"The Greatest Battle Implement Ever Devised"


So said, so the story goes, General George S. Patton about the M1 Garand rifle. This post is about neither General Patton nor the M1 Garand.

It’s about Continuous Positive Airway Pressure for treatment of Congestive Heart Failure.

Massachusetts is a bit, well more than a bit, behind the curve on this because only a select few EMS systems are allowed to use it.

Seems like the motto over that at OEMS should be “We didn’t invent the wheel, but we’ve perfected the art of reinventing it”. Only I don’t think they could fit that on their stationary or business cards.

No other treatment for CHF, including IV Nitroglycerin has such a fast or salutary effect on acutely dyspneic patients. Ready to be tubed one minute and five minutes later sitting up, comfortable, dyspnea relieved, happy as the proverbial clam.

It’s not only a great ALS procedure, but I hear tell some other states are starting to allow BLS personnel to use it.

You’d think that here in the medical center of the universe, our EMS systems would be allowed to use this. You’d be wrong, unless you work for one of a very small number of systems that are allowed to use it under the auspices of a “Demonstration Project” waiver.

Maybe someday OEMS will be convinced that the sun won’t come up in the west if they make this part of the statewide protocols.

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After a long career as a field EMS provider, I'm now doing all that back office stuff I used to laugh at. Life is full of ironies, isn't it? I still live in the Northeast corner of the United States, although I hope to change that to another part of the country more in tune with my values and beliefs. I still write about EMS, but I'm adding more and more non EMS subject matter. Thanks for visiting.


  1. Here in PA, BLS was just authorized to use it. I’ve seen it in action…it works. Huffing and puffing and blue one minute, and pink and happy the next! Good Stuff!PA EMT

  2. I think that it has been a BLS skill in Delaware for years. Pennsylvania still has it as an optional skill for ALS, even though it is being added to BLS optional skills. You know how it is. Anything new and different has to be forced on us, but only after the benefit can no longer be ignored. The old and ineffective treatments, or restrictions on treatments, take forever to be removed.You do have IV NTG, don’t you? IV NTG is progressive.

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