Emergency steps one should take (?)

[wardmiller]

Continuous Positive Air Pressure (CPAP), if available, shall be applied on all patients where indicated by the patient’s clinical condition. This skill is limited for implementation by EMT-P personnel only.

Well, that lets me out because I'm an EMT-B. I'll ask our Medics if they have been trained in this. Of all the patients I've transported, many with ALS, in 15 years, I've never encountered CPAP. So it can't be in very common use in emergency situations.

[mollete]

So it can't be in very common use in emergency situations.

No, just asthma, COPD, bronchospasm, acute pulmonary edema, and congestive heart failure. But how often do you really see those?

Of all the patients I've transported, many with ALS, in 15 years, I've never encountered CPAP.

At least that's encouraging.

Oh.

I guess that's not "amyotrophic lateral sclerosis".

In that case, that's discouraging.

[SethW]

So the question of the OP (quietmorning) was whether somebody should run and fetch her CPAP if she collapsed.The best advice on being prepared was given by PreemieNrsTiffy, who said the family should learn CPR. Assuming the person who collapsed is breathing, they should be placed in the recovery position like billbolton said, and should be monitored to make sure they keep breathing. If the person isn't breathing or stops breathing, then the airway can be opened with a head-tilt chin-lift or jaw-thrust, which is what somebody would learn in a CPR class.

There is a CPAP protocol in my state, but it is indicated only for people who are breathing and able to maintain a patent airway on their own and who have a chronic respiratory disease of some sort. So I would say if you are having trouble breathing, and they've already called 911, and you want to try it, then sure, have them get the CPAP device and bring it to you, and see if it helps until EMS arrives. But if you collapse and are unresponsive, they should do what they learned in CPR class. Me personally, my CPAP device is set to low pressure and I doubt it would help much if I were having serious trouble getting air in.

I found more here about why CPAP might be useful:

http://www.jems.com/article/patient-car ... cpap-s-eff

[PreemieNrsTiffy]

So the question of the OP (quietmorning) was whether somebody should run and fetch her CPAP if she collapsed.

. . the family should learn CPR.

There is a CPAP protocol in my state, but it is indicated only for people who are breathing and able to maintain a patent airway on their own and who have a chronic respiratory disease of some sort.

Discussing whether EMS should/shouldn't implement CPAP on their boxes is fascinating and all, but . . .

I'm just saying.

I'm a huge advocate of CPAP for a variety of uses. I only wish I could communicate how use of non-invasive CPAP has vastly improved our respiratory (and really all) outcomes in preterm infants, it's dramatic. But using CPAP on an adult who is apneic and doesn't have an obstructed airway is pointless. If the adult is nonresponsive and apneic, don't initially assume sleep apnea, that would be responsive. Community CPR standards don't even recommend respiratory interventions for nonresponsive adults which I'm still getting used to, but I digress. . .