E MERGENCY C ASE
V YGON B OUSSIGNAC CPAP -
• Facial masks
• cPaP B oussignac – V ygon
• Manometer
• Attachment cord
• Manometer tubing
CONTRAINDICATIONS
• Vigilance disorders
• Major pulmonary disease requiring ET intubation
• Protection of upper respiratory tract
• Impossibility of using a face mask
• Non-drained pneumothorax
• Intra-cranial hypertension
Code 5562.802 CPAP BOUSSIGNAC - VYGON
: Sizes 4, 5 and 6 CPAP = ContinuouS PoSitive Airway PreSSure How to proceed with
Physiological effects CPAP Boussignac Vygon
Ventilatory effects
- Enhancement of gas exchange (elevation of FRC, improvement of ventilation/
perfusion relation) with alveolar liquid redeployment in interstitial space of
patient with APE.
- Deacrease of pulmonary resistance.
- Decreased work of breathing.
Haemodynamics effects
- Increase of both cardiac and systolic index:
* Decrease of left ventricular preload (the CPAP reduces venous blood return).
* Decrease of both: left ventricular post load and transmural pressure
main indication: acute Pulmonary Edema (aPE)
always associate CPaP and medical treatment (nitrates and diuretics ).
Why CPAP ?
- Prompt clinical and gasometric improvement.
- Decrease number of endotracheal intubations.
For which APE ?
- Medium and severe APE (signs of ventilatory distress and/or respiratory fre-
quency >35 respiratory cycles/min and/or oxygen saturation with O2 < 90%).
- Hypercapnic APE with no paramount necessity for ET intubation in emergency
condition.
- Common APE with aggravation or with no response to medical treatment.
When to start CPAP ?
- Immediately, when the diagnosis is made, before set up of vascular access
(if hypertension, sublingual nitrates in spray form should be given before
• Harness mask set up).
• Flowmeter 0-30L/min.
- Facing a common APE, which does not respond to medical treatment. TREATMENT OF A CUTE
Which pressure level ?
• Syringe (20 ml) - Initially: 7.5 cm H2O. P ULMONARY EDEMA (APE)
- You can increase to 10 cm H2O if no or insufficient patient improvement.
- After improvement, progressive reduction of pressure level. E.M.S., E.D., C.C.U., I.C.U.
in case of low cardiac output, use of vasoactive drug
(dobutamine) is necessary.
CPAP BOUSSIGNAC
DB CPAP 03009 E
For further informations, please contact:
Tel.: + 33 1 39 92 63 99 - E-mail : export@vygon.com
Laboratoires Pharmaceutiques 5 à 11, rue Adeline 95440 Ecouen France
Tél. + 33 1 39 92 63 63 - Fax + 33 1 39 90 29 37 R ESPIRATORY TRACT
The information and specifications shown in this leaflet are for information only and are not, under any circumstances, of a contractual nature.
S ET - UP CHECK LIST OF V YGON B OUSSIGNAC CPAP
In emergency cases, a simple, safe and efficient CPAP to treat APE
S TEP 1: OXYGEN SUPPLY: Etape 2 : Mise en place du manomètre Etape 2 : Mise en place du manomètre
• Connect the O2 flowmeter 0-30L/min. • Connect the CPAP to the face mask. • Progressively increase the flow rate to obtain
30
28
26
24
22
on oxygen bottle. > ThE dEVicE is rEady. the desired pressure level (PEEP).
Position it vertically
20
18
16
14
12
10
8
6
4

• Connect the green extension tube

2

to the flowmeter.
30
28
26
24
22
20
AIR 18
16
14
12
10
8
6
4
2

15 10
10
5
15
5 20
AIR 0
20

0 25 cmH
2O 25
cmH2O

S TEP 2 : SET UP OF THE MANOMETER S TEP 4: SETTING UP THE CPAP ON A MONITORED PATIENT S TEP 5: ADJUSTMENT AND MONITORING
• Pass the manometer attachment cord around • Open the flowmeter at 10-12L/min:
30
• Check there are no:
the patient’s neck. - This will allow good oxygenation of the - Leakage
28
26
24
22
20
18
16

patient.
14

• Connect the manometer attachment cord - Areas where the mask presses too tightly on
12
10
8
6
4
2

to one of the PEEP pressure gauge wings. - This will prevent a too sudden positive the patient’s face.
• Insert the tubing firmly into the manometer
10 15
pressure effect from being exerted on
AIR

the patient.
5 20

port. 0
cmH2O
25

10 l/min

Etape 2 : Mise en place du manomètre
• Connect the other side of the manometer
tubing to the clear translucent port of the
CPAP.
10
Etape 2 : Mise en place du manomètre Etape 2 : Mise en place du manomètre
• Explain the procedure to the patient. • If needed, you can adjust the mask
• Apply the CPAP to patient’s face with one positioning
hand and put the other hand behind the - Inflate or deflate the cuff.

patient’s head.
15

- Change the harness traction.

5
20

0
25
cmH2 O

10 15

20
5

25
0
cmH2O

S TEP 3 : CHOICE OF THE MASK:
• Position patient with mouth half open.
• Define the distance between the nose root
and the chin furrow.
• Choose the best mask according to this
Etape 2 : Mise en place du manomètre
• When the patient is tolerates the mask,
position the harness (with the help of a
second person if necessary).
Check there is no leakage.
Etape 2 : Mise en place du manomètre
• After set up of the CPAP:
- Maintain clinical monitoring of the patient.
- Maintain cardiac monitoring of the patient.
- Make adjustments of the pressure (PEEP)
03
82
62

according to patient’s clinical needs.

42
22
02
81
61

distance.
41
21
01
8
6
4
2

If there is a pressure decrease, check for:

• Inflate the cuff. RI A

- Leakage (mask/extension tubing).

The mask's width must cover the mouth. 5
10

15

- Check whether the oxygen bottle is getting

0

empty.
This literature was developed with the kind cooperation of F. Templier M.D. (SAMU 92 - Prehospital Medical Care Unit, University Hospital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, France).