CPAP - Frequency of Use

[VentMonkey]

Sorry, regarding the near-drowning/ drowning victims, TJ.

 

[TransportJockey]

Sorry, regarding the near-drowning/ drowning victims, TJ.

Primarily for wet drowning victims, who have salt or brackish water in the lungs themselves, and our medical director has said there migjt ne some benefit of cpap use to prevent secondary injuries further down their clinical course. Im trying to find the studies now.

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[VentMonkey]

Primarily for wet drowning victims, who have salt or brackish water in the lungs themselves, and our medical director has said there migjt ne some benefit of cpap use to prevent secondary injuries further down their clinical course. Im trying to find the studies now.

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I wonder if it has any efficacy in relation to the likelihood of decreasing the risk for/ development of ARDS in these patients ling term.

Perhaps we can have a doc, or two chime in as well, and elaborate.

 

[Tigger]

We are burning crazy amounts of oxygen with our Pulmodyne yellow boxes. A portable tank has a lifetime of 3-4 minutes with ours, and a main is dead in 30 minutes. Not sure if it's normal function, but administration refuses to consider alternatives...

Do you mean portovent? We have those and find they work excellent, but they can be rough on the O2 supply. Not as bad you've listed though, we'll do hour plus transports on one house tank no problem. If you can't get a complete seal they will kill a cylinder real quick though.

CPAP has saved more than a few tubes on my calls and is useful for so many presentations.

 

[RocketMedic]

That's the one. They work well, but they are getting old and I think they are pulling way too much oxygen.

 

[NomadicMedic]

The portOvent should be serviced every year and you have to make sure all of the connections are tight and the hoses are in good shape. We had one that was burning through oxygen and found some cracked hoses that were just wasting oxygen.

 

[VentMonkey]

The PortO2Vent: "So easy, even LACoFD uses us."

 

[EpiEMS]

While we're on the topic of CPAP:

Has anyone had any experience, knowledge, or luck with using it to splint a flail segment?

Apparently, while not routine, it can, and has been done for these patients, and is supposed to work quite well given the patient selected is young, and healthy enough to tolerate it.

We went over this in my CCP course, and just wondered if anyone on the forum has any working knowledge of this, thanks.

Looks like there's a profusion of literature on the subject -- and it seems pretty safe

 

[RocketMedic]

The portOvent should be serviced every year and you have to make sure all of the connections are tight and the hoses are in good shape. We had one that was burning through oxygen and found some cracked hoses that were just wasting oxygen.

That would imply that leadership wanted or utilized my opinion....

 

[Handsome Robb]

How is that working for you? In my personal experience, sub-dissociative doses of ketamine tend to be anxiety-provoking most of the times I've given it. They'll stop complaining about the pain, but will get visibly anxious, occasionally diaphoretic, and tachycardic (that seems more pronounced and related to the anxiety as opposed to the typical symptathomimetic response ketamine elicits). So I'm curious to see if you've used it personally and to what effect.

We can re-dose it PRN at 50% of the first dose. So 25mg IM or 12.5mg IV. It's worked decently well however we're looking at doing lower dosing more frequently to try and avoid the side effects of sub-disassociative doses


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[VentMonkey]

We can re-dose it PRN at 50% of the first dose. So 25mg IM or 12.5mg IV. It's worked decently well however we're looking at doing lower dosing more frequently to try and avoid the side effects of sub-disassociative doses


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Not to take away from the original topic of this thread, but this to me, is interesting.

While I understand our medical director is more than happy to, and will (hopefully soon enough) return Ketamine to our RSI protocol, when I inquired about its use for DSI, and the like, I was informed of his concerns with the possibility of an emergence response, particularly in flight; this makes total sense to me.

Just interesting to me to be able to hear others experiences with Ketamine's utilization for sedation, and such.

 

[EpiEMS]

Not to take away from the original topic of this thread, but this to me, is interesting.

It's totally informative -- speaks to some of the issues with CPAP (i.e. patient anxiety, etc.)!

 

[VentMonkey]

We're allowed, and should be IMO encouraged to keep Versed handy, assuming their BP doesn't drop from the positive pressure alone, or isn't teetering to begin with.

 

[NomadicMedic]

That would imply that leadership wanted or utilized my opinion....

Thought you were a supe there?

 

[Kenneth Young]

Has anyone used the O_2 CPAP system? It's almost as simple as a simple NR mask, but uses O2 pressure to create the CPAP. We have one, and I've used it once. It seemed effective, yet I would like more feedback on if anyone uses it. Seems like it would be cost effective, and good for limited ability to carry supplies, like in remote environments.

Your feedback is appreciated.

 

[VentMonkey]

Has anyone used the O_2 CPAP system? It's almost as simple as a simple NR mask, but uses O2 pressure to create the CPAP. We have one, and I've used it once. It seemed effective, yet I would like more feedback on if anyone uses it. Seems like it would be cost effective, and good for limited ability to carry supplies, like in remote environments.

Your feedback is appreciated.

http://otwo.com/emergency-cpap/o_two-single-use-cpap/

This thing?

 

[Kenneth Young]

http://otwo.com/emergency-cpap/o_two-single-use-cpap/

This thing?

Yes that's the one. I used it on a CHF patient off shore in Alaska. Seemed to work well but I want more info if that's the norm.

 

[VentMonkey]

Yes that's the one. I used it on a CHF patient off shore in Alaska. Seemed to work well but I want more info if that's the norm.

Ah, cool. Are you an off shore paramedic?

It seems to be similar to what we use in our system. We use the Pulmodyne® disposable model, but I am venturing to guess most prehospital CPAP devices are a fairly simple to set up, and a very effective tool.

And FWIW, many of the in-hospital BiPap are this fairly straightforward as well.

 

[Kenneth Young]

Ah, cool. Are you an off shore paramedic?

It seems to be similar to what we use in our system. We use the Pulmodyne® disposable model, but I am venturing to guess most prehospital CPAP devices are a fairly simple to set up, and a very effective tool.

And FWIW, many of the in-hospital BiPap are this fairly straightforward as well.

Thanks. I've used the mechanical pre-hospital systems, and the normal vents, but this CPAP seemed so simple and easy to use I didn't know what to take from it. I wasn't sure to trust it. It did help save a patient who had a STEMI with CHF long enough for him to make it to a small shore clinic and on further for a 3 hour flight to Anchorage's Cath lab (along with other interventions). If I'm going to order more I want to ensure that's the norm.

Yes, off shore..... actually on a factory trawler in Alaska's Bering Sea. (Fishing Vessel with a processing factory on board crewing 130 people). It adds some interesting aspects and challenges to medicine out here.

 

[VentMonkey]

Thanks. I've used the mechanical pre-hospital systems, and the normal vents, but this CPAP seemed so simple and easy to use I didn't know what to take from it. I wasn't sure to trust it. It did help save a patient who had a STEMI with CHF long enough for him to make it to a small shore clinic and on further for a 3 hour flight to Anchorage's Cath lab (along with other interventions). If I'm going to order more I want to ensure that's the norm.

Yes, off shore..... actually on a factory trawler in Alaska's Bering Sea. (Fishing Vessel with a processing factory on board crewing 130 people). It adds some interesting aspects and challenges to medicine out here.

I presume you're a wealth of knowledge for anyone inquiring about wilderness medicine then, very nice.