Gold Cross Ambulance CPAP Protocol Flow Sheet

Asses pat., record vital and Pulse Ox at

Room air

Administer O2 by non-rebreather mask

Does Pat. Meet two or more inclusion

criteria

no

Continue standard ALS Protocol for

Resp. distress / CHF

no

Yes

Adm. CPAP using Max. FiO2

Reassess pat. , Record HR,RR,

Pulse Ox every 10 minutes

Pat. Condition is stable or

improving

Pat. Condition is deteriorating

Continue CPAP

Notify Med. Control

Consider endotracheal

Intubation

When leaving the unit, apply O2 at 10 L’s and connect O2 to CPAP

Mask with standard tubing to port on CPAP mask or to Non-rebreather

Reassess the Pat.

Yes

Does pat.meet any exclusion criteria

CPAP Inclusion Criteria

Respiratory Distress ( 2 or more of following)

• Retractions of accessory muscles

• Pulmonary Edema

• Resp. rate > 25/min.

• PaSO2 < 92%

Indications for CPAP

• Acute/Chronic CHF

• COPD

Pat. Excluded from the study

• Resp./Cardiac Arrest

• B/P < 90nnHg

• Unresp. To Speech

• Inability to maintain patent airway

• Major trauma. Pneumothorax

• Vomiting or active GI Bleeding

• Obvious S/S of Infection

Consider Ativan 0.5mg per Med. Control

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