Date Published

May 21, 2020

Updated For

ALS PCS Version ALS PCS Version 5.2


When we have a patient who is sob and we have decided to put CPAP on, what code and ctas is mandatory even though they are stabilized because of cpap? Is it code 4 ctas 1 always? And are we suppose to pre alert for an RT?


The Prehospital CTAS Paramedic Guide Version 2.0 lists Shortness of breath - severe respiratory distress as a CTAS 1 modifier. Since severe respiratory distress (along with Signs and/or symptoms of acute pulmonary edema or COPD) is the Indication for CPAP administration, these patients should remain CTAS 1. Although the Guide references that change in patient condition needs to be reported to the receiving institution, a patient requiring CPAP for severe shortness of breath is still actively being resuscitated, and without the CPAP would decompensate into severe respiratory distress again.

It is helpful for the receiving facility to receive a notification that the patient being transported is requiring additional equipment +/- personnel, to continue resuscitation upon the patients arrival.



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