LO5 CPAP

Question 1

• CPAP

Answer 1

is a respiratory modality which can assist patients in their breathing

distends alveoli preventing collapse on expiration

allows for greater surface area, which improves gas exchange

increases medication distribution when used for COPD

is very effective in reducing the amount of fluid in the alveoli and increase the FiO2 (Fraction of Inspired Oxygen) of the inhaled air up to 100%

Question 2

• The overall goal of CPAP

Answer 2

CPAP is to increase Functional Residual Capacity(FRC)

Question 3

• Functional Residual Capacity(FRC

Answer 3

is the volume of air present in the lungs at the end of passive expiration.

Question 4

How does CPAP work?

Answer 4

• CPAP mask forms a tight seal around patients mouth and nose.
• CPAP system pressurizes the patients airway while still allowing them to spontaneously inhale and exhale on their own

Question 5

What is CPAP?

Answer 5

• CPAP increases pressure in the lungs and holds open collapsed alveoli, pushes more oxygen across the alveolar membrane, and forces interstitial fluid back into the pulmonary vasculature.
• This improves oxygenation, ventilation and ease of breathing.
• The increased intrathoracic pressure decreases venous return to the heart and reduces the overwhelming preload (pressure in the ventricles at the end of diastole).
• This lowers the pressure that the heart must pump against (afterload), both of which improve left ventricular function.
• CPAP alters the pressure gradient

Question 6

protocol criteria for CPAP

Answer 6

• Patient must be alert and able to follow commands (GCS >13)
• Be able to maintain an open and patent airway on their own
• Patient is over 12 years of age and must be able to fit the CPAP mask
• PCP’s may apply CPAP to adult patients with severe respiratory distress
• Severe Respiratory distress as per Paramedic Clinical Practice protocols is RR greater than 25,SPO2 less than 92%, use of accessory muscle use.
• If the CPAP is on, try to keep it on. Alveoli can collapse again within seconds.
• It may take hours to reopen alveoli again

Question 7

Indications for CPAP

Answer 7

• Hypoxemia secondary to congestive heart failure
• Acute cardiogenic shock
• Pulmonary edema
• Asthma/COPD
• Respiratory distress (A respiratory rate >25bpm, SpO2 <92%, accessory muscle use during

Question 8

CPAP Contraindications

Answer 8

• Pneumothorax or chest trauma
• Hemodynamically unstable patients
• Altered mental state
• Patient has a tracheotomy
• Patient is actively vomiting
• Patient has an upper GI bleed