Non-Invasive Ventilation Objectives

Question 1

Describe the principles of non-invasive ventilation (NIV)

Answer 1

NIV works by creating a positive airway pressure - the pressure outside the lungs is greater than inside the lungs.
This causes the air to be forced into the lungs, resulting in reducing respiratory effort and reducing WOB

Question 2

what are the indications for NIV

Answer 2

• the treatment and prevention of tissue hypoxia
• critical illness ie major trauma or shock
• hypercapnoeic
• special cases of poisoning

Question 3

what are the contraindications for NIV

Answer 3

• inability to protect their own airway
• untreated pneumothorax
• imminent cardiac/respiratory arrest
• inability to protect upper airway

Question 4

discuss potential complications/risks and techniques to minimise/prevent these for NIV = Patient comfort

Answer 4

-PI - monitor areas and implement PI saving devices to assist against PI

Question 5

discuss potential complications/risks and techniques to minimise/prevent these for NIV = Eye care

Answer 5

conjunctival eyes/ eye irritation = 2 hourly eye care

Question 6

discuss potential complications/risks and techniques to minimise/prevent these for NIV = conscious level

Answer 6

may not be able to maintain airway - monitor sats, RR, may require higher level of O2

Question 7

discuss potential complications/risks and techniques to minimise/prevent these for NIV = gastric inflation

Answer 7

avoid by limiting peak inspiratory pressure to less than 25cm H2O