Respiratory Disease Management
Good breathing is vital to your overall health; conditions that affect your lungs and respiratory system can impact your quality of life.
To help improve breathing function, your healthcare professional may prescribe more complex respiratory care, such as a device for non-invasive ventilation (like the Trilogy or Astral™), airway clearance (like CoughAssit T70) or high-frequency chest wall oscillation (like AffloVest®). These innovative care devices can assist you on the road to better breathing! Frontier and our team of respiratory experts will be at your side for each and every breath.
Your Lungs & Breathing
At Frontier Home Medical, we aim to provide extraordinary patient disease management, improve quality of life, achieve measurable outcomes and change home healthcare delivery. We work to match the right equipment to your needs and support you in your journey.
As your home-based care manager and equipment provider, we have partnered with your physician to provide the best care possible. Your Frontier Non-Invasive Ventilation team includes:
Your Lungs & Breathing
Every cell in the human body needs oxygen to function properly. When you breathe in, your nose cleans, heats and humidifies the air. The air then moves through your windpipe (trachea) and into the bronchi (air passages) of your lungs.
At the end of each airway are grape-like clusters of air sacs (alveoli); this is where oxygen gets transported into your bloodstream via small capillaries. Then, oxygen passes from those capillaries and is transported throughout your body.
As you breathe in, your chest and ribs expand and the diaphragm moves downward; allowing air to fill your lungs. As you breathe out, your diaphragm and rib muscles relax and air leaves the lungs out of the mouth and nose.
As the body uses oxygen, blood carries the waste gas (carbon dioxide) back to the lungs. The carbon dioxide then leaves the body with the air you exhale. The process of getting oxygen into the body and carbon dioxide out is called gas exchange and it is your body’s fuel system to live a healthy life.
When you need support for your breathing, your healthcare professional may prescribe a respiratory assistive device. To get set-up with the device and have ongoing care as you utilize it, that’s where Frontier comes in. Our promise to you: Frontier will be there every step of the way!
Masks & Mouthpieces
Cleaning & Maintenance
When your healthcare professional prescribes Non-Invasive Ventilation (also known as NIV), this can be a method to better provide respiratory support and treat respiratory failure.
When used according to your care plan, you may experience many benefits with ventilation therapy:
Difficulty breathing occurs when the process of breathing is interrupted due to muscle weakness, blocked airways, chronic conditions or respiratory disorders. Symptoms will vary depending on the type and severity of the condition. Not breathing well can mean diminished oxygen levels, increased carbon dioxide levels and can challenge overall health. Improved breathing can improve your quality of life.
Many disorders, or a combination of such, can worsen breathing functions. Understanding respiratory symptoms will help you understand the importance of ongoing therapy and treatment. Non-Invasive Ventilation (NIV) is used to treat respiratory failure related to disorders resulting in high blood carbon dioxide and or low blood oxygen or progressive neuromuscular illnesses when all other therapies have been tried and failed. Disorders most commonly treated are:
When left untreated, severe or life-threatening health problems may develop. These include abnormal heart rhythm, heart failure, stopping breathing, brain injury, comas and more.
Chronic Obstructive Pulmonary Disease, or COPD, is a set of disorders that include emphysema, chronic bronchitis and bronchiectasis. COPD is characterized by chronic airflow limitations in the lungs making breathing in or breathing out difficult. Airflow limitations result from damage to the lung units responsible for the exchange of oxygen and carbon dioxide. Smoking and irritant exposures are the leading cause of COPD. COPD is a common, but serious, life-long condition that is preventable and treatable.
When you get less air in, less oxygen gets to the body and it gets harder to get rid of the waste gas carbon dioxide. Symptoms can vary from person to person and mainly depend on your overall health as well as the severity of this illness. These symptoms may be more severe with activity or during flare-ups. In general, people with COPD experience the following:
Progressive Neuromuscular Disease causes the muscles we use to breathe (including the diaphragm and intercostal muscles) to weaken. Expanding your chest can be become difficult, which causes breathing to become shallow and difficult. Illness progression can also result in a weakened cough with difficulty clearing retained mucus in the lungs. This can lead to mucus plugs and infections (commonly known as pneumonia). Common illnesses often requiring NIV include ALS (Amyotrophic Lateral Sclerosis; Lou Gehrig’s disease) and Muscular Dystrophy.
