The Australasian Sleep Association is calling a halt to non-essential face to face CPAP or NIV set ups and diagnostic and CPAP sleep studies, due to the risk of COVID-19 transmission.
The advice comes in a Consensus statement on the safe use of respiratory therapy and sleep studies to minimise aerosolisation of CoVID-19 released on 6 April.
Among the many points in the statement, the ASA advises that all patients requiring respiratory therapy should be assumed to have potential CoVID-19 “and be mindful that there is up to a 30% false negative rate for the viral swab.”
It states that as nebulisers, high flow oxygen and NIV (including CPAP) all pose a risk of COVID-19 transmission and should only be used in patients that really need them. Also, the tests should be used in isolation/single rooms and with appropriate PPE.
“Non-essential face to face CPAP or NIV set ups should now cease to limit the potential community spread of COVID-19 and for staff safety,” it advises.
The ASA notes that particle dispersion is highest using nasal pillows at higher pressures (e.g. 20 cmH2O) and may be the lowest with a well-fitting oronasal mask. It is possible to send equipment to patients and instruct them via telehealth or via phone.
Similarly, it recommends non-essential diagnostic and CPAP sleep studies and diagnostic home sleep studies with face to face set up should cease to reduce the risk of community spread of COVID-19 and for staff safety.
Other highlights of the statement include advice that nebulisation and humidification is not necessary for most patients and this therapy should be replaced by MDI and spacer.