Non-invasive mechanical ventilation in Australian emergency departments: A prospective observational cohort study. Export

@article{citeulike:4185429, abstract = {OBJECTIVES: Data describing use of non-invasive ventilation (NIV) in the emergency department (ED) setting consist primarily of physician surveys. Our objective was to conduct a prospective study to document the characteristics of patients receiving NIV, interfaces, mode, and parameters used as well as NIV duration and decision-making responsibility. METHODS: We conducted a 2-month prospective observational study of adult patients who received NIV in 24 EDs. Patient characteristics, delivery methods, and decision-making responsibility were documented for each ED presentation. RESULTS: Data were recorded on 245 patients; 185 patients received non-invasive positive pressure ventilation (NIPPV) and 60 received continuous positive airway pressure (CPAP). Acute cardiogenic pulmonary oedema (ACPO) (80/245, 33\%) and exacerbation of chronic obstructive pulmonary disease (COPD) (75/245, 31\%) were the two most frequent indications for NIV. Compared to patients with respiratory failure from other aetiologies, those with ACPO were more likely to receive CPAP (28/80 [35\%] versus 32/165 [19\%] P=0.008). Initial NIV settings were selected by ED nurses for 118/245 (48\%) patients, by ED physicians for 118/245 (48\%) patients, and by ICU staff for 3/245 (1.5\%) patients (not reported for 6 [2.5\%] patients). The role of ED nurses in the selection of initial NIV settings was not influenced by ED location, patient type or triage category. CONCLUSIONS: Acute exacerbations of CPO and COPD were the most common indications for NIV. Clinicians demonstrated a preference for NIPPV for all patient aetiologies except ACPO. Responsibility for NIV management was shared by ED nurses and physicians.}, author = {Rose, L and Gerdtz, M F F.}, citeulike-article-id = {4185429}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/j.ijnurstu.2008.10.009}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19084228}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19084228}, day = {10}, doi = {10.1016/j.ijnurstu.2008.10.009}, journal = {International journal of nursing studies}, keywords = {aecopd, apo, arf, copd, emergency, experience, niv, nivfailure, nurses, t2rf}, month = {December}, posted-at = {2009-03-17 08:07:18}, priority = {2}, title = {Non-invasive mechanical ventilation in Australian emergency departments: A prospective observational cohort study.}, url = {http://dx.doi.org/10.1016/j.ijnurstu.2008.10.009}, year = {2008} }

TY - JOUR ID - citeulike:4185429 L3 - citeulike-article-id:4185429 N2 - OBJECTIVES: Data describing use of non-invasive ventilation (NIV) in the emergency department (ED) setting consist primarily of physician surveys. Our objective was to conduct a prospective study to document the characteristics of patients receiving NIV, interfaces, mode, and parameters used as well as NIV duration and decision-making responsibility. METHODS: We conducted a 2-month prospective observational study of adult patients who received NIV in 24 EDs. Patient characteristics, delivery methods, and decision-making responsibility were documented for each ED presentation. RESULTS: Data were recorded on 245 patients; 185 patients received non-invasive positive pressure ventilation (NIPPV) and 60 received continuous positive airway pressure (CPAP). Acute cardiogenic pulmonary oedema (ACPO) (80/245, 33%) and exacerbation of chronic obstructive pulmonary disease (COPD) (75/245, 31%) were the two most frequent indications for NIV. Compared to patients with respiratory failure from other aetiologies, those with ACPO were more likely to receive CPAP (28/80 [35%] versus 32/165 [19%] P=0.008). Initial NIV settings were selected by ED nurses for 118/245 (48%) patients, by ED physicians for 118/245 (48%) patients, and by ICU staff for 3/245 (1.5%) patients (not reported for 6 [2.5%] patients). The role of ED nurses in the selection of initial NIV settings was not influenced by ED location, patient type or triage category. CONCLUSIONS: Acute exacerbations of CPO and COPD were the most common indications for NIV. Clinicians demonstrated a preference for NIPPV for all patient aetiologies except ACPO. Responsibility for NIV management was shared by ED nurses and physicians. JF - International journal of nursing studies TI - Non-invasive mechanical ventilation in Australian emergency departments: A prospective observational cohort study. KW - aecopd KW - apo KW - arf KW - copd KW - emergency KW - experience KW - niv KW - nivfailure KW - nurses KW - t2rf AU - Rose, L AU - Gerdtz, M F PY - 2008/12/10/ UR - http://dx.doi.org/10.1016/j.ijnurstu.2008.10.009 ER -