June 8, 2004 > CPAP - A Lifesaving Acronym
CPAP - A Lifesaving Acronym
by Ceri Hitchcock-Hodgson
Something new is coming to town to aid emergency personnel. Firefighters and Emergency Room personnel eagerly await its arrival. It not only has the potential to save time and money, it could save lives too. This extraordinary device, called Whisperflow CPAP (Continuous Positive Airway Pressure), manufactured by Tri-anim Health Services, Inc, is gradually being introduced to the Tri-City area. Similar devices have been used in the past to aid those afflicted with sleep apnea. Recently, the Union City Fire Department had the chance to test the unique equipment and will soon begin using it.
About 70% of the 4,500 annual calls made to the fire department in Union City are emergency-service oriented. Fires only account for 6% of all calls the Union City Fire Department answers. These days, firefighters are required to do much more than put out flames. They are usually the first responders on the scene of a medical emergency with an average emergency response time of 4 minutes 16 seconds. The department is dedicated to offering their services around the clock, 365 days a year. In order to do their job correctly, emergency services including fire departments require not only the proper equipment but also the appropriate number of firefighters.
"In any given geographic area there are a fixed number of fire stations so if we tie [the firefighters] up in one spot unnecessarily, you worry about what's going to happen. We try to get them back in service as soon as possible," explains Union City EMS Chief Marlene Rivers. Rivers believes that the Whisperflow CPAP system will be integral in making the transition from field to emergency room safer for the patient and as well as being more time efficient for the firefighters.
A large number of emergency calls are made in the early morning hours. This is a time of day when people are most susceptible to congestion. For instance, it is common for the elderly to have fluid build up in their ankles and lower extremities during the day. When they lie down at night the fluid travels upwards, putting pressure on the chest cavity, making breathing difficult and possibly producing a gurgling sound. This condition can lead to suffocation, cardiac arrest or even death. It is at this point that CPAP becomes instrumental in treating the patient.
What is unique about the Whisperflow CPAP is its compact size paired with immense power. A normal oxygen mask emits a relatively low burst of oxygen. In contrast, the Whisperflow gives the patient a full blast of oxygen, forcing the fluids away from the chest cavity and back down in to the rest of the body. During the initial, critical point in treatment, the device helps to improve ventilation and oxygenation. It may also help to avoid intubation in patients with congestive heart failure, acute pulmonary edema or those who are near drowning.
Once the patient is ready to be transferred from the field to the hospital, the CPAP device continues its valuable work. "A typical thing that could happen in an emergency room is they'll bring a patient in, they can't find a gurney, a nurse can't take the patient or they can't find the right equipment - that is the delay we're trying to prevent," says Rivers who is convinced that the Whisperflow CPAP will cut down on the transition time of the patient while quickly putting the firefighter back in action.
An excerpt from the Department's mission statement is "We are prepared to deliver these services 24 hours a day, 365 days a year, under any conditions. Our customers expect us to respond promptly with an adequate number of personnel who are trained and equipped to handle the situation, provide quality service, and do it efficiently. Therefore, the number of resources within the Department, the training and preparation of field personnel, and the deployment of those resources are important to our mission.
The Hayward Fire Department was the first in California to test the device. The Whisperflow has been used on the East Coast for some time but only recently made its way West to Seattle and the Bay Area. The Hayward Fire Department has used the Whisperflow CPAP system for nearly year with impressive results. Out of the approximately 30 instances, only one patient had to be intubated. The success of the device prompted the department to make its trial use of the device permanent. This action encouraged the Union City Fire Department to proceed with the introduction of CPAP into its own practices. The device is projected to be commonplace in Newark this month and in Fremont by the end of the year.
An added bonus of the device is that it is relatively inexpensive. Available for less than $1,000, the CPAP unit is comprised of a generator, a disposable mask and air hose. It fits compactly into a red plastic carrying case for easy access and storage.
Chief Rivers also notes that the precious minutes this device saves can mean the difference between a stay in the hospital with serious consequences or being able to walk out of the hospital on the same day.
CPAP cannot be used on everyone. Children under 8 and those who are having difficulty maintaining consciousness are not given the treatment. Firefighters are advised to be aware of individuals who are claustrophobic or with a history of asthma. Overall, this revolutionary device has the potential to save and drastically reduce hospitalization in a large number of medical emergencies.