Cpap

For BLS, I would say it depends on the device used.

Many prehospital CPAP devices are very simplistic with a 15 L/m flow, entrainment ports and a resistive valve. Some are better than others. If CPAP is from a mechanical device like a ventilator, then it definitely should be ALS.

As long as you have a grasp for the relationship between BP and CPAP, can clear an airway, by suctioning or however, and know when to move to plan B, EMT-Bs can probably do CPAP if they have the proper medical oversight.

Here is a good link:

http://www.johnmohler.com/documents/NLTFPD 2007/EMSCPAPLecture.pdf

The machine pictured in one of the slides is a Respironics Vision and is capable of 240 L/M of flow. There is no comparison between it and what is offered prehospital. Even on the LTV 1200 ventilator, I am only getting around 40 - 60 L/m with its internal PEEP/CPAP capabilities.
 
Vent, that's a very nice slideshow. Not too much A&P to really confuse people but enough to understand how your tools are working.

I might have to do some further research as to the name of the unit we use but it looks like the one on the right in the first slide with a "fighter pilot" mask and hose then the valve 5 or 7.5 we carry goes right on the front of the mask. We were told that it ran at 110-115 L/M which sounds very high based on your explanation of the other systems.
 
Here in the state of Maine, Intermediates can use CPAP (we use the oxy-peep device) with OLMC, Paramedics can use it as a standing protocol. I've only attempted the device once pre-hospital and had negative results. The patient was so hypoxic he began to panic. I went back to a non-rebreather and gave more Nitro with a lasix chaser. We were only a few minutes from the ER. He never went down needing intubation and at the ER they ended up sedating and placing him on BIPAP for a few hours to turn him around.
 
CPAP was recently added to the BLS protocols effective Nov 1, 2008 in Pennsylvania. A very nice addition I must say.
 
We have also added CPAP to the basic level as well.

R/r 911
 
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