Non-Invasive PPV (NPPV/NIPPV)

Question 1

Who is the ideal candidate for NPPV?

Answer 1

Alert & cooperative

A pathology that can be reversed acutely (CHF with pulm edema, COPD, asthma)

Question 2

List the absolute contraindications and the one relative contraindication for NPPV as per our MDSO

Answer 2

Absolute:
1. Active vomiting/unable to manage airway secretions
2. Decreased LOA/agitation
3. Inability to protect airway
4. Repeated hemoptysis
5. Cardiac or respiratory arrest
6. Immediate need for endotracheal intubation
7. Upper airway obstruction
8. Facial trauma
9. Recent esophagostomy
Relative: hemodynamic instability

Question 3

What are the initial settings for NIPPV as per Ornge MDSO

Answer 3

Initiate then patch
IPAP 10 cmH2O (max 20 cmH2O)
EPAP 5 cmH2O (max 10 cmH2O)