EMCrit Podcast 19 – Non-Invasive Ventilation - a podcast by Scott D. Weingart, MD FCCM

Intubation is a critical procedure, there is no doubt about it.



NIV does not have the glamour; it's not nearly as cinematic. But for the patient, to spend 30 minutes on a NIV mask is preferable to a couple of days on the ventilator. In this episode, I discuss some of the basic ideas and methods of NIV.



It is pretty simple as the mode only has 3 main settings:



FiO2 - set based on oxygen requirements, just like on the vent



PEEP/EPAP/CPAP - all the same thing, set this based on OXYGENATION needs. If the patient's sat is low, start at 5 cm H20 and titrate up to 15-17 as needed.



PSV/IPAP - this setting is for ventilation. If your patient does not have ventilation problems, they don't need PSV. If they do, start at 5 cm H20 and titrate to 15-17.



Yes, that's right, I did not tell you to put every patient at 10/5. Very few of your patients will have both ventilatory and oxygenation problems. Asthma and COPD need inspiratory support. APE, atelectasis, pneumonia patients need PEEP.



I also talk about sedation while a patient is on NIV.

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