Continuous Positive Airway Pressure (CPAP)

Continuous Positive Airway Pressure has been shown to rapidly improve gas exchange and decrease work of breathing and dyspnea. CPAP can greatly reduce the need for advanced airway procedures in patients who suffer from shortness of breath secondary to CHF/pulmonary edema or COPD. Ask an old-timer EMS professional about intubation rates before CPAP, they’ll attest to the effectiveness of this life-saving device.

For use in patients complaining of moderate to severe respiratory distress meeting ALL the following criteria:

1. Is awake and can maintain an open airway.
2. Has a systolic blood pressure above 90 mmHg (MAP of 65 mmHg).
3. Is over 12 years old and can fit the CPAP mask.

Contraindications:

1. Respiratory arrest
2. Non-cooperative patient
3. Suspected pneumothorax
4. Hemodynamically unstable – BP< 90 systolic
5. Presence of tracheostomy
6. Inability to maintain mask seal.
7. Active vomiting

Procedure:

1. Explain and coach the patient on the procedure.
2. Ensure adequate oxygen supply to ventilate device and adjust to maintain 5mmHg.
3. Place the patient on continuous pulse oximetry.
4. Place the CPAP over the mouth and nose.
5. Secure the mask with the provided straps.
6. Check for air leaks.
7. Monitor and document the patient’s respiratory response to the treatment, titrate to 10 cmH₂0 as necessary.
8. Continue to coach patient to keep mask in place and readjust as needed.
9. If respiratory status deteriorates, remove device, and consider bag valve mask ventilation.