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Re: cardiology and GERD

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Posted by deltadoc on March 17, 2003 at 19:52:24:

In Reply to: Re: cardiology and GERD posted by David Bresch on March 17, 2003 at 04:22:56:

GERD can't be dx by PSG unless a pH probe is down. We don't treat it, but the referring doc may. In actual practice many will try a clinical trial before invasive studies---just depends on where you are, managed care, availability, etc.
R wave on top of T wave=potentially lethal arrythmia developing. If arrythmia looks ominus first check for artifact, then be sure adequate CPAP/BIPAP pressure, maybe add O2 but if in doubt awaken and get out of lab. You should know benign arrythmias and potentially dangerous ones which are in the interpretation with recommendation for cardiology care, but the tech needs to know the 5 alarmers--VTAC, VFIB, SV TAC
H that is uncertain (wide complex) prolonged pauses (pre-asystole), anything that gives distress, plumeting SAO2. You are giving a sleep study, not becoming the PCP or cardiologist. Write a good report and perhaps make a call to the referring doc.
Pediatrics: varies from year to year. Know landmarks-when spindles apear, when R&K for scoring, seizures vs hypersyncronous theta or artifact, behavior problems at bedtime, brain damaged kids sleep study,criteria for OSA in children, counselling parents in sleep terrors, who knows--usually not over 15% but sometimes almost none.

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