Can CPAP be used on a patient with a DNR?
Question #64
In conversation with colleagues, I have been getting mixed opinions with applying CPAP to a pt with a DNR. Some see it as artificial ventilation other see it as treatment. Inwould love to hear base hospitals perspective on this.
Answer:
CPAP can be applied to a patient with a valid DNR.
Under the Do Not Resuscitate Confirmation Form standard in Ontario, the DNR applies only in cardiac arrest or respiratory arrest and directs paramedics to withhold resuscitative measures such as CPR, defibrillation, arrest medications, and artificial ventilation in arrest.
CPAP is not artificial ventilation. It is non invasive positive airway pressure delivered to a spontaneously breathing patient to treat respiratory distress. It does not replace absent respirations and is not a resuscitative intervention. If the patient has a pulse and meets the directive, CPAP remains indicated treatment.
Medical Directive Category
Acute Cardiogenic Pulmonary Edema
Published
24 February 2026
ALSPCS Version
5.4
Views
2
Please reference the MOST RECENT ALS PCS for updates and changes to these directives.