The healthcare providers involved in critical care must address complex problems addressed by specialists in therapeutic modalities or new technological devices. Also, there has been a fast-emerging trend of many other modalities. Thus, the CPAP and BiPAP systems have witnessed high acceptance in the last few years. The findings from different studies have long shown that noninvasive ventilation modalities are on the frontline in managing respiratory distress and even in support of diverse respiratory disorders.
Demonstrating how CPAP and BiPAP work can be done through a fictional presentation by creating a case. John Smith was 62 years old, with an already established diagnosis of chronic pulmonary disease. Since he had been admitted to the ICU due to severe respiratory failure was there. His condition was deteriorating fast, and it was more challenging to keep his general health parameters at a normal level. To combat the progressive respiratory collapse of Mr.John Smith, the physician considered it reasonable that the patient must be provided emergency respiratory support.
Explanation and Background
CPAP and BiPAP, as noninvasive methods of airway ventilatory support, offer positive airway pressure that oxygenates and maintains airway patency and, thus, a proper gas exchange. CPAP delivers a constant positive pressure throughout the respiratory cycle. At the same time, BiPAP provides two distinct pressure levels; therefore, to be used, inspiratory positive airway pressure (IPAP)is increased and expiratory positive airway pressure (EPAP) is reduced (Seyfi et al., 2019).
These modalities convey one’s lungs’ strength properties, bring air into the alveoli, and decrease the burden of breathing. CPAP and BiPAP are still popular in the management of different respiratory problems, including or, for instance, acute respiratory distress syndrome (ARDS), heart failure and obstructive sleep apnea (Seyfi et al., 2019).
Bronchodilators, corticosteroids, and sedatives might be considered when using CPAP or BiPAP to suppress anxiety and increase the patient’s acceptance during the procedure. The safety measures will encompass the correct fit of the masks, the race for adverse effects (e.g., aspiration, skin breakdown), and the very close observation of the patient’s respiration condition. On the one hand, the upfront cost of CPAP/BiPAP apparatus may be substantial. However, the cost-effectiveness of these modalities will be contemplated because the long-time savings accrued from the avoidance of intubating and mechanical ventilation make them cost-effective in appropriate clinical settings.
Risks and Benefits
The prime benefit of CPAP and BiPAP is that respiratory support is achieved without using mechanical ventilation, which is invasive. Thus, the risks of intubation-related complications like pneumonia and vocal cord injuries are reduced(Pinto & Sharma, 2020). They can facilitate gas exchange, eliminate breathing difficulties, positively impact patients’ conditions, and thus contribute to a speedy and quality recovery.
For successful outcomes, choosing the right persons for CPAP or BiPAP therapy is important, monitoring the patient’s response and adjusting pressure settings as required. Beyond that, educating the patients and offering support keeps them faithful to the treatment and tolerant of its adverse effects.
Nevertheless, there exist risks related to using CPAP or BiPAP. Complications can occur like skin trauma, abdominal distension, aspiration, and patient discomfort or restlessness. Continuous monitoring with special attention to symptoms of respiratory failure, deteriorating hypoxemia, or hemodynamic instability is crucial, as this may indicate that more invasive mechanical ventilation is needed.
Interdisciplinary Team’s Roles and Responsibilities
Applying CPAP or BiPAP therapy to achieve goals follows only a multidisciplinary healthcare team effort. This team includes respiratory therapists, physicians, registered nurses, nursing assistants, case managers, clinical nurse specialists, and researchers. Respiratory therapists are responsible for initiating and managing the CPAP/BiPAP therapy, adjusting settings, monitoring patient response, and troubleshooting equipment-related issues. Physicians: Establish the most fitting candidates for CPAP/BiPAP and give the registered nurses therapy settings and their overall medical condition observation (Pinto & Sharma, 2020). They conduct constant patient assessments, gather vital signs and respiratory statuses, guarantee proper mask fit and patient comfort, and collaborate with other team members. Nursing assistants attend to patient positioning and turning (under the supervision of registered nurses). Case managers help devise discharge plans and allow for coordinated care after discharge, including setting up home CPAP/BiPAP kits and keeping follow-up appointments. Clinical nurses provide expert nursing care, employee coaching and protocol development related to CPAP/BiPAP therapies. Researchers are researching to examine the effectiveness of CPAP/BiPAP in various patient groups and investigate how effectiveness can be increased or novel applications found.
