NIV: What’s the big deal?

Terminology: In general,Type 1 RF requires CPAP type of NIV. Type 2 RF requires BPAP type of NIV. PEEP=EPAP=CPAP i.e. they all mean the same! So you can say in Type 1 RF (Hypoxic failure), the pressure we provide is PEEP or just EPAP or CPAP.  For Type 2 RF (Hypercapnic), we provide IPAP as […]

Non-Invasive Ventilation

Noninvasive ventilation decreased endotracheal intubation rates and hospital mortality in acute hypoxemia non-hypercapnic respiratory failure excluding chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema patients. There is no sufficient scientific evidence to recommend bi-level positive airway pressure or helmet due to the limited number of trials available. Large rigorous randomized trials are needed to […]

Setting the Ventilator like a Pro

How to set up Non-Invasive Ventilation (NIV)

Who Needs It? Patients with moderate to severe COPD exacerbations Those patients with cardiogenic pulmonary edema with increased work of breathing or hypercapnia Patients with isolated blunt thoracic trauma The immunocompromised patient with hypoxic respiratory failure Patients who require pre-oxygenation prior to intubation

Optimal Bag-Valve-Mask Ventilation

  Remember to connect the device to an Oxygen Supply Use two providers wherever possible – one to maintain a good seal by lifting the face into the mask and applying a steady downward counter pressure to the mask using both hands (see image) and the other colleague squeezes the bag to ventilate. Don’t ‘bag’ […]

Emergency Ventilation

BMV is always a 2 person procedure (regardless of technique used) – Skilled person holds the mask and anyone else can provide the breaths + Consider the 2 thumbs down technique for BMV instead of the CE clamp. And Believe it or Not – Learning BMV is more important than mastering Laryngoscopy !!

Mechanical Ventilation- Terminology

Volume controlled ventilation We can put a certain volume of air into the patient with each breath in mechanical ventilation. Pressure controlled ventilation We can put air into the patient until the pressure reaches a certain value. Rate We can decide how often we give the patient a breath each minute. Flow rate For example, […]

Principles of Mechanical Ventilation

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Step by step guide to post intubation and ventilator management for everyone

Understanding intubation and ventilation…the Pearls and Pitfalls

A normal minute ventilation involves a minute ventilation between 5 and 8 L [ie, 500–600 mL, rate 10–14 breaths/minute]. In severely ill COPD and asthma patients, overventilation risks auto-PEEP and barotrauma; a starting rate of six breaths with a 500 mL volume allows maximum time for exhalation.