Weinmann MEDUMAT Standard2 Instructions Manual page 6

SOP
(Standard Operating Procedure)
Non-invasive ventilation (NIV) by the emergency medical
services
Modified by Prof. Dr. med. Thoralf Kerner
Logistical requirements
Oxygen supply: at least a 2-l bottle, filled ....................................................... Check
Emergency medical team familiar with NIV ..................................................... Check
Clinical requirements
alert, cooperative (GCS > 12) ......................................................................... Check
breathing spontaneously ................................................................................ Check
if applicable, light sedation of agitated patients e.g. morphine
(5-10 mg i.v. titrated) or a short-acting benzodiazepine.
Indications
Dyspnea ......................................................................................................... Check
Respiratory rate > 25/min (count!) ................................................................. Check
SpO < 90% despite O administration ........................................................... Check
2 2
Contraindications
Absolute contraindications: ............................................................................ Check
absence of spontaneous respiration, gasping, airway obstruction,
gastrointestinal bleeding or ileus
Relative contraindications: .............................................................................. Check
Coma, massive agitation, hemodynamic instability, severe hypoxemia
(SpO < 75% despite O ), problems with airway access, status post
2 2
gastrointestinal surgery
NIV sequence: Set the device, place the mask on the patient's face (explain the
measure!), connect the mask to the hose system while the device is running. Aim:
Synchronization of patient and device
Pulmonary edema
Primary device settings
Ventilation mode: ............................................................................................CPAP
PEEP (according to comfort and oxygenation): ......................................5/7/10 mbar
FiO : .............................................................................................. Air Mix or 100%
2
Aim and success criteria
Target SpO : > 90% ....................................................................................... Check
2
Decrease in dyspnea ...................................................................................... Check
Falling respiratory and heart rate .................................................................... Check
If applicable, improved vigilance ..................................................................... Check