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2 results

  • Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area

  • Fumitaka Mito, Tsuguo Nishijima, Shigeru Sakurai, Tetsuya Kizawa, Keisuke Hosokawa, Susumu Takahashi, Akira Suwabe, Hiroshi Akasaka, Sei-ichiro Kobayashi
  • Journal:
    Prehospital and Disaster Medicine / Volume 28 / Issue 6 / December 2013
    Published online by Cambridge University Press:
    04 December 2013, pp. 547-555
    Print publication:
    December 2013
  • Introduction

    The 2011 Great East Japan Earthquake caused major disruptions in the provision of health care, including that for patients with sleep-disordered breathing (SDB) using a nasal continuous positive airway pressure (nCPAP) device. This study investigated the ability of SDB patients to continue using the nCPAP device in the weeks immediately following the earthquake, whether inability to use the nCPAP device led to symptom relapse, and measures that should be taken to prevent disruptions in nCPAP therapy during future disasters.

    Hypothesis

    If nCPAP devices cannot be used during disasters, SDB patients’ health will be affected negatively.

    Methods

    Within 14 days of the disaster, 1,047 SDB patients completed a questionnaire that collected data regarding ability to use, duration of inability to use, and reasons for inability to use the nCPAP device; symptom relapse while unable to use the nCPAP device; ability to use the nCPAP device use at evacuation sites; and recommendations for improvement of the nCPAP device.

    Results

    Of the 1,047 patients, 966 (92.3%) had been unable to use the nCPAP device in the days immediately following the earthquake. The most common reason for inability to use the nCPAP device was power failure, followed by anxiety about sleeping at night due to fear of aftershocks, involvement in disaster-relief activities, loss of the nasal CPAP device, and fear of being unable to wake up in case of an emergency. Among the 966 patients, 242 (25.1%) had experienced relapse of symptoms, the most common of which was excessive daytime sleepiness (EDS), followed by insomnia, headache, irritability, and chest pain.

    Conclusion

    Developing strategies for the continuation of nCPAP therapy during disasters is important for providing healthy sleeping environments for SDB patients in emergency situations.

    MitoF, NishijimaT, SakuraiS, KizawaT, HosokawaK, TakahashiS, SuwabeA, AkasakaH, KobayashiS. Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area. Prehosp Disaster Med. 2013;28(6):547-555.

  • Chapter 16 - Misplacement of tracheal tubes

  • from Section 2 - Clinical
  • Edited by Ian Calder, Adrian Pearce
  • Book:
    Core Topics in Airway Management
    Published online:
    10 January 2011
    Print publication:
    16 December 2010, pp 151-157

  • Summary

    Worldwide, obstructive sleep apnoea (OSA) is the most common medical disorder affecting sleep, afflicting about 3-4 percentage of the middle aged population of the UK, of whom about 70% are male. This chapter deals with the pathophysiology of the condition and its presenting features, investigations and treatment. Tonsillar hypertrophy should be recorded because this may be the underlying problem, and usually is so in children presenting with OSA. The gold standard of treatment for OSA is to submit the patient to nasal continuous positive airway pressure (nCPAP) whilst asleep. Although avoidance of sedative and opioid drugs during the peri-operative period is the recommended practice, sedatives and opioids have been used freely in conjunction with CPAP therapy without complication in the post-operative period. Post operative management involves nocturnal oxygen supply for at least one more night after opioid therapy has stopped.