Sunnybrook Health Sciences Centre

Sunnybrook Health Sciences Centre

July 04, 2012 11:57 ET

Research Suggests More Paramedics Could Perform Ventilation Therapy Known as Continuous Positive Airway Pressure for People With Acute Respiratory Issues

TORONTO, ONTARIO--(Marketwire - July 4, 2012) - New research published in the journal Prehospital Emergency Care has shown that a potentially lifesaving piece of equipment appears to be used safely and properly by all levels of paramedics, not just those with advanced training, and could therefore be used more widely.

The device known as a continuous positive airway pressure (CPAP) machine pushes air into the lungs under high pressure. It improves the oxygen level of people suffering from acute respiratory issues such as acute pulmonary edema, a condition in which fluid accumulates in the lungs, or COPD (chronic obstructive pulmonary disease).

It is used by physicians in hospital emergency departments and intensive care units as well as by advanced care paramedics to avoid having to intubate a patient, which is a more invasive procedure and more difficult to perform outside the hospital. It's the same machine many people use, although at lower pressure, to stop snoring caused by sleep apnea.

Researchers from Sunnybrook Centre for Prehospital Medicine decided to investigate whether paramedics with basic life support (BLS) training - who are not trained to perform intubations - could use the continuous positive airway pressure machine and thereby assist more critically ill patients.

After studying more than 300 uses of the device by paramedics in Peel and Halton regions near Toronto, they found no statistically significant difference in the way they were used by advanced care paramedics and primary case paramedics, suggesting that wider use may be possible.

In both Peel and Halton, their paramedic services are about half advanced care paramedics and half primary care.

"What this study clearly shows is use of CPAP by BLS paramedics is feasible and would suggest that more widespread application of this treatment may be appropriate. Further study is warranted to ensure feasibility translates into safe use of CPAP by all paramedics," says Dr. Sheldon Cheskes, lead author of the study.

Dr. Cheskes is a collaborative investigator at the Li Ka Shing Knowledge Institute of St. Michael's Hospital and medical director for the Sunnybrook Osler Centre for Prehospital Care.

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    Laura Bristow
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