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Evaluation of the Effect of Prehospital Application of Continuous Positive Airway Pressure Therapy in Acute Respiratory Distress

Published online by Cambridge University Press:  28 June 2012

G. Scott Warner*
Affiliation:
Cullman Emergency Medical Services, Cullman, Alabama, USA
*
Medical DirectorCullman Emergency Medical Services1890 Alabama Highway 157Suite 420Cullman, AL 35055USA E-mail: swarner@prn-inc.net

Abstract

Objective:

The impact of the use of mask continuous positive airway pressure (CPAP) on patients with acute respiratory distress in the prehospital, rural setting has not been defined. The goal was to test the use of CPAP using the Respironics® WhisperFlow® CPAP in patients presenting with acute respiratory distress. This was a collaborative evaluation of CPAP involving a rural EMS agency and the regional medical center. Patient outcomes including the overall rate of intubation-both in the field and in the emergency department (ED), and length of stay in the hospital and Intensive Care Unit (ICU) were tracked.

Methods:

The study was an eight-month, crossover, observational, non-blinded study.

Results:

During the four months of baseline data collection, 7.9% of patients presenting with respiratory distress were intubated within the first 48 hours of care. Their average ICU length of stay was 8.0 days. During the four months of data collection when CPAP was available in the prehospital setting, intubation was not required for any patients in the field or in the ED. Admissions to the ICU decreased. Those patients admitted to the ICU, the average ICU length of stay deceased to 4.3 days.

Conclusions:

The use of the CPAP in the prehospital setting is beneficial for patients in acute respiratory distress.

Type
Brief Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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References

1.Kosowsky, JM, Gasaway, MD, Stephanides, SL, Ottaway, M, Sayre, MR: EMS transports for difficulty breathing: Is there a role for CPAP in the prehospital setting? Acad Emerg Med 2000;7(10):1165Google Scholar
2.Reissmann, HK, Ranieri, VM, Goldberg, P, Gottfried, SB: Continuous positive airway pressure facilitates spontaneous breathing in weaning chronic obstructive pulmonary disease patients by improving breathing pattern and gas exchange. Intensive Care Med 2000;26(12):17641772.CrossRefGoogle ScholarPubMed
3.Hubble, MW, Richards, ME, Wilfong, DA: Estimates of the cost effectiveness of prehospital continuous positive airway pressure in the management of acute pulmonary edema. Prehosp Emerg Care 2008;12(3):277285.CrossRefGoogle ScholarPubMed
4.Kosowsky, JM, Stephanides, SL, Branson, RD, Sayre, MR: Prehospitaluse of continuous positive airway pressure (CPAP) for presumed pulmonary edema: A preliminary case series. Prehosp Emerg Care 2001;5(2):190196.CrossRefGoogle ScholarPubMed
5.Sullivan, R: Prehospital use of CPAP: Positive pressure=positive outcomes. Emerg Med Serv 2005;34(8):120126.Google Scholar
6.Best Practices in Emergency Services: Hospital invests in EMS CPAP and saves money. Best Practices in Emergency Services: 2007;10(10):109,120.Google Scholar
7.Kallio, T, Kuisma, M, Alaspää, A, Rosenberg, P: The use of prehospital continuous positive airway pressure treatment in presumed acute severe pulmonary edema. Prehosp Emerg Care 2003;7(2):209213.CrossRefGoogle ScholarPubMed