Documentation Index
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Overview
The Medical Equipment module manages the assignment and tracking of PAP (Positive Airway Pressure) devices and mask interfaces provided to patients for home therapy. It serves as an inventory system and ensures proper equipment accountability. Model:EquipoMedicoLocation:
apps/exams/models.py:293-352
This module tracks equipment dispensed to patients, not facility inventory. Each record represents a device and mask combination assigned to a specific patient admission.
Equipment Data Fields
PAP Device Information
Device Brand - Manufacturer of the PAP deviceAvailable Choices:
Display Labels: Formatted brand names (e.g., “Philips RespiroNics”)
BMC- BMC MedicalRESMED- ResMedPHILIPS RESPIRONICS- Philips RespironicsSEFAN- SefanRESVENT- ResventCURATIVE- Curative MedicalPRISMA- PrismaDEVILBIS- DeVilbiss
Display Labels: Formatted brand names (e.g., “Philips RespiroNics”)
Device Serial Number - Unique identifier for the specific PAP device
- Max Length: 100 characters
- Format: Text field (alphanumeric)
- Form Label: “Serial del Equipo”
- Purpose: Equipment tracking, warranty management, recall identification
- Example: “RMD19A12345678”
Ventilatory Mode - Type of positive airway pressure therapy the device providesAvailable Choices:
CPAP- Continuous Positive Airway PressureBiPAP- Bilevel Positive Airway PressureBiPAP ST- BiPAP with Spontaneous/Timed backup rate
| Mode | Description | Typical Use Cases |
|---|---|---|
| CPAP | Single continuous pressure throughout breathing cycle | Standard obstructive sleep apnea |
| BiPAP | Two pressure levels (higher on inhale, lower on exhale) | High pressure needs, pressure intolerance, COPD overlap |
| BiPAP ST | BiPAP + backup respiratory rate if patient stops breathing | Obesity hypoventilation syndrome, central apnea, neuromuscular disease |
Mask Interface Data
Mask Type
Mask Type - Style of interface connecting patient to PAP deviceAvailable Choices:
Display Labels:
PILLOW NASAL- Nasal pillow (minimalist interface inserted into nostrils)NASAL- Nasal mask (covers nose only)ORONASAL- Full face mask (covers both nose and mouth)
Display Labels:
PILLOW NASAL→ “Pillow nasal”NASAL→ “Nasal”ORONASAL→ “Oronasal”
Nasal Pillow (Pillow Nasal)
Nasal Pillow (Pillow Nasal)
Design: Soft silicone plugs inserted into nostrilsAdvantages:
- Minimal contact (best for claustrophobia)
- Unobstructed field of vision
- Ideal for people who wear glasses or read in bed
- Lightweight and comfortable
- Requires nasal breathing (not for mouth breathers)
- Can cause nostril irritation at high pressures
- May dislodge more easily with movement
- Not suitable for CPAP >15 cmH₂O typically
Nasal Mask (Nasal)
Nasal Mask (Nasal)
Design: Cushion that seals around the noseAdvantages:
- Stable seal for most pressure levels
- Comfortable for most patients
- Good for side sleepers
- Wide variety of models and sizes
- Requires nasal breathing
- Mouth leak if patient opens mouth during sleep
- Pressure on nasal bridge
Full Face Mask (Oronasal)
Full Face Mask (Oronasal)
Design: Cushion that seals around both nose and mouthAdvantages:
- Works for mouth breathers
- Tolerates higher pressures
- No mouth leak issues
- Essential for BiPAP ST (prevents CO₂ rebreathing)
- More claustrophobic feeling
- Higher leak rates
- More difficult to fit properly
- Obstructs field of vision
- Associated with higher AHI (increases dead space)
Mask Specifications
Mask Size - Size of the mask fitted to the patientAvailable Choices:
SMALL- SmallMEDIUM- MediumLARGE- Large
Mask Model/Reference - Specific product model or reference number
- Max Length: 100 characters
- Form Label: “Referencia Mascara”
- Default: “No especificado”
- Purpose: Track specific mask models for reordering, troubleshooting
- Examples: “AirFit N20”, “Amara View”, “Mirage Quattro”
Relationships
Links to the patient’s active admission recordRelated Name:
On Delete: CASCADE
equipos_medicosOn Delete: CASCADE
User who registered this equipment assignmentRelated Name:
On Delete: SET_NULL
equipos_medicos_registradosOn Delete: SET_NULL
Timestamp when this equipment record was createdAuto-generated: Automatically set on record creation
Represents: Date equipment was dispensed/assigned to patient
Represents: Date equipment was dispensed/assigned to patient
Registration Workflow
View:register_equipo_medico (apps/exams/views.py:276-300)
Equipment Assignment Process
Equipment Assignment Process
Typical Workflow:
- Titration Study Completed (see Polysomnography)
- Determines optimal pressure settings
- Identifies best mask type and size
- Equipment Selection
- Choose device brand and model based on:
- Ventilatory mode needed (CPAP vs BiPAP vs BiPAP ST)
- Pressure requirements
- Available inventory
- Insurance coverage
- Select mask type and size from titration results
- Choose device brand and model based on:
- Patient Education
- Demonstrate device operation
- Teach mask application and adjustment
- Explain cleaning and maintenance
- Set expectations for adaptation period
- Equipment Dispensing
- Record device serial number
- Document mask specifications
- Create equipment record in system (this module)
- Provide user manual and contact information
- Follow-up Planning
- Schedule follow-up visit (typically 1-2 weeks)
- Explain how to access usage data
- Provide troubleshooting resources
Equipment Inventory Management
Tracking Considerations
