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