NIV - "Focus" setup
- Consultant/Senior Decision maker to commence NIV.
- NIV machine (Bipap Focus in CUH) + tube + CO2 exhalation port + mask + head-cap.
- On the Bipap focus machine, the O2 tubing can be attached into the port on the face mask or beside the exhalation port.
- Set EPAP at 4 – 5 cm H2O and IPAP at 10 cm H2O.
- Set back-up breathing frequency to 8 – 10 breaths/minute.
- Select appropriate size mask (full face in preference to nasal) to fit patient.
- Explain procedure to patient.
- Hold mask in place to allow patient to familiarize themselves.
- Attach pulse oximeter.
- Commence NIV, holding mask in place initially.
- Secure mask in place with straps/headgear to prevent leaks – do not attach too tightly!
- Reassess patient after a few minutes.
- Check for leaks and refit mask if necessary.
- Add O2 to maintain SpO2 >85%.
- Instruct patient how to remove the mask and summon help.
- Increase IPAP gradually up to about 12 - 15 cmH2O over 1 hr.
- Clinical assessment and, if appropriate, check ABG at 1 hour.
- If procedure fails, institute alternative management plan.
Content By Dr Íomhar O' Sullivan 22/04/2015. Last review Dr ÍOS 22/04/15.