CPAP

[joesph]

So has anyone used the CPAP system in EMS our medical director has opened up protocol to use it for COPD, CHF, asthma, ephazima in field. Disposable units run around 50 bucks but they are suppose to be O2 hogs. And the reusable systems are a lot better but run 1500 bucks. So is the system the whiz bang I have heard or just another nifty trinket.

[Ridryder 911]

So has anyone used the CPAP system in EMS our medical director has opened up protocol to use it for COPD, CHF, asthma, ephazima in field. Disposable units run around 50 bucks but they are suppose to be O2 hogs. And the reusable systems are a lot better but run 1500 bucks. So is the system the whiz bang I have heard or just another nifty trinket.

There is several articles about CPAP; as it has been out in the EMS world for several years now as a well proven device. Yes, they are one of the best devices to treat pulmonary edema. Remember, it is not for all types of respiratory diseases. As well, one should be formally educated in respiratory diseases and the details of CPAP before utilizing them.

In reference to oxygen usage, yes they use more than the normal nonrebreather but who cares? It works. True medical devices that increase outcomes and reduce morbidity and mortality should not be referred as a trinket.

R/ 911

[VentMedic]

So has anyone used the CPAP system in EMS our medical director has opened up protocol to use it for COPD, CHF, asthma, ephazima in field. Disposable units run around 50 bucks but they are suppose to be O2 hogs. And the reusable systems are a lot better but run 1500 bucks. So is the system the whiz bang I have heard or just another nifty trinket.

Emphysema?

What level are you? How much education have you had with the above diseases? How much do you know about CPAP? What additional education will your medical director provide you?

CPAP has been around for well over 50 years and its results are fairly well documented in the medical literature. However, prehospital devices do vary in their performance to meet patient demand.

Here is an educational website from Respironics. The sign on is easy and free. Look for NPPV courses under the CE modules as well as the training video of their product the WhisperFlow.

http://elearning.respironics.com/index_f.asp

Edited April 24, 2009 by VentMedic

[WolfmanHarris]

Thanks for the resource Vent. Word of advice for others though, if you want access to the full catalog of CME, don't check off EMS in your profile. I went back and checked "other" to get them all. Not all relevant obviously, but interesting.

[croaker260]

So has anyone used the CPAP system in EMS our medical director has opened up protocol to use it for COPD, CHF, asthma, ephazima in field. Disposable units run around 50 bucks but they are suppose to be O2 hogs. And the reusable systems are a lot better but run 1500 bucks. So is the system the whiz bang I have heard or just another nifty trinket.

Yep, its pretty much as whiz bang as promised....only real downside is we dont tube as much.... I liked snatching breathers from the jaws of death with an old fashioned nasal tube while the rookies were still searching for an IV line to RSI/MAI.... Ahh the good ol days...

Seriously...CPAP in EMS is a true boon to pt. care.

Just understand that:

1- Some people will still need a tube...

2- Hypotension risk

3- Upper GI/Gastric distention concerns

4- Importance of the face mask seal

Our protocol here:

http://www.adaweb.net/LinkClick.aspx?filet...d&tabid=798

[VentMedic]

Just remember that while protocols or recipes are good, you still need a thorough understanding of the disease processes and a good device rep to get you started correctly as to how to use it.

[Richard B the EMT]

As of this time, my experiences with CPAP is restricted to the treatment of Sleep Apnea, with humidified room air, at home.

I am the patient.

[VentMedic]

As of this time, my experiences with CPAP is restricted to the treatment of Sleep Apnea, with humidified room air, at home.

I am the patient.

Which model are you using?

I am just amazed at the technology available for that "industry".

Right now the Sleep Lab is still a nice cash cow for the RT department.

It is also a healthcare profession that quickly saw that proper education, certification and licensure are being obtained to work with these labs and the CPAP machines. Many places now require at least a two year degree.

Edited April 24, 2009 by VentMedic

[Niftymedi911]

I too have a CPAP machine at home for the evening as well.

I run a ResMed Elite II EPR with a HumidAire3i humidifier and a Mirage Liberty partial mask. I have the one were it covers the mouth and has nasal pillows for the nose. I'm running @ 11 of PEEP at night. In a way its kinda scary. The most we can use prehospital of PEEP is 10 unless we have MD's orders to go higher, at the very least at night I need 11.

The only down side to it, even with my humidifier on and set to almost max, I have frequnet nose bleeds.... roughly 2 times a week I'll wake up with dried blood in the nasal pillows or in my nose.

The CPAP machine at night for me was hands down one of the absolute best decisions in my life. I used to fall asleep all the time during the day, even after having a full 8 hrs of "sleep". It got to were work got invloved and threatened to take me off the road bc of the of complications. Found out after the sleep study I stopped breathing roughly 58-60 times an hour. My doctor said, it wasn't just some problem, it was life-threatening. And ever since the RT came to my home and set the machine up. I think more clearer, I act more appropriate, I have energy to do things I use to not be able to, and I actually wake up feeling completely refreshed in the morning.

[VentMedic]

Here's a little freebie full of good info for Niftymedi911 and Richard B the EMT.

http://www.sleepreviewmag.com/