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Ambulances Now Carry Forced-Air Breathing Devices

KANAWHA COUNTY, W.Va. -- A portable machine that helps people stop snoring and breathe easier at night is now being used in Kanawha County ambulances to treat patients on their way to the hospital emergency room.

About 15 Kanawha County Emergency Ambulance Authority trucks have been equipped with Continuous Positive Airway Pressure, or C-PAP, devices in recent weeks.

The noninvasive machines get air into the lungs faster, pushing in oxygen and pushing out fluid.

"These machines have been around for years, but we've just never had them on ambulances before," said Kanawha paramedic Wayne Harmon. "It gives positive pressure and pushes away fluid."

Harmon believes the Kanawha Ambulance Authority and the Charleston Fire Department are the first two agencies in West Virginia to equip ambulances with C-PAP machines. Ambulance companies in other states also are using them.

The ambulance authority plans to put C-PAP machines in all 35 of its vehicles by the end of the year. Each machine costs about $800.

"It's an extension of the ER into the field, so we can provide the most appropriate treatment," said Dr. John Burdette, the authority's medical director and an E.R. doctor at St. Francis Hospital in Charleston. "The earlier we get to them, the better."

C-PAP machines are most commonly used by people with sleep apnea, which occurs when the upper airway narrows and throat muscles relax during sleep. That reduces oxygen in the blood and prompts people to wake up at night.

Harmon demonstrated a C-PAP machine one morning last week. He likened the device's air pressure to the sensation of trying to breathe while sticking your head out of the window of a speeding car.

The machine features a mask placed over the nose and mouth. An attached air hose is connected to an oxygen tank. Air pressure can be adjusted with the turn of a switch.

Paramedicsuse the machines on people having trouble breathing because of congestive heart failure, cardio obstructive pulmonary disease, emphysema and asthma attacks.

Patients treated with C-PAP machines in ambulances are transferred to another C-PAP machine when they arrive at the hospital.

In the past, patients with severe breathing problems often had to be sedated and intubated with a breathing tube in the ambulance, and then hooked up to a ventilator at the hospital. That increases the risk of infection and usually results in longer stays in the hospital's intensive care unit. It's sometimes difficult to wean people off ventilators.

"Anytime you can stop someone from going on a ventilator, you're better off," Harmon said.

With the C-PAP machines, if patients' breathing improves after a few minutes, they are less likely to need a ventilator later.

"This is just another tool to help patients," Harmon said. "It's going to take off and become a standard of care."

Reach Eric Eyre at ericeyre@wvgazette.com or 348-4869.

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