Equipment 8-198 - Continuous Positive Airway Pressure (CPAP)

Polk, Hickory, Cedar, & St Clair EMS Protocols

Scope of Practice:

Registered Nurse

Paramedic

Indications:

Contraindications:

Less than 18 yrs old.

Patient unable to protect airway.

Need for immediate Intubation.

Ventilatory failure.

Gastric distention (GI bleeding).

Trauma (pneumothorax).

Tracheostomy.

Altered LOC.

Do not secure straps if Nausea or Vomiting.

Increasing ETCO2.

Precautions:

CPAP is not mechanical ventilation.

Blood pressure may drop due to increased intrathoracic pressure.

Patients may not improve (must reassess).

Patients may not accept mask (claustrophobia).

Risk of pneumothorax.

Risk of corneal drying.

Large Oxygen demand.

Procedure:

Inform and calm patient.

Connect and turn on Oxygen to "flush." Set PEEP to 10 cm H2O (may titrate to 15 as needed).

Flip head-strap forward.

Hand to or place mask on patient. Hold mask firmly against face to eliminate air leaks

Flip head-strap over head after patient is comfortable. Remove straps if Nausea develops

Clip bottom straps.

Adjust fit.

Monitor patient. May raise intrathoracic pressures, reducing preload, therefore reducing blood pressure.

Anxiety:

Consider Versed 2.5 mg IV/IO/IM.

An in-line bronchodilator Nebulizer may be placed in circuit, if needed.

Change Log:

Date	Link to previous version	Description of change
12/15/13	pdf	Changed to ALS skill.
08/24/17	pdf	Removed Ativan.
07/04/20		Renumbered the section to allow for future additions.
07/12/20	pdf	Added content (without substantive modification) from old Section 8-050 - Continuous Positive Airway Pressure (CPAP).
10/05/20		Added indication for 8-936 - Ventilator.
06/11/21	pdf	Moved to emsprotocols.online
10/14/21	pdf	Changed link from 2-198-01 to 2-198-50.
12/01/21		Updated link to Versed.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols by Theron Becker is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.