94645 Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (List separately in addition to code for primary procedure)

Name of the Procedure:

Continuous Inhalation Treatment with Aerosol Medication for Acute Airway Obstruction

Summary

This procedure involves the continuous inhalation of aerosolized medication to help open up airways during severe breathing difficulties. It is usually administered through a nebulizer or inhalation mask and can be provided for an extended period, with each additional hour of treatment noted separately.

Purpose

Medical Condition:

• Acute airway obstruction.

Goals:

• To reduce airway constriction.
• To improve breathing and oxygen levels.
• To prevent respiratory failure.

Indications

Symptoms and Conditions:

• Severe asthma attacks.
• Chronic Obstructive Pulmonary Disease (COPD) exacerbations.
• Anaphylaxis.
• Severe allergic reactions.
• Other forms of acute respiratory distress.

Patient Criteria:

• Patients presenting with severe breathing difficulties.
• Patients who do not respond to initial short-term inhalation treatments.

Preparation

Pre-procedure Instructions:

• No special preparation is generally required.
• Patients should inform the healthcare provider of any current medications.
• Vital signs will be monitored closely.

Diagnostic Tests:

• Spirometry or other pulmonary function tests.
• Blood oxygen levels (pulse oximetry).
• Chest X-ray or CT scan, if indicated.

Procedure Description

1. The patient is positioned comfortably, usually sitting up.
2. A nebulizer or inhalation mask is fitted to ensure effective delivery of aerosol medication.
3. The medication, often a bronchodilator or corticosteroid, is administered continuously.
4. Vital signs and oxygen saturation levels are closely monitored throughout the treatment.
5. The treatment is typically adjusted depending on the patient's response after the primary hour.

Tools and Equipment:

• Nebulizer machine.
• Inhalation mask or mouthpiece.
• Medications (e.g., albuterol, ipratropium).

Anesthesia or Sedation:

• Not required.

Duration

• Typically lasts 1 hour initially, with the option for additional hours based on patient need.

Setting

• Performed in hospitals, outpatient clinics, or emergency rooms.

Personnel

• Respiratory therapists.
• Nurses.
• Physicians (pulmonologists, emergency doctors).

Risks and Complications

Common Risks:

• Increased heart rate.
• Shakiness or tremors.
• Dry mouth or throat irritation.

Rare Risks:

• Severe allergic reactions.
• Paradoxical bronchospasm (worsening breathing difficulties).

Benefits

• Rapid relief from airway obstruction.
• Improved breathing and oxygen levels.
• Prevention of hospitalization or respiratory failure.

Recovery

Post-procedure Care:

• Continuous monitoring of vital signs after treatment.
• Additional treatments may be prescribed based on the patient's condition.

Expected Recovery Time:

• Immediate relief with continuous improvement over a few hours to days.
• Follow-up appointments to monitor progress.

Alternatives

Other Treatment Options:

• Oral or intravenous steroids.
• Short-acting inhalers.
• Oxygen therapy.
• Mechanical ventilation in severe cases.

Pros and Cons:

• Alternative treatments may have slower onset or more systemic effects.
• Continuous inhalation provides rapid, targeted relief.

Patient Experience

• Patients may feel initial relief as the medication begins to work.
• Continuous monitoring to ensure comfort and effectiveness.
• Potential for mild side effects like increased heart rate or mild shakiness.
• Overall improvement in breathing typically felt quickly.

Pain management generally not required, though comfort measures like sitting positions and hydration may be used.