CPAP- Why not be Bane from Batman?

I was just as excited as the next EMT personel when I saw the posters for The Dark Knight Rises:
While most individuals were confused, I knew Bane was on CPAP!

 Here is a better look at Bane's new high tech CPAP:

CPAP
CPAP  is for continuous positive airway pressure and is a great non invasive tool to use for patient in respiratory distress. CPAP may stop the need for such a risky procedure such as intubation. The positive pressure of the CPAP will help force open the airways, lungs, and collapsed alveoli. 



Before we get too far into CPAP, we must make sure our patient has the correct indications for CPAP:
Can your patients follow commands? Patients often get scared of the CPAP machine since it will force air into the lungs, a paramedic must coach the patient, but don't be overly forceful crazy coach that is just trying to overcome their childhood failures like this coach:
Yelling at the patient may not help!
Do they have a pulse oximetry less then 90%?
Is there systolic blood pressure > 100?
Do they have respiration's that are > 20? 


CPAP Settings:
Most CPAP's range between 3-20 cm H2O, but some machines go up to 30. Depending on the patient you want to start low, most patients will manage between 5-10 cm H2O, if they are critical, you may move up the CPAP between 10-20. 


CPAP can be used with an inline beta-2 agonist,anticholinergics and other great medications. The CPAP is great method to help out a patient in respiratory distress. Keep an eye out on the patients blood pressure, level of consciousness, and pulse oximetry, 


Remember, if your patient looks like this, you might want to reconsider your pressure settings on the CPAP!


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