Emergency steps one should take (?)

[wardmiller]

Of course it helps force air into the lungs

CPAP doesn't "force air into the lungs" - the pressures are much too low for that

CPAP is primarily for the purposes of "stinting" an airway that is blocked by muscular issues in the throat.

Many first-responder resuscitation protocols advise that a patient is physically arranged, if possible, so that they are lying on their side, to minimise the risk of airway blockages

Cheers,

Bill

As I said elsewhere, I'm an Emergency Medical Technician in New York State. Our protocol is ABC (Airway, Breathing, Circulation (bleeding)), in that order. For the unconscious patient, we first thrust the jaw forward. In virtually all cases, that separates the tongue from the soft pallet and opens the airway. Then we begin two puffs and 25 chest compressions, at the rate of 100/min. If we have our trauma bag (I always have mine in my car,) rather than give mouth-to-mouth we use the bag/valve/mask where squeezing the bag forces air into the lungs. But recent studies have shown compressions are more significant than forced air, so the American Heart Association has upped the rate of chest compressions (to keep the blood circulating) and reduced the number of forced breaths.

Also, our protocol requires we have the patient supine (on their back) in most cases, especially when performing CPR.

[Sheffey]

I'm a certificated Emergency Medical Technician in New York State and I've never heard of any EMTs carrying CPAPs. Could you perhaps be thinking of AEDs? (Automatic External Defibrillators)? We have them on all our ambulances, but I have never heard of anyone carrying one in their car.

It was in our little local newspaper a year or more ago that they are buying CPAPs in our area.

Seems to be plenty of info on the internet - https://www.google.com/search?q=cpap+an ... =firefox-a

Please correct me if I got the wrong impression. I am certainly not well informed on the subject. But it was a point of interest because I am a CPAPer.

[quietmorning]

Thank you everyone for your input. My husband and I had a very interesting talk concerning what to do - and had a mental run through of sorts. It's been a while since either of us have been CPR certified, I think that's something we might look into, you just never know when you might need it.

In any case, now he knows NOT to run to get my CPAP machine!! **laughing** And that mouth to mouth will be the best option for me until help arrives. Thankfully our emergency services are about four blocks from our house, and they already have directions to bust the door in if they need to.

[Sir NoddinOff]

It's a good idea to let all your individual doctors, med techs and RNs know about your CPAP requirements and provide them with a copy of your prescription. The more folders that your info is in, the better. That way if you have an incident on the Friday thru Sunday, when most of the doctors etc are on the golf links (just kidding, some are at wine bars) then they can find possibly one doctor to advise the hospital in the event of an emergency about your CPAP requirements and compel the hospital to provide a temporary machine and mask.

[mollete]

I'm a certificated Emergency Medical Technician in New York State and I've never heard of any EMTs carrying CPAPs.

Well down here (out of Appalachia) all the buses have CPAP, and have for a few years:

http://www.healthcare.philips.com/pwc_h ... 010_09.pdf

http://www.slideshare.net/croaker260/em ... esentation

Man, there's too many. Search Prehospital Use of CPAP

[wardmiller]

I'm a certificated Emergency Medical Technician in New York State and I've never heard of any EMTs carrying CPAPs.

Well down here (out of Appalachia) all the buses have CPAP, and have for a few years:

http://www.healthcare.philips.com/pwc_h ... 010_09.pdf

http://www.slideshare.net/croaker260/em ... esentation

Man, there's too many. Search Prehospital Use of CPAP

Those references are interesting. But I take, on the average, 48 hours of recurrent training every year and not once has CPAP been mentioned in the 15 years I've been an EMT. I'll ask about it at the next class.

Also interesting about your buses having CPAP. When would they be used? When a passenger wants to sleep? Who cleans them after they have been used? We have a lot of AEDs, in public places, our County's sheriff deputy's cars all have them, all our ambulances, gyms and so forth. But at each installation, employees are trained in their use.

