Evaluation of the effect of prehospital application of continuous positive airway pressure therapy in acute respiratory distress.
OBJECTIVE
The impact of the use of mask continuous positive airway pressure (CPAP) on patients with acute respiratory distress in the prehospital, rural setting has not been defined. The goal was to test the use of CPAP using the Respironics WhisperFlow CPAP in patients presenting with acute respiratory distress. This was a collaborative evaluation of CPAP involving a rural EMS agency and the regional medical center. Patient outcomes including the overall rate of intubation-both in the field and in the emergency department (ED), and length of stay in the hospital and Intensive Care Unit (ICU) were tracked.


METHODS
The study was an eight-month, crossover, observational, non-blinded study.


RESULTS
During the four months of baseline data collection, 7.9% of patients presenting with respiratory distress were intubated within the first 48 hours of care. Their average ICU length of stay was 8.0 days. During the four months of data collection when CPAP was available in the prehospital setting, intubation was not required for any patients in the field or in the ED. Admissions to the ICU decreased. Those patients admitted to the ICU, the average ICU length of stay deceased to 4.3 days.


CONCLUSIONS
The use of the CPAP in the prehospital setting is beneficial for patients in acute respiratory distress.
Warner
G Scott
GS
Cullman Emergency Medical Services, Cullman, AL 35055, USA. swarner@prn-inc.net
D022561:Advanced Cardiac Life Support; D045422:Continuous Positive Airway Pressure; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D014481:United States