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CPAP Survey

 

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1. What agency are you with?

What agency are you with?

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2. What was the gender of the patient?

What was the gender of the patient?   Female Male

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3. What was the age of the patient?

What was the age of the patient?   18 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80+

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4. Which patient condition was CPAP used for?

Which patient condition was CPAP used for?   Asthma CHF COPD

5. Who was the manufacturer of the CPAP device?

Who was the manufacturer of the CPAP device?   Pulmodyne Boussignac

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6. What size mask was used?

What size mask was used?   Small Adult (4) Medium Adult (5) Large Adult (6)

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7. What was the oxygen liter flow used?

What was the oxygen liter flow used?   15 lpm 20 lpm 25 lpm

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8. What was the cmH20 setting?

What was the cmH20 setting?   5 cmH20 7.5 cmH20 10 cmH20

9. What was the total amount of oxygen used while utilizing CPAP?

What was the total amount of oxygen used while utilizing CPAP?   >1000 psi >1500 psi >2000 psi >2500 psi >3000 psi >3500 psi >4000 psi

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10. Was there a change in the patient's condition?

Was there a change in the patient's condition?   Became worse Remained the same Improved

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11. Rate the ease of use of the CPAP device. (5 being the easiest)

Rate the ease of use of the CPAP device. (5 being the easiest)   1 2 3 4 5

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12. Did you experience any problems while using the CPAP device?

Did you experience any problems while using the CPAP device?

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13. What was the total amount of time from CPAP use to transfer of care in the Emergency Department?

What was the total amount of time from CPAP use to transfer of care in the Emergency Department?   15 minutes 30 minutes 45 minutes 60 minutes 75 minutes 90 minutes or greater

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14. Which hospital was the patient transported to?

Which hospital was the patient transported to?   Auburn Memorial Hospital Cayuga Medical Center Community General Hospital Cortland Regional Medical Center Crouse Hospital Oswego Hospital St. Joseph's Hospital Health Center SUNY Upstate Medical University Syracuse VA Medical Center

Other (please specify)

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15. Was there a smooth transition of care to the Emergency Department staff?

Was there a smooth transition of care to the Emergency Department staff?   Yes No

If "No", please explain.