FOOTHILL COLLEGE
CPAP
Candidate Name: _________________________________________ Date: ______________________
Examiner Name and Signature: _________________________________________________________
Time Started: __________ Time Ended: __________ Points: _____/37 PASS/FAIL (Circle One)
| Points Possible | Points Awarded | |
| Prepares patient | ||
| Takes or verbalizes appropriate PPE precautions | 1 | |
| Assures adequate blood pressure | 1 | |
| Positions patient in a position that will optimize ease of ventilation (high Fowler’s) | 1 | |
| Assesses patient to identify indications for CPAP | ||
| Congestive heart failure, COPD, asthma, pneumonia, pulmonary edema, near drowning | 6 | |
| Assesses patient to identify absolute contraindications for CPAP | ||
| Unconscious/unresponsive, inability to protect airway or inability to speak, inability to sit up, respiratory arrest/agonal respirations, nausea/vomiting, hypotension (systolic blood pressure <90mmHg), suspected pneumothorax, cardiogenic shock, penetrating chest trauma, facial anomalies/trauma/burns, closed head injury, active upper GI bleeding or history of recent gastric surgery (1 pt for each assessed) | 12 | |
| Relative contraindications | ||
| History of pulmonary fibrosis | 1 | |
| Decreased LOC | 1 | |
| Claustrophobia or unable to tolerate mask (after first 1-2 minute trial) | 1 | |
| Selects, checks, assembles equipment | ||
| Assembles mask and tubing according to manufacturer instructions | 1 | |
| Connects CPAP unit to suitable O2 supply/ensures oxygen is flowing | 1 | |
| Performs procedure | ||
| Places mask over mouth and nose (leaves EtCO2 nasal cannula in place) | 1 | |
| Titrates CPAP pressure (based on local protocols/device dependent) | 1 | |
| Coaches patient to breathe normally and adjust to air pressure | 1 | |
| Frequently reassesses patient for desired effects/goals of CPAP | ||
| Decreased or elimination of dyspnea, decreased respiratory rate, decreased heart rate, SpO2 >92%, stabilized blood pressure, absence of complications e.g. barotrauma and pneumothorax (1 pt for each assessed) | 5 | |
| In the event of Failure to Improve: | ||
| Should patient fail to show improvement with CPAP, asw indicated by sustained or increased heart rate, Respiratory rate or blood pressure or by a decrease in level of consciousness remove CPAP device and assist ventilations with BVM or ETI as needed | 3 |
Points Possible: 37 Total Points Awarded_______________
Critical Criteria
● Failure to list 10 of the 15 absolute/relative contraindications
● Failure to list desired effects/Goals of CPAP
● Failure to identify potential complications (Barotrauma, Pneumothorax)
● Failure to properly assemble the device
● Failure to frequently reassess the patient after application of the CPAP device