Weinmann MEDUMAT Standard2 Step-By-Step Instructions page 8

in the case of acute respirators insufficiency (ARI)
Modified in accordance with therapy recommendations for emergency medicine 2022
published by the Association of Emergency Physicians of Northern Germany
(Arbeitsgemeinschaft in Norddeutschland tätiger Notärzte e.V. - AGNN).
Indications
• Hypoxemic ARI with respiratory rate > 25/min (count!) and
SpO < 90 % despite O
2
• Hypercapnic ARI = clinical ventilatory insufficiency with high respiratory rate/low
TV; e.g. acute exacerbated COPD (aeCOPD), bronchial asthma.
Contraindications
• Absolute: Absence of spontaneous respiration, gasping, airway obstruction,
gastrointestinal bleeding or ileus, non-hypercapnic coma
• Relative: Hypercapnic coma, high-grade hypoxemia agitation, pronounced
secretion, hemodynamic instability with shock, mask leakages.
Procedure
• Ensure logistical requirements: Check oxygen supply: at least a 2-l bottle; filled.
Check and adjust ventilator.
• Monitoring of respiratory rate (count!), SpO
initiated
• Commence NIV with patient semi-seated or seated.
• Slowly adjust the patient's face mask; the patient can initially hold the mask in
place themselves where possible. The most important aim of the adaptation
phase is the synchronization of the ventilator and the patient.
• If the patient is highly agitated, careful sedation may be helpful and necessary.
A benzodiazepine, opiate or Propofol in a sub-anesthetic dose can be used here.
• In the case of continuing leakage or patient apnea, the device switches to Apnea
ventilation (if activated). This mode can also be selected before connection to
the patient.
Non-invasive ventilation (NIV)
administration; e.g. cardiogenic pulmonary edema.
2
SOP
, ECG and etCO
2
as soon as NIV
2