[Drowsy Dancer]

I'm a certificated Emergency Medical Technician in New York State and I've never heard of any EMTs carrying CPAPs.

Well down here (out of Appalachia) all the buses have CPAP, and have for a few years:

http://www.healthcare.philips.com/pwc_h ... 010_09.pdf

http://www.slideshare.net/croaker260/em ... esentation

Man, there's too many. Search Prehospital Use of CPAP

So from the first article, at least, the idea behind carrying a CPAP machine in an aid car is not so much in case they pick up someone with OSA, but as an alternative to intubation.

[The Choker]

the idea behind carrying a CPAP machine in an aid car is not so much in case they pick up someone with OSA

I guess it is good to state the obvious.

[MagsterMile]

I'm reading that 10's of millions of people have OSA and many more are underdiagnosed. I have a medical alert info tag on my fridge so that if the Fire Dpt./Police Dpt. ever need to enter my home if I can't answer the door, they go right to the fridge and the info is right there for them.

[jencat824]

Make a detailed living will, with specifics, not vague generalities. Have discussions with your spouse (or designated medical power of attorney) about what you want or don't want done if there were to be a devastating diagnosis and you are not able to communicate your wishes. Too many families are left with choices that are made that more difficult by not knowing what their loved one's wishes are.

This is a very good point - I'm big on making sure people have living wills - it gives everyone else in the situation the specifics of what you want done if you can't say so for yourself.

Jen

Some of the services listed on the medical ID thread that prompted this thread allow you to upload your living will/directive to physicians/etc. to their sites--most notably MedicAlert. Washington state used to have an upload program called the Living Will Registry. If I recall correctly they offloaded it to something called the U.S. Living Will Registry and my directive is uploaded there. I have a sticker on my driver's license to note that, but reference should go on my (future) medical ID as well.j

Also--just a usage point--the person in whose favor you have executed a medical power of attorney is not called your "medical power of attorney"--they are your "attorney-in-fact" for medical issues. A "power of attorney" is a document, not the name or status of a human being.

Thanks, DD, I stand corrected. I've heard this terminology used so much I just never thought of it the correct form.
Jen

[Drowsy Dancer]

the idea behind carrying a CPAP machine in an aid car is not so much in case they pick up someone with OSA

I guess it is good to state the obvious.

It's a dirty job but someone has to do it.

[mollete]

Those references are interesting. But I take, on the average, 48 hours of recurrent training every year and not once has CPAP been mentioned in the 15 years I've been an EMT. I'll ask about it at the next class.

You might want to make sure the device you get has "BiPAP" capability (AKA NIPPV ).

http://www.naemsp.org/Documents/POSITIO ... c-2011.pdf

Also interesting about your buses having CPAP. When would they be used?

Sorry, down here we call ambulances "buses" or "boxes". Trade talk for those in the field.

Play this at the next club meeting:

Modalities

[wardmiller]

[quote="mollete"
Play this at the next club meeting:

Modalities[/quote]

That is an interesting slide show and I'll forward it to our EMS Director. But our protocol is rigidly control by the State and the change would require approval of both the State and the hospitals. I don't see that happening any time soon, regardless of how persuasive the argument.

[mollete]

But our protocol is rigidly control by the State and the change would require approval of both the State and the hospitals. I don't see that happening any time soon, regardless of how persuasive the argument.

CPAP was approved by New York SEMAC in 2008. Here's the Hudson Valley protocols:

http://www.hvremsco.org/Documents/Hudso ... otocol.pdf

[mollete]

But our protocol is rigidly control by the State and the change would require approval of both the State and the hospitals. I don't see that happening any time soon, regardless of how persuasive the argument.

CPAP was approved by New York SEMAC in 2008. Here's the Hudson Valley protocols:

http://www.hvremsco.org/Documents/Hudso ... otocol.pdf

No clutter! People are interested in this!

Search the document using Control + F then keyword CPAP.