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