NIV Criteria and When to Use

When?

• Fi02 >60% or RR >35 or sustained increased work of breathing

Why?

• Avoids invasive intubations and associated critical care complications
• Shorter hospital stay
• Avoids sedation
• Patients able to interact
• Patients able to take meal breaks and therefore remain with enteral feeding
• Available in non-critical care settings e.g. acute respiratory units

How?

• Physiology

What is NIV?

Typically used as an umbrella term ‘Non-Invasive Ventilation‘ encompasses:

• Continuous Positive Airway Pressure (CPAP)
and
• Bi-Level Positive Airway Pressure* (BiPAP)*

Non-Invasive Ventilation (NIV) has been designated as an Aerosol Generating Procedure (AGP) by Public Health England (PHE) during the COVID-19 pandemic (Ref: BTS Oct 2020). NIV is the application of a comfortable closed circuit to the face to deliver pressurised air/oxygen mix to support and improve the ventilation of patients who are struggling to maintain good oxygenation and carbon dioxide clearance. We guide you through process of selection and initiating non-invasive ventilation in our NIV training video.

COVID Non-Invasive Ventilation (NIV)

During Wave-1 Chelsea initiated the successful approach using NIV for those eligible patients who were FOR and NOT for critical care escalation. Patients were successfully managed on CPAP alone, a smaller proportion required invasive mechanical ventilation and critical care transfer. CPAP when used appropriately may reduce bed days and may prevent the need for invasive mechanical ventilation. Many patients who were not critical care candidates for intubation, sedation, paralysis and ventilation were offered NIV.