Which of the following is a contraindication to CPAP therapy?

• A. Active vomiting
• B. Ability to protect airway
• C. Facial trauma
• D. Absence of recent surgery

Answer: (A)

CPAP relies on maintaining a patent airway and preventing collapse by delivering continuous positive pressure through a mask. A central safety requirement is that the patient can protect the airway and handle secretions. Active vomiting is a clear contraindication because the positive pressure from CPAP can push vomitus toward the lungs, greatly increasing the risk of aspiration and resulting lung injury or pneumonia. If a patient is actively vomiting, securing the airway or delaying CPAP until vomiting stops is the safer approach.

Having the ability to protect the airway is a positive factor for CPAP use, since it means the patient can manage secretions and maintain airway integrity while receiving positive pressure support. Facial trauma can hinder a proper mask seal or worsen injuries, so CPAP is typically avoided or used only with caution in significant facial injuries. Absence of recent surgery isn’t itself a contraindication; CPAP can be considered as long as there aren’t other immediate risks or reasons to avoid positive airway pressure.