Symptoms of progressive neuromuscular illness result from weakness of the muscles of the upper and lower respiratory tract. Symptoms may include:
OHS (Obesity Hypoventilation Syndrome) is a breathing disorder caused by excess body weight. When excess weight is carried in the abdomen and chest, it restricts the movement of the diaphragm and supporting muscles used to breathe. (This is also referred to as restrictive lung disease.) As moving air in and out of the lungs becomes increasingly difficult, it leads to lower oxygen and increased carbon dioxide levels in the blood.
The symptoms of OHS develop over time as a result of decreased air movement into and out of the lungs. Symptoms can include:
NIV is a type of therapy that aides in improving carbon dioxide and oxygen levels in the body. It is used when all other therapies like oxygen and PAP therapy have not worked.
The Non-Invasive Ventilator uses a mask or mouthpiece to provide breathing support during sleep, during the day (when awake or napping) and for rescue, all as prescribed.
There is no limit to how much or how often NIV can be used. You may only require NIV during sleep or naps, or you may require NIV assistance for rescue breathing or even 24 hours a day with a mask.
Philip Respironics’ answer to Non-Invasive Ventilation, the Trilogy is versatile and easy to use. With its lightweight and proven technology, the Trilogy 100 makes non-invasive treatment less complicated.
From ResMed®, the Astral™ is a user-friendly and easy-to-operate Non-Invasive Ventilation medical device. At only seven pounds, it is lightweight with simple, smart technology. Its versatility gives therapy options for a variety of respiratory complications.
Compliance & Care
Compliance refers to your successful adherence to Non-Invasive Ventilation therapy. The best way to achieve the best outcomes with NIV is to follow your specialized NIV care plan. Insurance does require compliance with NIV therapy for it to keep billing. Frontier will be monitoring your progress and encouraging you along the way!
At Frontier Home Medical, our chronic care management and ventilation team strives to obtain the best outcomes possible. We believe success with this can be measured by preventing hospital visits and improving your quality of life. To do this we are committed to providing superior quality care by integrating the use of technology with our highly skilled team of Respiratory Therapists and connecting us to you to your lung doctors. Your ventilator is connected to either a blue-tooth hub or modem. This allows your lung doctor and Frontier Home Medical Respiratory Care Specialist to access your NIV therapy data every eight hours.
Are you prescribed oxygen therapy—either continuous or nocturnal? If so, this can be done in conjunction with your non-invasive ventilation therapy. Please note: portable or pulse dose oxygen cannot be used with the Non-Invasive Ventilator. Utilizing the built-in oxygen port on your device will allow you to get both the oxygen flow and air pressure that you’ve been prescribed.
Non-Invasive Ventilation allows you to breathe through your nose, which is the body’s best air purifier and humidifier. Staying hydrated will also help to maintain lung humidification. However, when that is not enough, external heated humidification may be necessary.
If you experience any of the following symptoms after starting Non-Invasive Ventilation therapy, it may indicate a need for humidification:
Keep in mind that adding a heated humidifier requires extra care and cleaning; it also involves additional risk. Heated humidifiers can tip during use, causing water to leak from the mask into your body. The device requires weekly cleaning and monthly disinfecting; this can mean an increased risk of pulmonary infections. Consult with your Frontier Home Medical Respiratory Care Specialist to determine if a heated humidifier is right for you.
Masks & Mouthpieces
Together with your Respiratory Care Specialist, you will choose the best mask to fit your ventilation needs. Frontier offers a variety of masks—both full face and nasal—to achieve comfort and therapeutic benefit.
With a mouthpiece system, you’ll gain flexibility with ventilation therapy. The mouthpiece system gives you breathing support on demand. By sensing your touch to the tip of the mouthpiece, it will provide breathing support until it no longer senses you.
Mouthpiece ventilation can allow freedom to breathe without wearing a mask—a great solution if you are in a wheelchair, experience limited mobility or need extra support following exertion or anxiety. Mouthpiece ventilation can also provide freedom for those with neuromuscular disorders.
Cleaning & Maintenance
To correctly clean your supplies, use warm water and mild dish detergent or baby shampoo. Cleaning wipes can also be helpful for easy daily care practices.
