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1. Understand non-invasive ventilation settings:
2. NIV adjustments made according to disease state:
3. Remember the rule of 15’s for pre-oxygenation:
- Mode: pressure support
- Trigger: patient-initiated only
- IPAP (Inspiratory Positive Airway Pressure) = Ventilation
- EPAP (Expiratory Positive Airway Pressure) = Oxygenation
2. NIV adjustments made according to disease state:
- Crashing Acute Pulmonary Edema patient: ↑ EPAP (Start: 15/5)
- Decompensating Asthma: ↑ IPAP (Start: 10/2)
- Decompensating COPD: ↑ IPAP (Start: 12/2)
- Chest Trauma: Both IPAP/EPAP (Start: 10/5)
- For palliative care patients or those not tolerating the NIV mask: Consider Heated, Humidified High-Flow Nasal Cannula (HFNC).
- Pneumonia/ARDS patients: Intubate early, as this is not reversible disease process in the short-term.
- Maximum: 18/12
3. Remember the rule of 15’s for pre-oxygenation:
- Position: Head of bed @ > 15º
- Non-rebreather mask @ 15 L / min
- Nasal cannula @ 15 L / min
- CPAP / BVM + PEEP valve @ 15 cm H2O
