How to Maintain PAP Devices? What is the Importance of Care?

PAP devices absorb the outside air with their motors and create compressed air at the adjusted level and send it to the patient. Particles in the air are cleaned by passing through filters located outside and inside the device. Particles escaping from the external filter may accumulate inside the device over time and cause malfunctions. Harmful particles may go to the user with the compressed air and cause allergy or infection. In terms of both the patient's health and the efficiency of the device, regular service maintenance of the device is required. Not only the device, but also the humidification chamber, breathing circuit and mask should be cleaned. If PAP devices are maintained regularly, malfunctions that may occur can be prevented. This ensures the continuity of the treatment and prevents financial losses. As well as having it done regularly, who does the maintenance and how is very important.

What is PAP Device?

PAP = Positive airway pressure = Positive airway pressure

PAP devices are medical devices that produce positive airway pressure, are used in the treatment process of respiratory diseases, and have different functions. There are 7 variants available:

• CPAP Device
• OTOCPAP Device
• BPAP Device
• BPAP ST Device
• BPAP ST AVAPS Device
• OTOBPAP Device
• ASV Device

CPAP and OTOCPAP, sleep apnea disease They are medical devices used by people who have sleep problems, keeping the airway open during sleep and allowing the patient to sleep comfortably. BPAP and BPAP ST devices are generally advanced. sleep apnea or COPD are respiratory devices used in the treatment of lung diseases such as Apart from these, there are also PAP devices called BPAP ST AVAPS, OTOBPAP and ASV.

Although the application method is different, all of these devices work with a similar system and provide continuous positive airway pressure. CPAP and OTOCPAP devices produce a single level of pressure, applying the same pressure as the patient inhales and exhales. BPAP, BPAP ST, BPAP ST AVAPS, OTOBPAP and ASV devices produce bi-level pressure. In this way, high pressure is applied while the patient inhales and lower pressure is applied when exhaling. Although this is their main difference, more respiratory parameters can be set on BPAP, BPAP ST, BPAP ST AVAPS, OTOBPAP and ASV devices. The choice of device is made by the physician according to the type and level of the disease to be treated.

How to Maintain PAP Devices?

PAP devices include the motherboard, pressure sensors, motor, pipes that allow air to be transmitted, filters that clean the air, and sponge blocks that provide silence while the device is operating. The electronics of the device are connected to the motherboard. The usage parameters recommended by the physicians are saved in the memory on the motherboard. Thus, the device applies the therapy pressure in accordance with the recorded respiratory parameters. This pressure is created by the engine with the air taken from the outside environment and transmitted to the patient. Air taken from the external environment to the device and then delivered to the patient, passing through filters free from harmful particles. Thus, it is ensured that the patient is not exposed to polluted air and that the device has a longer life.

Cleaning and maintenance should be done regularly in order to extend the service life of respirators and to provide cleaner air to the user. First of all, attention should be paid to the cleanliness of the filters. The lifetime of the filters may vary depending on the usage time and the filter quality of the device. The devices should be used in a clean and dust-free environment as much as possible. The external filter of the device should be changed by the user regularly and within the period specified in the user manual.

The devices have disposable or reusable filters according to the brand model. Disposable filters should be replaced with a new one when dirty, as they lose their particle retention properties when washed. Reusable filters can be washed, dried and reused every 3-4 days. It is recommended to replace these filters with a new one every 3 months. If the filters are used when they are wet, moisture may accumulate inside the device and due to liquid contact malfunction may occur. Liquid contact causes the device to be out of warranty.

In respirators, chambers in which water is placed are used to humidify the air going to the patient. The most common complaint about humidification chambers is calcification. Calcification causes both a bad appearance and clogging. It causes parts of the humidifier to stick together and narrows the air duct. If mains water is used, calcification problem may occur in a very short time. Boiled and cooled water or distilled water can be used to delay calcification. Cleaning the hopper with apple cider vinegar can be done easily. In this way, calcification can be removed and hygiene can be provided.

The remaining water in the humidification chamber must be drained after each use. Carrying the device with water inside is dangerous. The hopper should be kept empty. Otherwise, bacteria or microbes may form in the water that has been waiting in the chamber for a long time. These can reach the lungs directly by breathing and cause infection. The water waiting in the reservoir also accelerates calcification.

The cleanliness of the masks and breathing circuits (hoses) used in PAP devices is very important for health. Bad odors may occur in the contaminated mask and this may prevent the use of the device. Bacteria or germs can form in the mask as well as in the humidifier chamber. Also, masks that remain dirty wear out quickly and can cause both air leakage and skin sores. The hose should be kept clean for the same reasons as the mask.

Accessories kept clean can be used for up to one year without any problems. Mask and hose maintenance should be done with organic disinfectants that do not leave any residue. In this way, it is purified from both body dirt and bacteria and microbes. It should be noted that substances such as alcohol can damage the accessories.

It is absolutely necessary to clean accessories such as reservoir, mask and hose. organic substances that leave no residue should be used. Devices and accessories can be cleaned with natural apple cider vinegar. Chemical substances that can harm the body can cause irreversible damage to the respiratory system. For this reason, any substance that has the risk of leaving residue should not be preferred for device cleaning.

All equipment must be cleaned as specified in the operating and service instructions. Improper maintenance and service procedures may impair the effectiveness of the treatment and may cause damage to the devices.

PAP Device Care Quality Standard

Apart from the cleaning that the users have to do, there are maintenances that the technical service should do. Every 3 months if the technical service maintenance period of the device is not specified in the user manual. TSE (Turkish Standards Institute) certified It should be serviced by an authorized company. It is useful to carry out this maintenance every three months in order to prevent many problems that may arise. Our expert technical team applies this process to a certain quality standard for every brand and model device. Our quality standard for the maintenance of PAP devices is given below.

• Service maintenance of PAP devices can only be done at our service. It is not possible to do it at the user's address as test devices are required during maintenance.
• First of all, the user is given detailed information about the operations to be applied to the device.
• It is recommended to carry out maintenance every three months.
• User complaints are heard.
• The device is started, the normal sound level is checked, and the way it works together with the accessories on it is examined in case of a possible malfunction.
• Accessories such as chamber, mask and breathing circuit are separated from the device and tested with the air pressure analyzer produced by the device.
• If the device has a heated humidifier, it is controlled by activating it.
• If a problem is observed in the operation of the device or a malfunction is detected in the controls up to this item, the repair process is started by informing the user.
• If there is no fault in the device, maintenance operations are continued.
• The case of the device opens.
• The inside of the device is cleaned with disinfectant spray and compressed air.
• It is checked whether there is a problem with the electronics inside the device and whether the sockets are properly seated.
• The engine, air ducts and keys of the device are cleaned.
• All filters inside and outside the device are replaced with new ones.
• The case of the device is closed. All accessories are installed and the way of working is checked.
• It is tested again with the air pressure analyzer produced by the device.
• The current parameters of the device are compared with the patient report, and any errors are corrected.
• The time and date setting is checked, and any errors are corrected.
• The outer casing and cable of the device are cleaned with disinfectant.
• All removed dirty filters are destroyed.
• A service report is prepared regarding the transactions performed and the necessary information is conveyed to the user.

Carrying out maintenance operations at the determined quality standard is very important both for the efficiency of the devices and for the health safety of the patient.