CPAP
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1. Default Section
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1
. How many times have you used CPAP?
How many times have you used CPAP?
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2
. After your initial assessment of the patient, which respiratory disease best describes your patient?
After your initial assessment of the patient, which respiratory disease best describes your patient?
Asthma/COPD
CHF
Pulmonary Edema from fluid overload (dialysis Pt)
Other
Other (please specify)
3
. Once the patient was on CPAP did the patients vital signs, respiratory rate and effort improve?
Once the patient was on CPAP did the patients vital signs, respiratory rate and effort improve?
Yes, improved
NO, remained the same
No, became worse
4
. How well did your patient tolerate CPAP?
How well did your patient tolerate CPAP?
Pt. reported relief and tolerated ok
Pt. struggled with CPAP and did not tolerate
Pt. was not able to tolerate at all
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5
. Have you experienced any problems or leaks that you could not fix on scene?
Have you experienced any problems or leaks that you could not fix on scene?
Yes
No
If yes please explain the issue
6
. Each CPAP unit was equipped with two designated O2 bottles to run the generator. Has this been an adequate amount of oxygen to go from scene to hospital?
Each CPAP unit was equipped with two designated O2 bottles to run the generator. Has this been an adequate amount of oxygen to go from scene to hospital?
Yes
No
Please explain delay
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7
. If you notified the hospital of your patient being on CPAP was the hospital ready for you upon your arrival?
If you notified the hospital of your patient being on CPAP was the hospital ready for you upon your arrival?
Yes, immediately transfered to hospital CPAP
Was taken to a room but had a less than ten minute delay moving to hospital CPAP
More than ten minute delay in transferring to hospital CPAP
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8
. Which hospital did you transport to? Please use the transport to code, to complete this answer
Which hospital did you transport to? Please use the transport to code, to complete this answer
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9
. If you experienced a significant delay in transferring your patient to the hospital CPAP, please explain
If you experienced a significant delay in transferring your patient to the hospital CPAP, please explain
10
. Once patient was placed on CPAP, are you aware of the patient being intubated either before or after transfer of care to the ER?
Once patient was placed on CPAP, are you aware of the patient being intubated either before or after transfer of care to the ER?
Yes
No
Not sure
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