Main difference between Bi-level S and Bi-level S/T???

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Main difference between Bi-level S and Bi-level S/T???

Postby rangerray300 » Mon Dec 16, 2013 12:27 pm

Just curious as to the main difference between Bi-level S and Bi-level S/T and when to use either or switch from S to S/T? One lab I work in allows us to switch from S to S/T freely. Another lab I just started in, I just got in trouble for switching from S to S/T.. Lab protocol isn't clear reading them that I wasn't allowed to do it, I looked before I did. I titrated the patient easily after making the switch. Thanks for any answers or advise about this.
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Postby tiredjohnny1 » Mon Dec 16, 2013 5:27 pm

Protocols can differ however the concern may be whether or not the S/T therapy is appropriate. Some labs may feel the physician needs to determine that. Other labs may feel that because the typical requirement is at least 50% central apneas they want to ensure that criteria is met so S/T would be ordered post-scoring. Many, many labs just leave it to the acquisition tech's discretion.
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Postby jmassey » Mon Dec 16, 2013 7:31 pm

BiLevel S: "S" stand for spontanious, to trigger from EPAP to IPAP the patient must initiate it (inhale).
Bilevel ST: Stands for spontanious/timed. Works same as "S" unless you add a Rate (breathes per minute). If the patient doesn't take a breath to initiate IPAP within a certain time window (depends on rate) then the machine will cycle itself into IPAP
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Postby somnonaut » Mon Dec 16, 2013 9:49 pm

tiredjohnny1 wrote:Protocols can differ however the concern may be whether or not the S/T therapy is appropriate. Some labs may feel the physician needs to determine that. Other labs may feel that because the typical requirement is at least 50% central apneas they want to ensure that criteria is met so S/T would be ordered post-scoring. Many, many labs just leave it to the acquisition tech's discretion.


Also, lab specific breathing rate per minute minimum should help keep everyone on same page. If centrals are happening, then if BPM drops to below this approved level, it could be the trigger to switch to S/T mode with the lab specific minimum back up rate in place.
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Postby SCNVsleep » Tue Dec 17, 2013 3:25 am

the main difference between Bi-level S and Bi-level S/T


About $700 cost, and about $1500 allowable
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Thanks everyone!!

Postby rangerray300 » Fri Dec 20, 2013 6:46 am

I was told I couldn't do it.. one lab I work in leaves it up to us. The new Lab I started working it's a no no... Live and learn.. bottom line it fixed the patient in no time flat... right move,, but not to protocol in that Lab...
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Postby rangerray300 » Fri Dec 20, 2013 6:46 am

Thanks everyone for your responses!!!!!
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Re: Main difference between Bi-level S and Bi-level S/T???

Postby RayMeece » Tue Jul 18, 2017 7:58 am

Tip to learn --

You better read your lab's protocols yourself. Don't let someone "Tell" you how to do it. Oh, and by the way - read it again.

And again - you should read all of them every 6 months. And whenever you do a rare procedure (like ASV) READ IT AGAIN.
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Re: Main difference between Bi-level S and Bi-level S/T???

Postby RayMeece » Tue Jul 25, 2017 2:32 am

I just learned an interesting fact about the 'timed inspiration" option on the ST (if yours has it).

The time should be 30-40% of the individual breath time. So, if their breath rate is 15, that means they breathe every 4 seconds or so. 40% of 4 seconds is 1.6 seconds. That should be the "inspiration time".

I've been doing this for 23 1/2 years, and still learning!! Don't ever stop learning!!
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