Cpap

[Scuba Emt]

Has anyone ever used a CPAP in a hyperbaric chamber?

[ronbeau]

Originally Posted by Scuba Emt

Has anyone ever used a CPAP in a hyperbaric chamber?

I think it would be questionable at best.

I doubt the units have been tested at 2 - 3 ATA.

Also, I doubt that they are certified for an oxygen rich environment. My wife has a high-quality CPAP (actually APAP - auto adjusting) and it does not indicate anywhere that it is certified for an oxygen rich environment.

[dittrimd]

With no disprepect meant, I guess I would ask why?

CPAP or Continuous Positive Air Way Pressure is used for a multitude of reasons. I have used it mostly for CHF patients who have serious pulmonary edema. If you get them on CPAP quick enough you have a good chane of keeping them off the tube/vent which greatly improves survivability. Recently paramedics in our area have gotten prehospital CPAP which has been a great tool.

If I had to guess you are thinking about a diver who not only suffered a barotrauma but also a wet drowning. I am no expert on barotrauma injuries but you always follow the ABC so securing a patent airway would be critical. CPAP usually administerd through a mask or nasal canula does not provide a patent airway. The patient would be intubated and on a vent. Then they would be treated for the barotrauma since the airway and lack of oxygen is going to be the most critical problem. I am not sure how the ventilator works in a decompression chamber. My guess is that you would have to dial in higer vent pressures to overcome the increased atmospheric pressure.

I just do not see the application for a CPAP in the chamber. Maybe you could elaborate on what you thoughts are.

Mark D.

[Scuba Emt]

We were courious is a CPAP could be used in a chamber when a drowning victim or diving victim had fluids in the lungs. There will be new training standards and Standing Orders issued next year as more units purchase CPAPs and use them. We had a drowing victim this summer . He had recent cardiac surgery and probably should not have been swimming anyway. He may have been diving ( against the recommendation of his doctor I would guess). Just curious if anyone tested the equipments possible uses! Thanks for the reply.

[logos]

You can always set the patients vent to something like bipap...which is pretty much just fancy cpap. Of course they have to be intubated.

[TC]

Not familiar with CPAP at all but I'm on crew out at the Catalina Hyperbaric chamber. If there are any electronics at all we wouldn't be able to take the device inside, to much danger of implosion (In the chambers early days they demonstrated that an ECG will implode quite nicely before reaching the target depth of 165 fsw. The secondary danger would of course be even a minor circuitry spark causing a fire. We compress with air and have the nitrox or oxygen on masks for those inside but at 165 fsw the partial pressure of oxygen is enough that any fire would likely be catastrophic.

Tom

[Steve in Seattle]

Pointless.

CPAP/APAP units usally push at 4 to 20 cm H2O of pressure. What's that in atmospheres? an extra 0.0039 to 0.019 atm.

The benefits of CPAP to sleep apnea sufferers is not that it's a high pressure to increase O2 partial pressures... but instead that it stimulates inhalation and provides a slight force to push back tissue flaps that may flop into the wind path (some apnea is neurological, others physical).

There would be no measurable benefit to DCS sufferers. Its a tiny pressure increase, not enough to push Nitrogen back into the blood, nor enough to increase O2 levels if that was a concern (i.e. due to bubble occlusion).