Prehospital Noninvasive Ventilation: An NAEMSP Position Statement and Resource Document

Abstract

Noninvasive ventilation (NIV), including bilevel positive airway pressure and continuous positive airway pressure, is a safe and important therapeutic option in the management of prehospital respiratory distress.

NAEMSP recommends:

• NIV should be used in the management of prehospital patients with respiratory failure, such as those with chronic obstructive pulmonary disease, asthma, and pulmonary edema.

• NIV is a safe intervention for use by Emergency Medical Technicians.

• Medical directors must assure adequate training in NIV, including appropriate patient selection, NIV system operation, administration of adjunctive medications, and assessment of clinical response.

• Medical directors must implement quality assessment and improvement programs to assure optimal application of and outcomes from NIV.

• Novel NIV methods such as high-flow nasal cannula and helmet ventilation may have a role in prehospital care.

Key words:

• noninvasive ventilation
• prehospital
• CPAP
• BiPAP
• NIPPV