WESTERVILLE, OHIO — The Westerville Division of Fire (WFD) has partnered with Nationwide Children’s Hospital to equip all medic vehicles with pediatric CPAP (Continuous Positive Airway Pressure) equipment. WFD is among the first emergency medical service (EMS) providers to carry the equipment full-time to treat infants and children in respiratory distress and avoid the invasive procedure of intubation with better long-term outcomes.
The custom device was designed by WFD medics and emergency medical specialists experienced in helping the youngest patients overcome breathing obstructions and/or facilitate rest from work of breathing (caused by some medical issue). Further, medics worked with manufacturers to develop a tubing piece that facilitates the airflow needed for small patients.
“We want to use CPAP en route to the hospital instead of intubation when possible,” said Frank Orth, M.D., WFD’s Medical Director. “Intubation is an invasive procedure, and the goal is to avoid having to admit these children for long-term health care if we can eliminate work of breathing through CPAP. What we see in CPAP use is that it helps us prevent further deterioration and the difficulty of weaning off ventilation if intubated.”
CPAP in adults is a standard intervention for emergency care. WFD was among the first in the state to carry adult CPAP equipment.
“We’re excited to be one of the pioneers in this and know it will have a major impact in EMS,” said Fire Chief Brian Miller. “Westerville Fire was in front of this for use in adults, and pediatric CPAP is now part of our protocol if we have a child in respiratory distress.”
Part of the innovation will be monitoring the data to push for the manufacturing of a full kit for pediatric use, says Chief Miller. The pediatric kits include about $100 in equipment (tubes, ports, masks, depending on size); four kits have been assembled for each of the medics responding to medical emergencies in and around Westerville.
“There’s some healthy discussion right now about how to study this and how to move forward with manufacturing,” said Chief Miller. “The innovation is in the design and retro-fitting of equipment to work for this purpose. But it doesn’t exist yet as an entire kit and we’re eager to share our success with manufacturers so that EMS providers everywhere have access.”
Westerville and NCH plan to monitor results and future cases to study the intervention of patients who start on CPAP and continue treatment in the emergency department. Further, WFD plans to offer demonstrations and gather Central Ohio-area departments interested in implementing the strategy.
“This is a good opportunity to capture some of the good work and start the momentum to learn in the field,” said Dr. Orth. “Other departments are right behind us on this because it makes sense.”