Tag: CCU

Non-invasive ventilation – basics

Presented below is Dr Terence Yuen’s presentation on the basics of non-invasive ventilation (NIV) which was deferred from March 16th 2016.

Non-Invasive-Ventilation-Western-ED-teaching-2016

 

Also consider this brief troubleshooting guide from Life in the Fast Lane:

 

NIV-guide-from-LITFL

 

Please also see these relevant Western Health policies:

Guideline for Non Invasive Ventilation (NIV) in the Cardiac Care Unit (CCU) – last review September 2012

fine print of note:

  • other contraindications listed in the policy include
    • upper airway obstruction from foreign body (intervention required clearly different)
    • chronic restrictive lung disease (consider pressures and alarms, also check for limitations of treatment)
    • unilateral lung disease (undefined in policy)
    • Raised intracranial pressure
    • Pre-existing hyperinflation (unsure if this means asthma and obstructive lung disease)
    • Compromised cardiac output related to hypovolaemia (NIV may still be a necessary intervention with other adjuncts eg. fluid / inotropes)
    • Patients who have had a Fontan Procedure performed (a paediatric cardiac procedure for congenital cyanotic disease)
    • Normal lungs (presumably a trigger to consider alternative diagnosis other than APO)

Admission and Discharge to the Intermediate Respiratory Care Unit (IRCU) – last review May 2010

fine print of note:

  • re: NIV, other than patients with COPD and type 2 respiratory failure, IRCU will also admit (if indicated) patients with
    • obstructive sleep apnoea
    • non-respiratory conditions eg. neurological or neuromuscular; consider first however if these patients will require HDU
  • IRCU also accepts patients with non-NIV related issues such as:
    • acute asthma on low-dose adrenaline infusions
    • tracheostomy management
  • IRCU does not accept patients who require invasive monitoring