logging in or signing up CPAP aSGuest36580 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 1010 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: January 24, 2010 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: GreyP (10 month(s) ago) There is a whole array of CPAP equipment at http://www.activa-medical.com Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Continuouspositiveairwaypressure : Continuouspositiveairwaypressure Department of Training and Education Grady EMS Mark Griffin Chief Training Officer Grady EMS Slide 2: Presentation Structure Goal of CPAP in the field CPAP and its physiological effects CPAP delivery systems Medical applications of CPAP When not to use CPAP Slide 3: History of CPAP 1912 - Maintenance of lung expansion during thoracic surgery (S. Brunnel) 1937 - High altitude flying to prevent hypoxemia. (Barach et al) 1967 - CPPB + IPPV to treat ARDS (Ashbaugh et al) 1971 - Term CPAP introduced, used to treat HMD in neonates 1972 - CPAP used to treat ARF (Civetta et al) 1973 - CPAP used to treat COPD (Barach et al) 1981 - Downs generator (Fried et al) 1982 - Modern definition of CPAP (Kielty et al) Slide 4: CPAP and Partial Pressure ‘The pressure of a gas mixture is equal to the sum of the partial pressures of its constituents. This allows oxygen into the blood during inspiration and Carbon Dioxide out during expiration. Example : Air at sea level has a pressure of 760mm Hg. Air is 21% oxygen and 79% nitrogen. ? partial pressure of oxygen is 760 X 21% = 159mm Hg Slide 5: CPAP alters the pressure gradient! 7.5cm H20 CPAP 1cm H2O is equal to 0.735mm Hg. 7.5cm H2O CPAP increases the partial pressure of the alveolar air by approximately 1%. This increase in partial pressure ‘forces’ more oxygen into the blood. Even this comparatively small change is enough to make a clinical difference. Slide 6: Important Aim Of CPAP Is To Increase Functional Residual Capacity (FRC) Volume of gas remaining in lungs at end-expiration CPAP distends alveoli preventing collapse on expiration Greater surface area improves gas exchange Slide 7: Physiological Effects Of CPAP Increases PSO2 Increases FRC Reduces work of breathing Slide 8: Goal of CPAP To have an effective way to treat CHF/COPD Medications are continued throughout patient care Slide 9: CPAP And Pulmonary Edema Severe pulmonary edema is a frequent cause of respiratory failure CPAP increases functional residual capacity CPAP increases transpulmonary pressure CPAP improves lung compliance CPAP improves arterial blood oxygenation CPAP redistributes extravascular lung water Anatomy of the Airway : Anatomy of the Airway Slide 11: So why does oxygen pass into the blood? Pressure Gradient Deoxygenated blood has a lower partial pressure of oxygen than alveolar Air so oxygen transfers from the air into the blood. Slide 13: CPAP And Acute Respiratory Failure CPAP overcomes inspiratory work imposed by auto-peep CPAP prevents airway collapse during exhalation CPAP improves arterial blood gas values CPAP may avoid intubation and mechanical ventilation Slide 14: Common Complications With CPAP Pressure sores Gastric distension Pulmonary barotrauma Reduced cardiac output Hypoventilation Fluid retention Slide 15: Disposable CPAP Device Fixed flow rate, which is dependent of the interchangeable valve Interchangeable valves range from 5-20 cm and flow generator Treatment Areas : Treatment Areas In the treatment of dyspnea, in patients with Congestive Heart Failure it has been proven to: Decrease hypoxia Increase intra-thoracic pressure, which can result in a reduction in left ventricular preload/afterload Marked clinical improvement Decrease patient mortality Helps patients to breath better, before they stop breathing Trouble shooting CPAP : Trouble shooting CPAP Patient Anxiety Vomitus in Airway and on face Unable to tolerate due to hypoxia Unable to get a good seal on the mask..dentures Check oxygen level in tank ALWAYS WATCH THE PATIENT FOR SIGNS OF DESATURATION Airway procedures: : Airway procedures: Oral pharyngeal Airway Nasal pharyngeal Airway Bag-Valve Mask with or without PEEP Valve Endo-Tracheal Intubation (Oral) King Airway Device Slide 19: When Not To Use Mask CPAP Hypercapnia Pneumothorax Hypovolemia Severe facial injuries Patients at risk of vomiting Facial Dysfunction : Facial Dysfunction Thank you Sir, may I have another : Thank you Sir, may I have another : You do not have the permission to view this presentation. 