than several minutes can, in some circumstances, lead to suffocation. This applies to most models of CPAP or bilevel devices
.


http://www.resmed.com/us/dam/documents/p...er_eng.pdf

While recognising that there is an element of CYA here, perhaps we should always remember to recommend that the machine must be running when wearing a mask. In the case of ASV machines, these can react to normal breathing pauses and get quite uncomfortable if used when you're awake. In this case it's probably better not to wear the mask except when your ready to sleep.

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#2
RE: Wearing mask without running the machine
I have not seen such recommendation to strap the mask on your head without having the pressure on, block the vents holes and walk around the house or go down the local pub for a schooner or two Smile


Anyway, no Q&A tonight, all about the leadership, boring
I was looking forward seeing Joan Baez on the panel

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Sleep-well

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#3
RE: Wearing mask without running the machine
I've not noticed that either. Now I have recommended that they move their CPAP machine to the living room or a room where they can sit up wearing mask while reading or watching the television for a while to get used to the feel of the blower and mask. This helps out a person who is anxious and has a hard time with therapy when they first start out.

Hopefully, a person would not misunderstand that recommendation and think to wear just a mask without the blower on! Oh-jeez
OpalRose
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#4
RE: Wearing mask without running the machine
Good Point! Even if one person construed the recommendation, as using the mask without the machine, then making a mental note to clarify this point is a good idea.
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#5
RE: Wearing mask without running the machine
(09-14-2015, 07:42 AM)OpalRose Wrote: Hopefully, a person would not misunderstand that recommendation and think to wear just a mask without the blower on! Oh-jeez

Yes, hopefully. But a lot of people brand new to CPAP come here with little or no knowledge of how things work. So following the precautionary principle, I think it's a good idea to avoid any misunderstanding.
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#6
RE: Wearing mask without running the machine
(09-14-2015, 06:57 AM)zonk Wrote: I have not seen such recommendation to strap the mask on your head without having the pressure on, block the vents holes and walk around the house or go down the local pub for a schooner or two Smile

I don't drink with my FFM on - maybe I should consider pillows...

Quote:Anyway, no Q&A tonight, all about the leadership, boring
I was looking forward seeing Joan Baez on the panel

Boring? We have a new Prime Minister! And a far far better choice than that idiot Abbott has been. Anyhow, Q&A is on here in Perth, maybe you can catch it on iView tomorrow. I'll be seeing Joan Baez in a couple of weeks - front row seats!! SHa_clap2 SHa_clap2 SHa_clap2 SHa_clap2 SHa_clap2 SHa_clap2 SHa_clap2 SHa_clap2
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#7
RE: Wearing mask without running the machine
(09-14-2015, 09:04 AM)DeepBreathing Wrote:
(09-14-2015, 06:57 AM)zonk Wrote: ... and walk around the house or go down the local pub for a schooner or two Smile

I don't drink with my FFM on - maybe I should consider pillows...

I still think the FFM needs some sort of built in straw attachment.

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#8
RE: Wearing mask without running the machine
The important question is how much air are you rebreathing, and how much does your O2 go down. Many people talk about CO2, but it's the low O2 that will hurt you.

With the CPAP machine on, there is pressure in the mask, and the vent holes in the mask leak out enough air to keep the O2 levels good.

If you have the mask on, but no hose, most of your exhaled air goes out the hose connection and you end up only breathing a little stale air. There's no problem with wearing the mask all the time as long as you don't have the hose attached.

If you put the hose on the mask, but no CPAP, most of your exhaled air goes up the hose, and then you rebreathe it when you inhale. Think of it as being like putting a plastic bag over your head with a small hole in the other end. You get some fresh air, but O2 will drop.

Full face masks have an anti asphyxia valve for this reason. With no pap pressure, it opens up and much of your exhaled air goes out into the room directly.

Don't think the the vent holes on the mask will help. While they are under the pressure, a lot of stale air goes out the vent holes. When the mask isn't pressurized, most of the exhaled air will go up the hose, where it can be rebreathed.

If you're hooked up to a non-working CPAP machine the situation is similar to having just the hose hooked up. As you exhale, there's not much air resistance and your exhaled air can go back up the hose and be rebreathed.

How bad is the problem? It's hard to say.

Oxygen deprivation is insidious. Google "confined space entry." The problem is that in a low oxygen environment, such as an enclosed space, you may lose consciousness without ever noticing something is wrong.

In theory, if you have a full face mask, the anti-asphyxia valve will keep you safe. If you have a nasal mask, the assumption seems to be that you'll just open your mouth.

Even if you don't open your mouth, there's still some fresh air. There's a little stale air that leaks out of the vents. There's also some amount of fresh air that comes in the far end of the hose, and slowly mixes with the stale air you're exhaling.

It will definitely give you a headache. Can it kill you? Well, we haven't heard of people dying like that from a CPAP machine that shut off or someone wearing just a mask and hose. However, we wouldn't necessarily know. If a CPAPer dies in the middle of the night, they'll probably not know that the power went off. If they did know the power went off, and gave it any thought, they'd probably just decide that they patient died because of his apnea. The coroner will probably just take the easy way out and decide "the poor sick, old geezer on the breathing machine just died of whatever medical condition cause him to need a ventilator."

The risk doesn't worry me unless you've taped your mouth shut with a nasal mask.
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#9
RE: Wearing mask without running the machine
I think that Resmed's statement is worth some consideration but I also think it may be Resmed covering their butts. We should definitely take note.

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#10
RE: Wearing mask without running the machine
I don't see anything wrong holding the mask against my face (few seconds, not all day), without strapping the headgear to see whether the cushion is the right size or like feel of it
If I'm happy with size and the feel, next step, try the mask with the air pressure on or even take a nap

As for re-breathing, they say re-breathing may occur at lower pressures and yet we see number of auto machine set at default settings 4-20, even by doctors and the like or fixed CPAP with Ramp start at 4. EPR is another option may also lower the pressure during exhale, if set at level 3 full time, with CPAP pressure at 7, you'll always be breathing out at 4
Personally, anything below 9, would feel like struggling and not getting enough air to breathe ... YMMV

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