EM Cases · Non-invasive ventilation
Acidotic COPD exacerbation — BiPAP settings, failure criteria, and when to intubate
ACEM Fellowship resus station on evidence-based NIV for COPD, settings/titration, monitoring, and escalation to intubation.
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Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A known COPD patient with pH 7.28 and rising CO2; you must start BiPAP, set targets, and recognise failure.
Stem
All persons, presentations and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
References3ShowHide
- [1]O'Driscoll BR, Howard LS, Earis J, et al. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax, 2017.PMID 28507176
- [2]Gray A, Goodacre S, Newby DE, et al. Noninvasive ventilation in acute cardiogenic pulmonary edema. New England Journal of Medicine, 2008.PMID 18614781
- [3]Plant PK, Owen JL, Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet, 2000.PMID 10859037