Leaderboard

I've seen a doc use it when I use to moonlight in an ER as a tech. I asked the doc about it, he told me that sometimes treating the wheezing/bronconstriction with albuterol will allow the pt. to breathe a bit easier, therefore lowering O2 demand on the heart and all the associated benefits that brings. The CPAP was hooked up to a neb. This is all what a doc told me in the ER, so it is not a study etc. For the bad CHF'ers CPAP/NTG/Lasix seems to work great in the field. CPAP has taken away a LOT of our tubes, and that is a good thing for the patients.

Firstly Welcome: Some pretty broad statements here. I would dispute that statement. You may find that around 46% of CHF patients have associated COPD, the study by singer is suggestive that is an increase in mortality with the use of "albuterol" in the CHF with no pre-existing COPD. In the combined COPD / CHF (the 46 % club) the mortality was decreased, other studies footnoted in this link may help. http://www.medcontrol.com/omd_pub/bronchodilator_and_chf.pdf Could you explain in your statement that all CPAP is PEEP, can one positively say that a PEEP valve on a BVM (spring loaded valve) is true PEEP ? Squeezing the bag will apply PEEP most interesting, as I thought (as in your statements above) that PEEP was Positive "END" expiratory pressure, not PIP Peak Inspiratory Pressures. (the squeeze part) When you stated "fluid around the heart" as I always though that was called an effusion ? Are there any other choices if diuretics or other rx used in your practice perhaps that are potassium sparing ? Furosemide is being looked at with a more critical eye these days in CHF. Are there no J receptors triggered to respond when pulmonary oedema is present, this leading to an increase in hypoxia and that Bronchospasm in the CHF patient never occurs, as a result. http://en.wikipedia.org/wiki/Juxtacapillary_(J)_receptors Taken from an RT book (Dr. Creed) As one can see there is quite a bit of controversy in the medical field regarding the use of bronchdialators in CHF. cheers

Wow, that sucks! Did your state suddenly drastically increase the CE requirements without any notice?

Wow tniuqs I dont know why all your relpys are so brief, try actually including some detail in your responses. To answer your question I am a paramedic. As far as I know, and as I read the protocols, EMT's will not be administering CPAP, as it is part of the continum of care for CHF/Pulmonary Edema, including Nitro, which is also of EMT scope in that instance. I by no means take offense to your characterization of Paramedics knowledge of CPAP and ventilators. I learned a lot about the subject in school. However, the only expierence I have had with vents in practice was during my OR practicum, where I basically hooked it up to the ET tube after intubating and was sent onto the next pt. ACP seems to want us to be knowledgable about vents, based on the numerous questions asked about them on last summers paramedic exam. The same exam, in fact, that had exactly zero questions regarding 12 lead ECG's or ACS. Our training on CPAP was quite minimal. It involved a demonstration on its use. We had about 15 mins to set it up. Went over indications/contraindications. About a half hour on total I guess. As for your CPAP questions... Well lets just say I have some reviewing to do.