Indications for CPAP
- Alert and able to follow commands
- Able to maintain own airway
- Age >13 years old
Displays ALL of the following: - RR >24/min
- SP02 <94% on supplemental oxygen
- Accessory muscle use
Contraindications for CPAP
- Age <13 years old
- DLOC / ability to comply
- Unable to fit the mask
- Vomiting / risk of aspiration
- Respiratory arrest or hypoventilation
- Traumatic cause of respiratory distress
- Tracheostomy
- Pneumothorax
- Systolic BP <90mmHg
Dose for CPAP
Start at 5cmH2O, increase by 2.5cmH2O to max of 10cmH2O
Indications for PEEP
Hypoexemia (Sp02 <90%) despite good BVM ventilation and airway management
Contraindications for PEEP
- Cardiac arrest
- Patients >12 years old: Systolic <90mmHg
-Patients <12 years old: Systolic blood pressure ≤ lower limit for age range - Known or suspected pneumothorax
- Traumatic cause of respiratory arrest
Dose for PEEP
Start at 5cmH2O, increase by 2.5cmH2O to max of 10cmH2O
Indications for iGel
Patients who are unable to protect their airways due to DLOC
Contraindications for iGel
- Ability to place device due to difficulties with mouth opening
- Known or suspected pathological or foreign-body airway obstruction, including epiglottis
- Trauma to the trachea, neck or oropharynx
- Caustic ingestion
- Active vomiting
Indications for BVM
Patients who are unable to effectively ventilate on their own due to DLOC
O2 flow for BVM
15L/min
02 flow for NRB mask
10-15L/min
02 flow for Nasal Canula
2-6L/min
02 flow for NO DESAT
NRB: 15L/min
Nasal Canula: 10L/min
02 flow for Nebulizer mask
6-8L/min
Points for chest auscultation on the front of the body
1st point: mid-clavicular (1st intercostal space) bilaterally
2nd point: midline (3rd intercostal space) bilaterally
3rd point: mid-axilla (6th intercostal space) bilaterally
Points of chest auscultation from the back of the body
1st point: Above the scapula at the C-7 area bilaterally
2nd point: mid-thoracic area (T-5 area) bilaterally
3rd point: mid-axilla area bilaterally
Steps for IV administration
- Select and prepare injection site
- Apply tourniquet
- Insert catheter using acceptable technique
- When flash is obtained and the catheter is advanced, safely withdraw the needle and place in sharps container
- Remove tourniquet
- Apply plastic protective film over IV site
- Flush IV using saline flush to insure patency
Adult CPR ratio
30:2
Pediatric CPR ratio
15:2
CPR ratio with iGel inserted
continuous compressions with 1 ventilation every 3-5 seconds
Infant CPR ratio
15:2
Neonate CPR ratio
3:1
Recognition of Life Extinct (ROLL)
- No palpable carotid pulse for 90 seconds
- No heart sounds for 90 seconds
- No breath sounds for 90 seconds
- Fixed and dilated pupils
- No response to central stimuli (CPR is enough to demonstrate lack of response)
Indications for an OPA
Patients who are unable to protect their airways due to DLOC
