PPV vs CPAP

[Gingerbell, BSN, RN]

OK, this may seam like a silly question but I need some help!! I'm a new grad RN and taking an NRP course. I am having a hard time visualizing the difference between PPV and CPAP (its in the algorithm). I've watched the video's on the NRP DVD and even googled it. But for a new grad this is a little confusing (at least for me it is).

Can anyone clarify the difference for me and possibly link me to any visuals? Again, I really feel as an RN, I should already know this!

Thanks in advance!!

P.S. Sorry if I posted this in the wrong section, I'm hoping that it will get moved to the correct sub-forum if needed.

~GB

[umcRN, BSN, RN]

If we are talking in terms if resuscitation (as we would be in NRP) both PPV and CPAP can be given via a flow inflating bag mask (not a self inflating). CPAP is provided this way by creating a full seal with the mask over the infants nose/mouth. The infant should be breathing on their own and the CPAP via the flow inflating bag will assist their breathing providing continuous positive airway pressure and enabling fuller lung expansion while still allowing the infant to do some work.

PPV or positive pressure ventilation is when using either a flow inflating bag or a self inflating bag you are also giving the infant breaths, this is what we consider "bagging" a patient and fully supporting their respiratory system

Another way of looking at it is that CPAP is going to provide support similar to that of a nasal cpap device while PPV is similar to being intubated and mechanically ventilated

Just out of curiosity, are you a new grad working in a specialty where NRP would be used? When I was a new grad in the NICU we took NRP but not until we had been on orientation for 6 months, these concepts are a lot easier to understand after being exposed to it for a while and not fresh out of school because really, nursing school doesnt include these types of skills

[MsBungleRRT]

A new grad usually does not have much of an understanding toward the more intricate equipment towards respiratory care. So don't worry about not fully understanding. It took me, while in respiratory school, 9 weeks of intense learning, plus 16 weeks of clinical 3xweek to have a good understanding of ventilation/CPAP/BiPAP.

For NRP, for PPV is assisting the infant in ventilation using the flow inflating bag and "bagging" the infant. You are giving the breaths.

CPAP is placing them on the an actual CPAP ventilator or placing the flow inflating mask over their mouth as the infant breaths on their own.

CPAP is for a spontaneously breathing, PPV is assisting the infant to breath.

[Gingerbell, BSN, RN]

umcRN,

Thank you so much! Now I get it! All this equipment is new to me and it is used so fluidly throughout the NRP book.

To answer your question, I signed myself up for the NRP course to make myself more competitive in the job market. I am also scheduled to take the ACLS, PALS, and ECG certification early in August.

It's extremely hard being a new grad right now. Unless you know somebody, no one will hire you. I had a perfect GPA, excellent references, and have personal contacts within my local hospitals but I keep getting beat out by daughters and sons of doctors or someone who was a unit clerk on the department before. It's very discouraging. So anyway, I thought I would do all that I could to make myself look more appealing in hopes of getting hired.

Thanks again!!

~GP

[Gingerbell, BSN, RN]

MsBungleRRT,

Thanks for your words too .. they made me feel much better about not knowing this info. These are very hard concepts to understand!!

Thanks to both the responses I received, I have a much clearer understanding but I'm sure more questions will follow! I'm only on lesson 3 of the 9 in the NRP. I passed the first 2.

Thanks again!

~GB

[umcRN, BSN, RN]

Well good luck to you.

Personally I'm not sure those classes are going to help much in the overall scheme of things and if you think NRP is hard the others are sure to be much tougher without prior knowledge. Also many hospitals will pay for those courses when you get a job. I graduated three years ago when the market was also very tight. I did have to relocate 10 hours from home for my job, I am still here and will likely relocate home eventually but for now am learning all I can.

[andrewfaniku]

If you think of the lung as a balloon that works better when it is slightly filled with air, rather than completely collapsed, It will be easier to understand the concept of PEEP- Which stand for positive end expiratory pressure. PEEP is that small pressure that keeps the balloon just a little filled with air- to keep it open so that it doesn’t collapse altogether. PEEP is just what CPAP gives. CPAP gives just a little continuous pressure to keep the lungs open, but what is the use of a lung that's only slightly opened if is not breathing? Now, that's where PPV comes in, PPV or bagging gives the “open and close” pressure that makes the balloon (lungs) inflate and then deflate. Just like we do when breathing- we inhale and then we exhale. So that’s why PPV is better than CPAP for a baby that’s apneic or not breathing at all, and CPAP will be better for a baby that is able to breath on it’s own but just needs a little support to keep the lungs from collapsing. I hope this explanation helps.

[NicuGal, MSN, RN]

Great explanations! But I have to agree, taking all those classes is commendable but if I were interviewing you it would not play into hiring at all. Without the baseline knowledge you receive in orientation you will have a hard time applying the things you learn. We send our people when they are done with orientation. If you are doing the classes on line, have you found somewhere to do the hands on part?

[Crich18]

This was SO helpful! I think the NRP manual is fantastic but this was the one thing they didn't really explain and it had me confused as well (4th semester nursing student), interested in NICU. I have really enjoyed reading this manual so far I feel like I've learned a ton, and while I know I won't be ready to assist in this capacity right away I think learning it is going to be a huge asset to my general neonatal knowledge. Thanks again for asking this!