By rray, 25 April, 2023 If NEB used air driven preferred vs O2 driven to avoid potential uarr PaCO2 Use standard COVID 19 precautions keep circuit intact use mesh NEB in ventilated pts
By rray, 25 April, 2023 Route No significant FEV1 difference between MDI w or w o spacer vs NEB though NEB may be easier for sicker pts continuous NEB not recommended
By rray, 25 April, 2023 Initiate short acting BDs SABA albuterol levalbuterol MDI NEB SAMA ipratropium MDI NEB C Use spacer or NEB hourly x2 3 doses then q2 4h
By rray, 25 April, 2023 Invasive ventilation indications nbsp nbsp Failure of and or can t tolerate NIV nbsp nbsp S P resp cardiac arrest nbsp nbsp darr consciousness psychomotor agitation inadequately controlled w sedation nbsp nbsp Massive aspiration persistent vomiting nbsp n
By rray, 25 April, 2023 NIV nasal facemask indications nbsp nbsp Resp acidosis PaCO2 45 mmHg pH 7 35 nbsp nbsp Severe dyspnea w signs of resp muscle fatigue and or uarr work of breathing e g accessory muscle use paradoxical abdomen motion intercostal retractions nbsp nbsp Persis
By rray, 25 April, 2023 Assess need for assisted ventilation and initiate if appropriate Use NIV first if not absolutely contraindicated NIV improves gas exchange decreases breathing work need for intubation and hospitalization duration and improves survival A