Device Accountability
Per Record:
- Which specific device (serial number)
- Assigned to which patient (ingreso)
- Dispensed by whom (registrado_por)
- When dispensed (created_at)
Replacement Tracking
Multiple Records Per Patient:
- Device malfunction replacement
- Mask size change (initial fitting error)
- Mask type change (intolerance)
- Mode upgrade (CPAP → BiPAP)
Analytics Queries
Clinical Workflow Integration
Equipment Assignment Timeline
Connection to Other Modules
From Titration to Equipment
From Titration to Equipment
Data Flow:
PolisomnografiaTitulacion → EquipoMedicoTitration Study Determines:tipo_titulacion→modo_ventilatorio(CPAP/BiPAP/BiPAP ST)tipo_mascara→tipo_mascara_eq_medico(mask type)talla_mascara→talla_mascara(mask size)presion_ipap/presion_epap→ Device programmed with these settings
marca_equipo(brand selection based on availability)serial_equipo(specific device accountability)referencia_mascara(specific mask model)
Equipment to Monitoring
Equipment to Monitoring
Data Flow:
EquipoMedico → MonitoreoEquipment Record Establishes:- Device capabilities (CPAP can’t deliver BiPAP pressures)
- Expected mask interface (leak detection baseline)
- Serial number for data download
- Device usage data (adherence metrics)
- Mask leak rates (may indicate sizing issue)
- Pressure settings actually used (vs. prescribed)
- Equipment malfunction indicators
talla_mascaraEquipment Troubleshooting
Common Issues
Excessive Mask Leak
Excessive Mask Leak
Symptoms: High leak rate on device data download, whistling noise, low residual AHI improvementPossible Causes:
- Wrong size:
talla_mascaraSmall when Medium needed - Wrong type: Pillow nasal with mouth breathing
- Worn cushion: Needs replacement (typically every 3-6 months)
- Facial hair: Beard prevents proper seal
- Over-tightening: Paradoxically increases leak
- Re-fit mask using manufacturer sizing template
- Try different
tipo_mascara_eq_medico(e.g., nasal → full face) - Replace cushion
- Adjust headgear tension
- Consider mask with seal designed for facial hair
- Document new assignment in EquipoMedico if equipment changed
Device Malfunction
Device Malfunction
Symptoms: Device won’t turn on, error messages, unusual noise, pressure fluctuationsTroubleshooting Steps:
- Check power connection and outlet
- Verify filter is clean (replace monthly)
- Ensure water chamber properly seated (if humidifier)
- Review user manual for specific error codes
- Check warranty status using
serial_equipoandcreated_at
- Check if under warranty (typically 2-3 years)
- Contact manufacturer using
marca_equipoandserial_equipo - Dispense replacement device
- Create new EquipoMedico record with new serial number
- Keep old record for audit trail (don’t delete)
Patient Requests Different Equipment
Patient Requests Different Equipment
Scenarios:
- Prefers different brand (quieter, smaller, etc.)
- Wants different mask type (claustrophobia with full face)
- Needs different mode (CPAP intolerable, requests BiPAP)
- Validate complaint: Is it preference or actual clinical issue?
- Review data: Check adherence and residual AHI first
- Education: Many issues resolve with adaptation (1-2 weeks)
- Legitimate change: If clinical indication or persistent intolerance
- Document reason for change
- Obtain prior authorization if insurance required
- Create new EquipoMedico record
- Note this is a replacement in clinical documentation
Compliance and Regulatory Considerations
Insurance Documentation
PAP devices are expensive durable medical equipment (DME). Most insurance plans require:
- Documented diagnosis (polysomnography with AHI ≥5)
- Medical necessity (typically AHI ≥15 or AHI 5-14 with symptoms)
- Compliance demonstration (≥4 hours/night for 70% of nights during first 90 days)
- Serial number documentation for reimbursement
Recall Management
Critical Safety Function:- Manufacturer recalls (e.g., Philips Respironics foam degradation recall 2021)
- Serial number tracking enables rapid patient identification
- Query affected devices: Filter by
marca_equipoandserial_equipopattern - Contact patients: Retrieve via
ingreso.pacienterelationship - Replace devices: Create new EquipoMedico records for replacements
Data Retrieval
View:patient_clinical (apps/exams/views.py:34)
Equipment records are filtered by the patient’s active admission and ordered by ID (most recent first). Multiple records indicate equipment changes during the treatment cycle (e.g., mask size adjustment, device replacement).
Best Practices
Serial Number Accuracy
Critical:
- Double-check serial number entry
- Photograph device label as backup
- Verify against manufacturer database
- Essential for recalls and warranty
Mask Fit Verification
Essential:
- Use manufacturer sizing guides
- Have patient wear mask 10-15 minutes
- Check for red marks (too tight)
- Verify seal with device running
- Document specific model reference
Patient Education
Required:
- Demonstrate assembly/disassembly
- Explain cleaning procedures
- Set realistic expectations (adaptation)
- Provide written instructions
- Emphasize replacement schedule
Follow-up Planning
Important:
- Schedule 1-2 week check-in
- Plan data download at 30 days
- Mask cushion replacement at 3 months
- Full mask replacement at 6 months
- Device servicing per manufacturer
Related Modules
Polysomnography
Titration study determines equipment needs
Monitoring
Track device usage and effectiveness
Pulmonology
Specialist prescribes advanced device modes