Which is a contraindication to CPAP therapy?

• A. Facial trauma or burns
• B. Facial congestion
• C. Mild headache
• D. Controlled airway protection

Answer: (A)

Noninvasive positive pressure ventilation like CPAP relies on a tight, tolerable seal against the face to deliver continuous positive pressure and recruit collapsed airways. Facial trauma or burns disrupt that seal and can worsen the injury, increase the risk of skin breakdown, bleeding, or surgical wound irritation, and make it impossible to deliver a consistent, safe airway pressure. Because of these risks, CPAP is contraindicated when the face is injured. Other options described—facial congestion or a mild headache—do not inherently prohibit CPAP, though they may affect fit or comfort. If an airway is already protected with an endotracheal tube or similar device, CPAP isn’t used because ventilation is being provided invasively.