CPAP/BiPAP equipment recommendation

[Doczilla]

Hey y'all, I'm looking for a recommendation for CPAP/BiPAP machines for prehospital use. Our service is adding this to the armamentarium, and I put a great deal of stock in experiences people have had with field use (everything looks great in the box when the rep is trying to sell it to you. Doesn't mean it works.). If there is a particular device/manufacturer you have used and like or don't like, please chime in. If there is something cool and high-speed/low-drag that you have heard about, I'd like to look into that too. I am looking specifically for CPAP or BiPAP, not ventilators (though if the device does double duty, that's fine too).

I am NOT intending to open a discussion as to the various merits of prehospital CPAP use, general treatment of respiratory distress, pathophysiology of CHF, the dumbing down of the EMS curriculum, or whether or not volunteer squads should be eliminated. :wink:

Thanks for your input.

'zilla

[Ridryder 911]

We have been using the "oxygen saver " model types for about 6 months and appear to be doing great. They are better than the ones we had, that really sucked the oxygen down.

Link :

http://online.boundtree.com/store/product_...amp;Prod=531501

Easy to use and light weight, we have placed one on each truck.. (we have vents as well). I used it last night on a CHF and did good enough not to have to intubate...

good luck,

R/r 911

[PMedic850]

Yes, the PORTO2VENT CPAPos by Emergent rocks!

http://www.eresp.com/

Our agency has had these for over a year maybe 2 years & we love them.

Advantages:

-single adjustable knob & pressure gage on the front so you can see the pressure instead of having to guess by turning 3 different knobs.

-Since its a demand valve it runs on a jumbo D tank for +25-35 mins.

-Doesn't blow air in the patients eyes & face like other products and I think it's more comfortable for the pt (soft foam mask which makes a nice seal).

You can also click on the unit & see a demo.

[flash width=600 height=400:bc23eb1ee6]http://www.eresp.com/CPAPosSim.swf[/flash:bc23eb1ee6]

[Ace844]

(Chest. 2006;129:1424-1431.)

© 2006 American College of Chest Physicians

Influence of Two Different Interfaces for Noninvasive Ventilation Compared to Invasive Ventilation on the Mechanical Properties and Performance of a Respiratory System*

A Lung Model Study

Onnen Moerer @ MD; Sven Fischer; Michael Hartelt; Bahar Kuvaki, MD; Michael Quintel, MD and Peter Neumann, MD, PhD

* From the Department of Anaesthesiology, Emergency, and Critical Care Medicine (Drs. Moerer, Quintel, and Neumann), University of Göttingen, Göttingen, Germany; University of Göttingen (Mr. Fischer and Mr. Hartelt), Göttingen, Germany; Department of Anaethesiology and Critical Care Medicine (Dr. Kuvaki), Balkan Dokuz Eylül University School of Medicine, Izmir, Turkey.

Correspondence to: Peter Neumann, MD, PhD, Department of Anaesthesiology, Emergency and Intensive Care Medicine, Georg-August-University of Göttingen, Robert Koch Str. 40, D-37075 Göttingen, Germany; e-mail: pneuman@gwdg.de)

Abstract

Background: Noninvasive ventilation (NIV) is increasingly used in intensive care medicine, but only little information is available how different NIV interfaces affect the performance of a ventilatory system. Therefore, we compared delay times, pressure time products (PTPs), and wasted efforts during inspiration among patients receiving invasive ventilation and NIV with a helmet (NIV-H) or a face mask (NIV-FM).

Methods: Using an in vitro lung model capable of simulating spontaneous breathing, gas flow and airway pressure were measured with varying positive end-expiratory pressure and pressure support (PS) levels. Wasted efforts were determined while lung compliance, respiratory rate (RR), continuous positive airway pressure (CPAP), and PS levels were changed.

Results: Delay times were more than twice as long with a helmet compared to NIV-FM or invasive ventilation (p < 0.001), but decreased during NIV-H with increasing CPAP (p < 0.001) and PS levels (p < 0.001). During the initial inspiratory phase, PTP was smaller with NIV-H compared to NIV-FM or invasive ventilation, but not so when a complete inspiration with PS was evaluated. Wasted efforts occurred earlier during NIV-H and were aggravated with rising PS, RR, and compliance.

Conclusions: Although delay times are prolonged during NIV-H, PTP is initially smaller compared to NIV-FM and invasive ventilation, indicating less work of breathing due to the high volume the patient can access. Increasing the CPAP or PS level decreases delay times in NIV-H and should therefore be considered whenever possible. Wasted inspiratory efforts occurred at higher RRs and should carefully be monitored during NIV.

[AZCEP]

Here's a system that looks pretty slick

http://www.jems.com/jems/31-6/106692/

Instead of having a hang on the wall system, this device uses the pressure from the oxygen flow to generate the needed pressure. Much cheaper than other systems as well.