Welcome to Episode 89
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Tip of the Week– CPAP Therapy Review for Nurses
Continuous Positive Airway Pressure (CPAP) is a non-invasive procedure used to improve oxygenation, reduce work of breathing, mechanically reduce afterload and preload in heart failure. It has also been shown as an effective alternative to intubation in some patients.
CPAP Therapy is indicated for the following conditions:
- Alveolar collapse (atelectasis, ARDS)
- Fluid-filled alveoli (pulmonary edema, pneumonia, pulmonary contusion)
- Airway closure (post surgical hypoventilation)
- CHF, Asthma, COPD
- Sleep apnea
- Acute respiratory failure
- Near drowning
In providing CPAP, therapy must be started at lowest setting (0-2 cmH2O) and titrated upwards (maximum of 10 cmH2O). It should be used with caution in patients with history of pulmonary fibrosis, claustrophobia (keep patient calm), complaints of nausea and vomiting, excessive secretions and facial deformities that may inhibit use of CPAP.
Nurses should watch out for complication such as decrease in blood pressure, pneumothorax, gastric distention, vomiting and corneal drying. Frequent reassessment and sometimes reassurance is key to quality nursing care for CPAP patients.
Physiologic contrandications include, unconsciousness (except for CPAP via ET tube ventilators), inability to sit up, respiratory arrest, persistent nausea and vomiting, hypotension, and inability to obtain a good mask seal.
Pathologic contraindications are suspected pneumothorax, shock, penetrating chest trauma, trauma/burns, closed head injury, and active upper GI bleeding.
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Other Podcasts from Jamie Davis:
- The MedicCast (for EMTs, Paramedics, EMS field work)
- MedicCast News (Weekly short medical news program)
- MedicCast Live (Monthly live call-in show with a single EMS topic)
Song this week:
Music from The Podsafe Music Network
This week- Matthew Ebel with “Drive Away”
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