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CPAP aSGuest36580 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 1010 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: January 24, 2010 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: GreyP (10 month(s) ago) There is a whole array of CPAP equipment at http://www.activa-medical.com Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Continuouspositiveairwaypressure : Continuouspositiveairwaypressure Department of Training and Education Grady EMS Mark Griffin Chief Training Officer Grady EMS Slide 2: Presentation Structure Goal of CPAP in the field CPAP and its physiological effects CPAP delivery systems Medical applications of CPAP When not to use CPAP Slide 3: History of CPAP 1912 - Maintenance of lung expansion during thoracic surgery (S. Brunnel) 1937 - High altitude flying to prevent hypoxemia. (Barach et al) 1967 - CPPB + IPPV to treat ARDS (Ashbaugh et al) 1971 - Term CPAP introduced, used to treat HMD in neonates 1972 - CPAP used to treat ARF (Civetta et al) 1973 - CPAP used to treat COPD (Barach et al) 1981 - Downs generator (Fried et al) 1982 - Modern definition of CPAP (Kielty et al) Slide 4: CPAP and Partial Pressure ‘The pressure of a gas mixture is equal to the sum of the partial pressures of its constituents. This allows oxygen into the blood during inspiration and Carbon Dioxide out during expiration. Example : Air at sea level has a pressure of 760mm Hg. Air is 21% oxygen and 79% nitrogen. ? partial pressure of oxygen is 760 X 21% = 159mm Hg Slide 5: CPAP alters the pressure gradient! 7.5cm H20 CPAP 1cm H2O is equal to 0.735mm Hg. 7.5cm H2O CPAP increases the partial pressure of the alveolar air by approximately 1%. This increase in partial pressure ‘forces’ more oxygen into the blood. Even this comparatively small change is enough to make a clinical difference. Slide 6: Important Aim Of CPAP Is To Increase Functional Residual Capacity (FRC) Volume of gas remaining in lungs at end-expiration CPAP distends alveoli preventing collapse on expiration Greater surface area improves gas exchange Slide 7: Physiological Effects Of CPAP Increases PSO2 Increases FRC Reduces work of breathing Slide 8: Goal of CPAP To have an effective way to treat CHF/COPD Medications are continued throughout patient care Slide 9: CPAP And Pulmonary Edema Severe pulmonary edema is a frequent cause of respiratory failure CPAP increases functional residual capacity CPAP increases transpulmonary pressure CPAP improves lung compliance CPAP improves arterial blood oxygenation CPAP redistributes extravascular lung water Anatomy of the Airway : Anatomy of the Airway Slide 11: So why does oxygen pass into the blood? Pressure Gradient Deoxygenated blood has a lower partial pressure of oxygen than alveolar Air so oxygen transfers from the air into the blood. Slide 13: CPAP And Acute Respiratory Failure CPAP overcomes inspiratory work imposed by auto-peep CPAP prevents airway collapse during exhalation CPAP improves arterial blood gas values CPAP may avoid intubation and mechanical ventilation Slide 14: Common Complications With CPAP Pressure sores Gastric distension Pulmonary barotrauma Reduced cardiac output Hypoventilation Fluid retention Slide 15: Disposable CPAP Device Fixed flow rate, which is dependent of the interchangeable valve Interchangeable valves range from 5-20 cm and flow generator Treatment Areas : Treatment Areas In the treatment of dyspnea, in patients with Congestive Heart Failure it has been proven to: Decrease hypoxia Increase intra-thoracic pressure, which can result in a reduction in left ventricular preload/afterload Marked clinical improvement Decrease patient mortality Helps patients to breath better, before they stop breathing Trouble shooting CPAP : Trouble shooting CPAP Patient Anxiety Vomitus in Airway and on face Unable to tolerate due to hypoxia Unable to get a good seal on the mask..dentures Check oxygen level in tank ALWAYS WATCH THE PATIENT FOR SIGNS OF DESATURATION Airway procedures: : Airway procedures: Oral pharyngeal Airway Nasal pharyngeal Airway Bag-Valve Mask with or without PEEP Valve Endo-Tracheal Intubation (Oral) King Airway Device Slide 19: When Not To Use Mask CPAP Hypercapnia Pneumothorax Hypovolemia Severe facial injuries Patients at risk of vomiting Facial Dysfunction : Facial Dysfunction Thank you Sir, may I have another : Thank you Sir, may I have another :