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 17/06/21.