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NIV/ BiPAP vision machine on a tracheostomized Pt.

Guys i need your feedback on this:

Placing a tracheostomized, chronic adult pt on a Bipap vision/ NIV machine? Tranferred from ICU/HDU and being managed in the Wards.

Do you agree on this practice? Do you find it safe?

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Replies to This Discussion

Permalink Reply by Dan Sosa on December 3, 2009 at 9:07pm

What's the Problem bottom line it is still a vent Normally used to ventilate via mask but you can still set up rate pressures alarms humidification etc. Just like we did with the Bird ventilators pressure rate Fi02 disconnect alarms. Bipap or Ippb can be used as a pressure ventilator

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Permalink Reply by Jeff Whitnack on December 3, 2009 at 11:54pm

You can do it. I just consider it an act of desperation and not inspiration.

The main proposed "use" for it at my hospital is so they can transfer trached patients who DO need mechanical ventilation to floor wards where "Bipap" is allowed, but "ventilators" aren't. It's a technical "reach around". IMO if that is what they want to do then an LTV would be a better choice. But to get around the rules then they opt for something which, IMO, is less safe.

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Permalink Reply by GHALIB NAWAZ on December 10, 2009 at 2:51am

yes, i have also used it on a copd patient who was on ventilator adn difficult to wean. so, just like this i prepared the circuit with a small hole at elbow connector which was for exhalation, then this pt. remained on bipap for one weak jut for observation in icu then discharged gradually to home. there, he after one month weand off from bipap. although it has some risk factor like no alarm and emergency approach at home but remained successful.
now pt is also free from tacheostomy.

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Permalink Reply by HASAN RT on January 27, 2010 at 9:52am

It is not safe
because the servece in icu diffrence than in the wards
in the ward they not have experience for ventilated pationt.

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Permalink Reply by Shahid Khan on September 13, 2010 at 1:44am

BiPAP on a trache patient is not indicated. This is a supported by the books of medicine in which you will find not indication of putting a patient on a BiPAP. I have yet to see a policy from any hospital which clearly states that a trache patient can go on a BiPAP. If you hospital have a policy kindly share it with me. I will really appreciate it.