The Core of Asthma Management: Noninvasive Positive-Pressure Ventilation
Noninvasive Positive-Pressure Ventilation:
- Consider BiPAP for patients with impending respiratory failure unresponsive to medical therapy
- Evidence shows that NIPPV reduce hospitalizations and improve respiratory rate, percent predicted FEV1, FVC, PEF
- Avoid in patients with suspected pneumothorax
- Intubation and mechanical ventilation should be considered if patient has persistent hypercarbia, acidosis or becomes exhausted/altered while on NIPPV
NIPPV has saved many a patient from intubation...good for them....disappointing for EM residents!
Maybe its most important function is to make the EM provider feel better, i.e. "this patient looks terrible, but I've got them on bipap so I feel better and will hold off intubating them" while the medical therapies do their job.