Congestive Heart Failure

[bassnmedic]

Rid, great article, covered every aspect and was very informative. What is your take on pre-hospital use of CPAP in CHF and Cardiogenic Pulmonary Edema? We just started using it at my service and have had excellent results, even in the severe cases and have prevented ET use on most all of them.

[Ace844]

Rid, great article, covered every aspect and was very informative. What is your take on pre-hospital use of CPAP in CHF and Cardiogenic Pulmonary Edema? We just started using it at my service and have had excellent results, even in the severe cases and have prevented ET use on most all of them.

I personally think that BiPAP should be useed in lieu of CPAP pre-hospital and that it is more effective in these cases.

ACE

[hammerpcp]

I had a pt with "suggestive heart failure" the other day. Now that is a serious medical condition!

[JPINFV]

^

Was the heart failure psychosomatic?

MD: You are not in heart failure.

Pt: Yes I am

Monitor: ___/______/_____/_____/_____/_______///////_________________

[ffmedic9588]

Great read Rid thank you for sharing your knowledge and helping us all become better medics. This site has so many great knowledgable people who like to teach and learn and share ideas it is great.

[Ridryder 911]

CPAP is one of the newest and best treatment regime we have started performing in years. My state is reviewing and meeting next week on the possibility of allowing the Basic EMT to perform CPAP. This definitely would help out CHF patients, I am concerned although on the diagnostic capabilities of differentiating between the CHF and COPD/Asthmatic, which could blow a bleb and cause barotrauma.

Speaking of, they now have neat device to allow you to administer neb's in line with CPAP either traditional neb, or per ETT. This is great for those with both CHF and asthma at the same time. Like any other tool, it has its' limits and dangers as well as benefits.

R/r 911

[AZCEP]

As Ace brought up, wouldn't BiPAP be a better choice for COPD?

Don't CPAP generators carry the ability to use BiPAP, or would this be an entirely separate piece of equipment?

I ask because we are looking at the Boussignac device, which is reasonably priced and doesn't require any other system mods.

[Ridryder 911]

Be careful of the Boussignac device. I just listened to a CPAP lecture yesterday discussing it. It is true it is reasonable, and does not use oxygen like the determined type set; however your oxygen set must be able to deliver 25 lpm to deliver the appropiate level of pressure. One needs to purchase a manometer as well to measure the amount of pressure ( I heard it was approx $10.00 for disposable and about $100.00 for a permanent one. The other disadvantages was the mask was not as form fitting, (which is important for high pressure) and it is very noisy!....

Like I said, it is economical and it does work....

R/r 911