Ambulance CPAP saves lives: why don't we use it?

Abstract

Abstract published with permission. Continuous positive airway pressure (CPAP) is an established in-hospital therapy for the treatment of multiple aetiologies of breathlessness, primarily for acute cardiogenic pulmonary oedema (ACPE) due to acute exacerbations of congestive heart failure (CHF), but also (amongst others): exacerbations of chronic obstructive pulmonary disease (COPD), asthma and pneumonia (Gray et al, 2009; Wesley et al, 2011). The use of CPAP as an adjunctive treatment for ACPE patients in front-line ambulances has been proven to improve patient outcome, preventing them from reaching the ‘point of no return’ and a downward spiral into total respiratory failure. This article will discuss current UK ambulance practice and examine the issues surrounding the introduction and use of CPAP as an adjunctive therapy in the treatment of ACPE, secondary to acutely exacerbated CHF, whilst also briefly discussing its use in other aetiologies of breathlessness.