|Equipment||Cleaning Instructions||Cleaning Frequency|
|Device||Unplug device and gently wipe down with a dry cloth.||Weekly|
|Humidifier Chamber||Only use distilled water in your humidifier chamber. Empty and rinse with warm water daily. Turn upside down and allow to air dry. Refill with fresh, cool distilled. Once a week, clean with warm, soapy water and allow to air dry.||Daily|
|Tubing||Wash with warm, soapy water and rinse thoroughly. Hang tubing; allow to dry.||Weekly|
|Frame||Wash with warm, soapy water and rinse; or use cleaning wipes. Allow to dry.||Weekly|
|Cushion||Each day, wash with soapy water or use cleaning wipes. Allow to dry.||Daily|
|Headgear||Wash by hand in warm, soapy water. Rinse and air dry.||Weekly|
For some, starting ventilation therapy is not exactly a walk in the park. Getting used to the device can be a lengthy process that requires gradually adapting to the therapy; however, Frontier is here to help make your journey a little easier. Here are a general few tips:
Using a Non-Invasive Ventilator can be frustrating as you try to get used to it, but it’s important you stick with it. The treatment is essential to avoid complications of respiratory failure, such as heart, kidney and brain damage. Regular visits with Frontier and your physician can help you troubleshoot any issues you have with your ventilation therapy. Always remember, with time and patience, using your Non-Invasive Ventilation device can positively impact your quality of life and health.
Relying on a medical device for your survival can feel overwhelming. If you experience anxiety as you adjust to life with your Non-Invasive Ventilator, there are many tools you can use to overcome those feelings.
First, try wearing just the mask for short periods of time while you’re awake—for example, while watching TV. Then try wearing the mask and hose with the device turned on during the day while you’re awake.
Once you get used to how that feels, start using the device every time you sleep—including naps. Just wearing the Non-Invasive Ventilation device every now and then may delay getting used to it. Stick with it for several weeks or more to see if your mask and pressure are right for you.
Practice using your mask while you’re awake. First, hold it up to your face without any of the other parts. Once you’re comfortable with that, try wearing the mask with the straps.
Next, try holding the mask with the attached hose on your face, without using the straps. Turn on the machine. Next, do this using the straps too. Finally, try sleeping with the mask and machine on.
You may be able to overcome this by using a machine with a ramp feature. This setting allows you to start with low air pressure. The machine then automatically, and slowly, increases the air pressure to your prescribed setting as you fall asleep.
A leaky or ill-fitting mask means you’re not getting the full air pressure you need, so try adjusting cushions and straps to get a better fit. Check your resupply schedule to be sure your mask is up to date; replace as needed.
Be sure your mask fits well. A leaky mask can dry out your nose. If you have to tighten straps often to prevent air leakage, the mask does not fit properly. Using a nasal saline spray or sinus wash at bedtime also may help ease a dry, stuffy nose.
If you sleep with your mouth open, some devices may worsen dry mouth. A chinstrap may help keep your mouth closed and reduce the air leak if you wear a nasal mask. A full-face mask that covers your mouth and nose also may work well for you. (Remember, adding a heated humidifier is not indicated for mouth dryness, but is only for lung humidification.) Using dry mouth products also may help, such as Xylimelts® or Biotène® brand products.
Swallowing air during ventilation therapy can lead to bloating, gas and discomfort. It may help to sleep at an incline by using a wedge-shaped pillow or utilizing an adjustable bed. If swallowing air is causing heartburn, be sure to consult with your Frontier Home Medical Respiratory Care Specialist.
First check to make sure the air filter is clean and unblocked and that your hose and mask are clean. If this doesn’t help, notify Frontier. We can ensure that the device is working properly. If the device is working correctly and the noise still bothers you, try wearing earplugs or using a white noise sound machine to hide the noise.
Your NIV machine is designed to function without an oxygen source. If your physician has prescribed oxygen, tubing from your concentrator will connect to the back of the machine via an oxygen adaptor. Your Respiratory Specialist will do this for you during the set up.
Some people may find getting a proper mask seal more challenging with facial hair. Using beard wax and trying different mask styles can help.
Yes. For many, you can spend one or two nights away from the machine; however, you may not be very comfortable and run the risk of hospitalization without adequate support for your breathing.
Leave your mask on; just detach the hose using the quick release clips. When you’re done, reattach the hose and start your machine. If you use oxygen, consult your FHM Care Specialist for further instructions.
Yes, NIV is used to treat respiratory failure caused by advanced chronic illness. In very rare cases, such as post successful lung transplant, it may only be temporary.
Yes, always take your machine, tubing and mask for scheduled hospital procedures and emergency visits; however, leave your communication hub at home. Please contact your FHM Respiratory Specialist as soon as possible to alert us of the hospitalization.
If your machine does not feel right, please contact your Frontier Respiratory Care Specialist.
There are no similar alternatives to NIV treatment. This is the best option for non-invasive respiratory therapy.
When you leave home, always bring your Non-Invasive Ventilation device along. Follow these tips to get the benefits of better breathing while traveling:
You may need a letter from your healthcare professional stating your need for the medical equipment, including your level of dependency on the device.