NPPV - Respiratory

Question 1

What are the 9 contraindications to NPPV, and the 1 relative contraindication?

Answer 1

1. Active vomiting/unable to manage airway secretions
2. Decreased LOC/severe agitation (patch for sedation)
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
10. Hemodynamic instability

Question 2

What are the initial settings for CPAP/NPPV as per the MDSO? What are the max settings?

Answer 2

iPAP 10 cm H2O (max. iPAP 20 cm H2O)
ePAP 5 cm H2O (max. ePAP 10 cm H2O)

Note:
iPAP = PEEP + PS
ePAP = PEEP

Question 3

Do you need to patch for NPPV if the patient doesn’t have any contraindications?

Answer 3

Initiate then patch, no patch required if maintaining NIPPV from sending facility