Interdisciplinary teams may experience one of the greatest challenges in communication and cooperation. Implementing the roles, responsibilities and protocols, including how to manage the issue, would neutralize the deviation and enhance the patient care issue.
Nursing Scope of Practice
Registered nurses are an indispensable part of successfully implementing CPAP and BiPAP therapy. The necessary knowledge includes a thorough knowledge of respiratory physiology, gas exchange principle, and mechanisms of action for CPAP and BiPAP. Also, nurses must be highly knowledgeable of the abovementioned therapies’ indications, contraindications and possible complications.
Registered nurses need to have good skills in patient assessment, interpreting vital signs and arterial blood gases, and the ability to spot possible respiratory distress or deterioration. They will also need to know how to size/adjust and fit Complementary/Bi-level Positive Airway Pressure/BiPAP masks while maintaining patient comfort and giving patients the education and support they need to maintain compliance (Bambi et al., 2023).
Additionally, nurses must have the essential attributes for treating patients treated with CPAP or BiPAP therapy. For example, such traits include gentleness, patience, and the capacity to console the patient in times of anxiety or pain. Nurses must, therefore, monitor for any complications and call for interventions that appropriately address any issues or concerns.
Patient Education
CPAP and BiPAP are inefficient for the patient and essential for successful implementation. The information to be taught to the patient and family should include comprehending the purpose behind the use of CPAP/BiPAP machines and the impact they have, correctly wearing and maintaining the machines, which involves having the most appropriate mask, cleaning and repairing the mask, learning to deal with possible side effects and complications, when to seek medical help, changing attitude towards sleep, adapting sleeping hygiene and position to make therapy more effective(Pinto & Sharma, 2020).
The teaching must be delivered in a clear and simple view, including narration, visual presentation, and written materials. Measuring the comprehension of patients and families on the treatment plan is important to ensure that there is adequate room to have their queries addressed and their concerns diminished.
Potential cultural issues when teaching include dealing with a language barrier, health beliefs, special demands in decision-making, or caregiver involvement. Using culturally appropriate methods and bringing in interpreters or other community resources related to the purpose will lead to a better understanding by the students.
The teacher’s effectiveness will be evaluated by return demonstration, follow-up assessment, and monitoring of medication adherence. Overcoming the notices in the assessment through continuous education and support can result in a more productive outcome for the patient.
Conclusion
CPAP and BiPAP are noninvasive modes that are widely used today in the management of respiratory distress as well as other respiratory conditions. These techniques are noteworthy as they optimize oxygen-carrying capabilities, diminish breathing effort, and prevent invasive mechanical ventilation.
The successful implementation of CPAP and BiPAP therapies calls for multidisciplinary teams of healthcare professionals to ensure the best possible patient outcome. For example, registered nurses are an important part of the rehabilitation team- patients who serve as primary providers of assessment education and are involved in designing and supporting patients through rehabilitation.
Healthcare professionals can understand the risks and benefits and find the correct ways of applying CPAP and BiPAP, which helps them serve their patients better. In turn, the quality of care is improved. Research into and development of these modalities, such as transfusion of stem cells, will play an even larger role in the future effectiveness of these modalities and their expansion of applications across clinical settings.
References
Bambi, S., Parente, E., Bardacci, Y., Baldassini Rodriguez, S., Forciniti, C., Ballerini, L., Caruso, C., El Aoufy, K., Poggianti, M., Bonacaro, A., Rona, R., Rasero, L., & Lucchini, A. (2023). The Effectiveness of NIV and CPAP Training on the Job in COVID-19 Acute Care Wards: A Nurses’ Self-Assessment of Skills. Nursing Reports, 13(1), 17–28. https://doi.org/10.3390/nursrep13010002
Pinto, V., & Sharma, S. (2020). Continuous Positive Airway Pressure (CPAP). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482178/
Seyfi, S., Amri, P., & Mouodi, S. (2019). New modalities for noninvasive positive pressure ventilation: A review article. Caspian Journal of Internal Medicine, 10(1), 1–6. https://doi.org/10.22088/cjim.10.1.1
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