AirCare 6 · 20 min · rotor

COPD — NIV then the tube

BTS oxygen — retainer · 88–92% (BTS — COPD / chronic CO2 retainer, not asthma) · 6 mL/kg PBW (4–8) · Pplat ≤30 · ΔP ≤14 (trainer) · Permit CO2 if pH ≥7.15–7.20 — empty the lung

69-year-old 80-pack-year, BiPAP fail, pH 7.18 / 92. You start NIV-ST on the T1 at the house. If he tires, you RSI and fly.

Handoff

Home O2 3 L. Cor pulmonale. He will not tolerate high mean Paw. First 6 minutes are a NIV trial. If RR stays > 30 or pH falls, take the airway.

1
Honest NIV trial — or commit
NIV-ST backup rate, EPAP 6–8, PS 8–12.
2
After the tube, empty the lung
Rate down, Te up. Same disease, new interface.
3
SpO2 88–92% (BTS retainer) — not the asthma band
He lives on 3 L. Do not treat him like a 52-year-old asthmatic.

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