2015 Trumbull Memorial Hospital Demo

CPAP

CPAP

Indications:  Acute respiratory distress other than pneumothorax. Particularly pulmonary edema, asthma, COPD.  Patient is alert and oriented.  Is over 12 years of age and CPAP mask has proper seal.  Has ability to maintain open airway.  Has a systolic pressure above 90mmHg.  Uses accessory muscles during respirations.  Signs and symptoms consistent with pulmonary edema, asthma, COPD, pneumonia. Contraindications:  Patient is in respiratory arrest.

 Patient is suspected of having a pneumothorax.  Decreased cardiac output and gastric distention.  Hypotension secondary to hypovolemia. Precautions:  Watch for impairment of mental status during therapy.  Patients with upper GI bleeds.

 History of recent gastric surgery. Use 5 cm H2O and no higher in these patients.  Complaints of nausea or vomiting. Discontinue immediately and ensure patent airway.

 Patient has inadequate respiratory effort or excessive secretions.  Patient has facial deformity that inhibits proper CPAP mask seal.

Steps

Performed? Yes No

1. Assure spontaneous respirations. Perform appropriate patient assessment including vital signs, pulse oximeter, and heart monitor. 2. Ensure that the proper valve or flow rate is to be applied. Typically, start with 5 cm H2O and increase to 10cm H20. Ensure that the filter is attached to prevent infection. Many devices have a conversion chart from LPM to cmH2O. Know your equipment. 4. Explain the procedure to the patient.  Advise the patient that they will feel strange at first, then they should experience relief.  Flip head strap forward and place mask on face. 5. Flip head strap back over patient’s head, bring tabs forward on top head strap and adjust equally to proper fit. Attach bottom 2 clips and repeat above sequence. 6. Adjust as necessary, or per the manufacturer’s recommendations. DO NOT OVERTIGHTEN HEAD STRAP. 7. Success is highly dependent upon patient tolerance and provider’s ability to coach the patient.  Anticipate and control anxiety  Verbally coach breathing as needed  Consider having the patient hold the mask to reduce anxiety. The provider may also hold the mask. 3. Remove mask from inner bag and attach circuit. Turn on oxygen.

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8. Adjust flow rates as necessary.

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EMR

EMT

AEMT

Paramedic

Extended