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prehospital c pap usage


EMS828

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Novisen,

What CPAP or PEEP valve are your using?

Are you running all your patients at approximately an FiO2 of 0.30?

High PaO2 is not the issue in the initial phase. High CPAP level can affect affect hemodynamics. Flow too high can increase expiratory work of breathing. Flow too low can increase inspiratory work of breathing.

1 bar = 14.5 psi

1 Cubic foot = 28.31 liters

H tank is 56 inches in Height with a Diameter of 9 inches

M tank is 47 inches in Height and 7 inches in diameter

D tank is 20.25 inches in Height and 4.25 inches in diameter

American tanks are usually filled to 2200 psi. Some composite tanks can hold up to 3000 psi.

Respiratory equipment such as ventilators or the Whisperflow run off a working pressure of 50 psi.

Size*** Factor *** Liters

H **** 3.14 **** 6908

G **** 2.41 **** 5302

M**** 1.65 **** 3625

E **** 0.28 **** 616

D **** 0.16 **** 352

B **** 0.068 **** 150

A **** 0.035 **** 76

Number of liters available in a tank = (PSI)(Conversion Factor)

For those that don't remember the conversion formula I mentioned earlier:

minutes = (PSI)(Conversion factor)/liter flow

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Novisen,

What CPAP or PEEP valve are your using?

Are you running all your patients at approximately an FiO2 of 0.30?

High PaO2 is not the issue in the initial phase. High CPAP level can affect affect hemodynamics. Flow too high can increase expiratory work of breathing. Flow too low can increase inspiratory work of breathing.

1 bar = 14.5 psi

1 Cubic foot = 28.31 liters

H tank is 56 inches in Height with a Diameter of 9 inches

M tank is 47 inches in Height and 7 inches in diameter

D tank is 20.25 inches in Height and 4.25 inches in diameter

American tanks are usually filled to 2200 psi. Some composite tanks can hold up to 3000 psi.

Respiratory equipment such as ventilators or the Whisperflow run off a working pressure of 50 psi.

Size*** Factor *** Liters

H **** 3.14 **** 6908

G **** 2.41 **** 5302

M**** 1.65 **** 3625

E **** 0.28 **** 616

D **** 0.16 **** 352

B **** 0.068 **** 150

A **** 0.035 **** 76

Number of liters available in a tank = (PSI)(Conversion Factor)

For those that don't remember the conversion formula I mentioned earlier:

minutes = (PSI)(Conversion factor)/liter flow

Thanks for your answear VentMedic!

What CPAP or PEEP valve are your using?

7.5cmH2O is standard and 5cmH2O for the ones who doesn´t accept 7,5. http://caradyne.respironics.com/valves.htm

For the intubated patients we have Oxylog 3000 for planned transportation. Every ambulance have one AMBU Matic Ventilator with demand valve 0-20cmH2O. http://www.med-worldwide.com/product4202.html

http://www.med-worldwide.com/peepvalve.html

Are you running all your patients at approximately an FiO2 of 0.30?

Yes! FiO2 is always 0.30. The liter flow Per/minutes is 120-150 liters/minutes.

Novisen//

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  • 2 months later...

two points that i want to bring up and the first is and it may sound rediculous but if cpap is new to you the most important part is a good mask seal and i know for a fact that if you have any air leak that it will burn through o2, the second thing is that atleast when treating CHF the problem is not the need for o2 it is the need to remove the fluid from the alveoli, you can bring a pt with an spo2 of 70% to an spo2 of 100 using only 30% Fio2 so the units that use high levels of o2 can be excessive for this purpose. using 30% i can usually make a D cylinder last for about 20 to 25 min

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two points that i want to bring up and the first is and it may sound rediculous but if cpap is new to you the most important part is a good mask seal and i know for a fact that if you have any air leak that it will burn through o2, the second thing is that atleast when treating CHF the problem is not the need for o2 it is the need to remove the fluid from the alveoli, you can bring a pt with an spo2 of 70% to an spo2 of 100 using only 30% Fio2 so the units that use high levels of o2 can be excessive for this purpose. using 30% i can usually make a D cylinder last for about 20 to 25 min

One point,maybe more, I want to make is please read the rules and start posting with sentences, capital letters to begin them. Thanks.

A little extra effort will make it easier to read your posts. Welcome to the city by the way.

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One point,maybe more, I want to make is please read the rules and start posting with sentences, capital letters to begin them. Thanks.

A little extra effort will make it easier to read your posts. Welcome to the city by the way.

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Not if you have one of these on your ambulance 8)! We have one on our newest unit. Well worth the money and the County gets a break on their Workers Comp because of it.

http://www.ziamatic.com/3000-ots.HTM

Yeah, CPAP use quite a bit of O2. As others have stated, carrying extra cylinders with you is the way to go for long transports.

Does the ziamatic raise it back into place as well?

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We've had CPAP since December 1, 2007 and so far it is being used about once per week with great success. The hospital emergency rooms are doing a great job of having respiratory ready for us when we arrive. We give early notification because our transport times are usually less than 10 minutes. I review every trip sheet where CPAP has been used and all cases were appropriate.

Live long and prosper.

Spock

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