ANAESTHETICS AND AIRWAY
NIV
PromptIndications for NIV
ResponseAPO with elevated WOB
Asthma with fatigue or worsening hypercarvia
COPD with elevated pCO2
T1RF
T2RF
Delayed sequence induction
Asthma with fatigue or worsening hypercarvia
COPD with elevated pCO2
T1RF
T2RF
Delayed sequence induction
PromptContraindications for NIV
ResponsePatient preference - intolerance of mask, goals of care not including NIV
Apnoeic, or Inadequate respiratory effort
Unconscious patient/ALOC
Significant facial trauma
Need for intubation -Unprotected airway or Airway threat - vomiting, haematemesis, haemoptysis
Peri-arrest
Lack of staff, monitoring
Apnoeic, or Inadequate respiratory effort
Unconscious patient/ALOC
Significant facial trauma
Need for intubation -Unprotected airway or Airway threat - vomiting, haematemesis, haemoptysis
Peri-arrest
Lack of staff, monitoring
PromptNIV vs CPAP
ResponseCPAP - T1 resp failure - APO, Preoxygenation for RSI
BIPAP - T2 resp failure - COPD, Asthma, Neuromuscular disease
BIPAP - T2 resp failure - COPD, Asthma, Neuromuscular disease
PromptInitial settings for hypercapnoeic respiratory failure (Acute respiratory acidosis)
ResponseIPAP 10-12
EPAP 5
FiO2 60% and titrate down to target 88-92%
EPAP 5
FiO2 60% and titrate down to target 88-92%
PromptComplications of NIV
ResponsePtx
Aspiration
Local trauma (nasal bridge, eyes)
Hypotension
Delay to intubation
Aspiration
Local trauma (nasal bridge, eyes)
Hypotension
Delay to intubation
PromptHFNP
ResponseIndications - T1RF
MOA - Oxygenation, humidification, CPAP effect (probably minimal)
Might wash out dead space of CO2
MOA - Oxygenation, humidification, CPAP effect (probably minimal)
Might wash out dead space of CO2