The Science Journal of the American Association for Respiratory Care
BACKGROUND: The Allen-Bean Bi-level Index is a clinical tool designed to identify potential long-term noninvasive nocturnal Bi-level candidates. Such therapy has proven to significantly decrease morbidity, mortality, the need for endotracheal intubation, the number and duration of hospital admissions, and to significantly improve the overall quality of life. However, despite many studies and articles on the subject, until now a detailed protocol to identify potential candidates has yet to appear.
METHOD: Based upon present research data and years of clinical experience, the index provides a probability score that effectively identifies candidates likely to benefit from long-term Bi-level therapy. A score
Results: The index was tested in a clinical study which took place over ten-months and focused on a core population of 380 home 02 patients. 221 COPD patients were screened. 88 prime candidates were identified.
EXPERIENCE: The index was created by two seasoned respiratory therapists, Desmond Allen, PhD, CRTT and Robert Bean, RRT. Each have broad backgrounds with 25 years experience in the field.
CONCLUSION: With this index to reference, even the inexperienced clinician can successfully identify potential Bi-level candidates likely to benefit from the use of long-term noninvasive nocturnal Bi-level therapy.
ALLEN-BEAN BI-LEVEL INDEX
Medical Diagnosis ___ COPD Stage 1, add 30 ___ COPD Stage 2, add 40 ___ COPD Stage 3, add 25 ___ Restrictive Wall, add 45 ___ Neuromuscular, add 45 ___ OSA, add 50 ___ OSA, CHF & Arrhythmia, add 50 ___ Hypertension Hx, add 10 ___ Obesity, add 10 ___ Gross Obesity, add 20 Clinical Assessment & Hx ___ HR> 80, add 0.5 ea >80 ___ RR, add 0.5 ea > 10 ___ ETC02 add 2 ea mm Hg > 40 ___ Sa02 rest on room air, add 2 ea mm Hg < 98 ___ Sa02 on room air with exertion, add 2 ea mm Hg < 98 ___ Sa02 Recovery, add 2 ea 15 sec ___ Age > 70 < add 1 ea. < 70, subtract 1 ea > 70 ___ Intubations, add 10 ea in last 2 yrs ___ Hosp/ER/Phys. visits, add 5 ea in last 2 yrs ___ Dyspnea, none-5, slight+5, moderate+10, severe+15 ___ > Use of 02, none-5, slight+5 , mod+10, severe+15 ___ < Function, none-5, slight+5 , mod+10, severe+15 ___ Quality of sleep, poor+20, fair+10, good+0, excel-10 ___ Total (A score of