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CPAP Use With Pneumonia

Question# 879

I've done a few calls with pt complaining of SOB with some crackles on one side of their lungs. With other signs and symptoms, we concluded it is probably a pneumonia, and I was wondering if they met the criteria for CPAP is it a good thing to apply it to them?

I've heard different response such as no because it will push all the bacteria and the infection in the blood and other said yes it will help with the breathing. I've done some research on internet and I couldn`t get a clear answer as well.

Answer:

The ALS PCS medical directive specifies that CPAP is indicated for severe respiratory distress AND signs and/or symptoms of acute pulmonary edema or COPD.

When encountering a patient with hypoxic respiratory failure, and you suspect pneumonia, CPAP can be used to support oxygenation, as long as they meet the indications for CPAP otherwise (pulmonary edema or COPD) and no contraindications exist per the ALS PCS guidelines. In such cases, CPAP is both appropriate and often beneficial.

If a patient is in hypoxic respiratory failure and requires positive pressure but does not meet the criteria outlined in the ALS PCS, consider using CPAP. In this situation, it's advisable to contact a Base Hospital Physician (BHP) for guidance on a safe and customized treatment plan.

References

ALS PCS
BLS PCS

UpToDate:
- Noninvasive ventilation in adults with acute respiratory failure: Benefits and contraindications

Published

03 March 2025

ALSPCS Version

5.4

Views

95

Please reference the MOST RECENT ALS PCS for updates and changes to these directives.