Exit this survey CPAP Survey 1. Question Title * 1. What agency are you with? Question Title * 2. What was the gender of the patient? Female Male Question Title * 3. 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+ Question Title * 4. Which patient condition was CPAP used for? Asthma CHF COPD Question Title * 5. Who was the manufacturer of the CPAP device? Pulmodyne Boussignac Other (please specify) Question Title * 6. What size mask was used? Small Adult (4) Medium Adult (5) Large Adult (6) Question Title * 7. What was the oxygen liter flow used? 15 lpm 20 lpm 25 lpm Question Title * 8. What was the cmH20 setting? 5 cmH20 7.5 cmH20 10 cmH20 Question Title * 9. 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 Question Title * 10. Was there a change in the patient's condition? Became worse Remained the same Improved Question Title * 11. Rate the ease of use of the CPAP device. (5 being the easiest) 1 2 3 4 5 Question Title * 12. Did you experience any problems while using the CPAP device? Question Title * 13. 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 Question Title * 14. 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) Question Title * 15. Was there a smooth transition of care to the Emergency Department staff? Yes No If "No", please explain. Done
