Posted by Stuart Holtby MD ABSM on March 08, 1998 at 19:07:16:In Reply to: Re: Case H3.98 posted by Robert on March 07, 1998 at 19:26:06:
I really hope that "Robert" isn't taking the ABSM part 2. This forum is meant for people to post cases to practice EXAM ANSWERS, NOT as an advice column for problem cases.
His answer does serve as a good example of how NOT to answer such a question on the Board exam.
Although the answer contains valid suggestions, it is very incomplete, and an answer like this would get a FAILING grade!
You need to come up with a COMPREHENSIVE discussion of what to do with problem patients, not just assume that the techs did it wrong. (In this case the patient was tried with BiPAP at a number of settngs- he couldn't fall asleep again at any level)
To answer an exam question about problem patients- make sure you outline all the alternatives to CPAP and BiPAP therapy, show that you would communicate them to the patient and his physicians, as well as communicating the natural history of OSAS to the patient, and addressing other concerns such as safety and followup.
(...and by the way Robert, experienced is not spelled experianced, at least not by experienced technologists)