Airway support management: a teaching module.

Abstract

N ONINVASIVE airway support management is a relatively new treatment modality for pediatric patients requiring ventilatory assistance. Continuous positive airway pressure (C-PAP) and bilevel systems (Bi-PAP, Bi-PAP S/W) are examples of mechanisms presently being used to provide this support (Respironics, Inc., 1988). Children with poor respiratory effort such as sleep apnea, neuromuscular disorders, and spinal cord injury can benefit from noninvasive airway support management. Both methods of airway support can be used in acute as well as chronic situations, thereby avoiding complications associated with intubation and surgery. There are 10 children currently being followed at Children’s Hospital of Duke University Medical Center who are using C-PAP or bilevel systems. These children have been diagnosed with a variety of disorders from traumatic spinal cord injury to muscular dystrophy. Most are on a bilevel system because it is better tolerated and offers increased comfort. Therefore, it has a higher home compliance rate than C-PAP (Respironics, Inc., 1988). Because the C-PAP and bilevel systems are used infrequently in pediatric settings, it was necessary to develop a program to educate the nursing staff in the airway systems and preparing families for discharge and home use. The teaching module for staff includes a brief description, criteria checklists for family training, and guidelines for discharge preparations.