Episode 1 - CPAP



February 2023


John Hill

Scott Wildenheim

Caleb Ferroni

Ray Pace

Product Links

Pulmodyne CPAP
Emergent PortO2Vent

Episode Videos

CPAP - A Deep Review of an Underrated Skill, Part 1 

CPAP - Continue the Deep Dive, Part 2 

CPAP - Training, Alternatives and Unit Service, Part 3 

CPAP Recap, Part 4

Episode Audio

Show Notes

The episode that started it all, the pilot and proof of concept. In this episode John, Scott, Caleb, and Ray discuss the two most prevalent CPAP systems in the University Hospital system, their features, benefits, and drawbacks. Not surprisingly the conversation turns in many directions from things that concern out of hospital CPAP use.

 New device introduced into UH equipment inventory

Pulmodyne O2-Max disposable CPAP device

Legacy devices in the system

Emergent Respiratory products PortO2Vent

Pros / Cons

Pulmodyne Device

Pro - More transportable - can now go in first in bag - treat in place

Pro - Single patient use - minimize contamination

Pro - Has all nebulization pieces in kit (UH supplied kit also supposed to have EtCo2 nasal cannula as well)

Pro - Better mask design - easier to get on / easier to tip up corner to admin NTG if CHF patient

Pro - Comes with quick disconnect adapter in kit / plug and play

Pro - Plugs directly into high pressure port on O2 source 

Pro - Unrestricted flow - patient can take any inspiratory volume needed

Pro - Less “up front cost”

Con - Consumes oxygen quickly

Con - Fixed CPAP settings 5 / 7.5 / 10 cmH20 - Nothing in between (As Supplied)

Con - Fixed FiO2 (% of Oxygen) at 30% - May need to titrate additional oxygen in through nasal cannula

Emergent Respiratory Products Device

Pro - High FiO2 (% of Oxygen) - Fixed at 95%

Pro - Variable CPAP 0-20 mmHg

Pro - Conserves more oxygen as it only delivers during inspiration

Con - Inspiratory flow limited to about 100 lpm

Con - Requires routine biomedical service

Con - “Box” is bulky and requires cleaning (Only circuit  / mask disposable)

Con - Mask and strap more difficult to put on, and less amenable to giving NTG to patients

Con - Requires extra parts to administer concurrent aerosols

Con - Upfront cost of the “box”

Both of these are high flow systems, use unrestricted flow directly from the oxygen outlet

Do not hook esther of these devices up to a flowmeter

Low flow systems hooked to flowmeter may “throttle” inspiratory flow

Put on Etco2 nasal cannula under any system mask - trend EtCo2 and augment delivered O2 if necessary  - follow Spo2

EtCo2 may not be “normal” due to oxygen wash out - trend this patient numbers specific to this therapy

Indications - Protocol

Indications - Non Protocol


CPAP is not a ventilator - patient must have spontaneous respirations 


CPAP / PEEP same physiological effects and pressures =

One is actively supplying pressure, the other is passively keeping pressure in airway

Positive pressure benefits

Positive pressure issues / concerns


Transition to BVM

The Protocols

Episode Shorts

CPAP Part 2

CPAP Recap

From The Episode

Ray demonstrates the differences in oxygen adapters

Dr. Hill discusses the concurrent use of breathing treatments with CPAP

Caleb demonstrates the transition to BVM with a patient who has failed CPAP

Scott discusses the importance of PEEP valves with BVM use