Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Prescription for BiPAP
#1
Prescription for BiPAP
Can someone tell me what is the minimum data that my doctor should include in her prescription for a Resmed AirCurve 10 vAuto.

The first one she made included the following:
BiPAP (checked)
EPAP 7
IPAP 20

The supplier for the Resmed says the prescription is not correct for the AirCurve 10 vAuto.

DanEm

"If life hands you lemons, make lemonade! Words to live by, especially when you keep in mind that the only way to make them into lemonade is to squeeze the hell out of them."
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: Prescription for BiPAP
Other than having BiPAP checked, the other values can be a standard CPAP. You need a PS value setting. Also, there isn't a brand specified either. This would allow or a Philips BiPAP. Have them specify a Resmed AirCurve VAuto and the words, "dispense as written".

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#3
RE: Prescription for BiPAP
Typical is:
Resmed Vauto, EPAP min 7.0, IPAP max 20.0, PS 4.0. Dispense as written.

A more complete prescription will include the HCPCS Codes, for example my Rx was written:
BiPAP / CPAP E4070 EPAP min 9.0, IPAP max 18.0, PS 4.0
DME Supply tubing with integrated heating element A4604
Nasal interface A7034 w/ pos airway pressure headgear A7035 patient choice.

BiPAP is a proprietary term for a Philips bilevel, but the term gets thrown around like Kleenex for tissue. The purpose of including the manufacturer and model is to ensure you get the Resmed and not a substitute.

It would help to know something about your current settings and EPR. I have not seen a good daily details with your settings and results.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#4
RE: Prescription for BiPAP
Hey Sleeprider

It took a long time to get a prescription for a BiPAP.
But, I still have problems with my supplier which does not recognize the prescription as a valid one for the Resmed AirCurve 10 vAuto.
I trying to get my doctor to talk to them and sort things out.

I am including my last results with Oscar and some of my own graphics to get the overall picture.
(Those are the ones I used to convince my doctor for the change)

When I get my hands on the machine, I will come here to get all the parameters adjustments that would be required.

DanEm

"If life hands you lemons, make lemonade! Words to live by, especially when you keep in mind that the only way to make them into lemonade is to squeeze the hell out of them."
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: Prescription for BiPAP
Looking at your results, the pressure is increasing on flow limits. You're currntly limited to 3-cm pressure support with the Airsense 10 Autoset. I think the minimum EPAP pressure could be as low as 6.0 with more PS, but you should understand we may increase PS or minimum pressure based on what we see in bilevel therapy. I think you will do fine with EPAP min 6.0 PS 4.0, Max pressure 14.0. I will not be surprised if you require PS 5.0 or more based on this, but we want to start at 4.0 and move up to control flow limitation as needed. For this the following script:
EPAP min 6.0, Max pressure 14.0, PS 4.0 to 6.0, patient to self-titrate PS as needed for flow limitation and comfort.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#6
RE: Prescription for BiPAP
My priority at the moment is to get the new machine.

The people I have to deal with are not too savvy and I have learned not to forward much information.

I am hopeful I will succeed getting the machine. When I have it, I can set the parameters and follow the progress on my own. 

There is also the possibility the delivery will take some time.

I will come here when I have the machine and check all parameters with you people.

DanEm

"If life hands you lemons, make lemonade! Words to live by, especially when you keep in mind that the only way to make them into lemonade is to squeeze the hell out of them."
Post Reply Post Reply
#7
RE: Prescription for BiPAP
I wonder if they would accept that "BiPAP" means "S mode", which is specified on the VAuto in terms of EPAP and IPAP?  Those are crazy settings, but who cares as long as he sells you the machine and you set it up yourself before using it.
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: Prescription for BiPAP
The sh..... has hit the fan again :-(
The prescription I had is now on hold and my doc wants me to get titrated.

I am wondering what happens if you use an auto-titrating machine like the AirCurve 10 vAuto.
If the machine sets the pressures automatically (what I think it does), what would be the benefit of getting a titration beforehand ?

I don't mind getting titrated but I do want to understand.

All or any input will be appreciated.

Merry Xmas to all. 

DanEm

"If life hands you lemons, make lemonade! Words to live by, especially when you keep in mind that the only way to make them into lemonade is to squeeze the hell out of them."
Post Reply Post Reply
#9
RE: Prescription for BiPAP
Titration is a simple procedure of exposing the patient to pressure, observing the results, and making changes according to a decision-tree method. Typical is to start with CPAP pressure, and gradually increase pressure in 1-cm increments until obstructive apnea and hypopnea are resolved.  The main reason for performing a clinical titration is to demonstrate medical necessity for bilevel and efficacy, otherwise, there is no advantage or improvement in terms of outcome vs self-titration.  So it is mainly for satisfying insurance.  You should ask your doctor his rationale to verify.  This manual discusses the titration procedure for CPAP, bilevel and more advanced machines. https://document.resmed.com/en-us/docume...er_eng.pdf

Since a titration is being performed with the objective of determining a single IPAP and EPAP that is effective, this is a common decision-tree.  

[Image: attachment.php?aid=4203]

Obviously with the Vauto, self-titration is not only possible, but desirable.  We use the same principles shown in the procedure above to optimize the minimum EPAP and maximum pressure range and pressure support.  Typically we can identify that optimum range after a single night of recorded data with Oscar.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#10
RE: Prescription for BiPAP
First of all I and others feel the need to observe a full night's sleep, actually several to determine ones optimum settings. A titration study selects the optimum settings based on a fairly small portion of the night.

Minimum EPAP /exhale pressure is the first item to look at as that manages OA events. While an Auto device will increase pressure due to OA Events ALA PAP devices benefit from having the min setting closer to what is actually needed.

PS titration typically starts at 4 and is incremented to manage other obstructive events.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  BiPAP new therapy DanEm 41 797 02-05-2023, 06:33 PM
Last Post: DanEm
  Retrying with BiPAP Takeout Neutron 6 230 02-02-2023, 09:11 PM
Last Post: Takeout Neutron
  BiPAP Therapy nearenough 7 341 01-28-2023, 11:47 AM
Last Post: Sleeprider
  Difficulties with BiPAP cpapnewbie18 6 265 01-25-2023, 04:30 PM
Last Post: Sleeprider
  BiPAP not working for CA PSlebow 24 1,149 11-12-2022, 03:55 PM
Last Post: PSlebow
  How to get a prescription - live in rural area Madison320 22 1,604 11-11-2022, 10:54 AM
Last Post: Madison320
  Finally got the BiPAP! RainbowFish 6 786 10-25-2022, 01:56 PM
Last Post: RainbowFish


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.