By entering information below, the DoctorBach website will build a customized sample Letter of Medical Necessity. When a diagnosis of SMA Type 1 is selected below, other values will be changed to SMA1 sample settings. Click Clear Changes to return to non-SMA1 sample settings. When finished, click Submit.
The information entered is not stored, it is used only for creating the sample letter.
|Inspiratory Muscle...||Failure Dysfunction|
|For SMA1:||Paradoxical chest wall motion|
|(If VC is blank, no results will be displayed)|
|Sitting Vital Capacity (VC):||ml % of normal|
|Supine Vital Capacity:||ml|
|Maximum Insufflation Capacity (MIC):||ml|
|Peak Cough Flow (PCF) from MIC:||L/s|
|PCF from MIC with Abdominal Thrust:||L/s|
|SaO2 Range:||% to %|
|End-Tidal pCO2:||mm Hg|
|Trained: Patient Family Caregiver|
|Trained in nasal IPPV|
|Trained in mouthpiece IPPV|
|Trained in manually assisted coughing|
|Trained in mechanical in-exsufflation|
|Practice Air Stacking|
|Practice Sliding Board Transfers|
|Patient Given Ambubag|
| Portable volume ventilator (PLV-100)|
|BiPAP-ST (night use)|
|Mechanical In-Exsufflator (In Home)|
|Mechanical In-Exsufflator (Rapid Access)|
|Portable Suction Equipment|
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