Download Non-invasive Ventilation - Basildon and Thurrock University Hospitals

Patient Information
Non-invasive Ventilation (NIV)
Author: Pulmonary Physiology & Sleep Medicine
Produced and designed by the Communications Team
Issue date Oct 2015 - Review date Oct 2018 - Expiry date Oct 2019
Version 1
Ref no. PILCOM1751
What is Non-invasive Ventilation (NIV)?
Non-invasive ventilation (NIV) is a treatment to help with your breathing.
If your breathing becomes difficult and your muscles tire, it can lead to
a build-up of carbon dioxide in your blood. In addition you may not have
enough oxygen in your blood.
NIV is used to support breathing in exacerbations of chronic obstructive
pulmonary disease (COPD or emphysema), in infections e.g. pneumonia,
respiratory failure, muscle weakness, motor neurone disease, chest wall
disorders and sometimes if breathing is limited by obesity.
NIV must be worn every night during sleep. It provides support for the
lungs through a tight mask fitted carefully over the nose and/or mouth.
This is attached with a tube to the ventilator (breathing machine) which
gently blows air into the lungs to help you breathe in and out easier by
supporting the muscles which make your lungs work. It doesn’t breathe
for you, but gently assists each breath that you take. By assisting your
breathing, NIV can increase the oxygen levels and decrease the carbon
dioxide levels in your blood.
The mask can sometimes be uncomfortable. The clinical staff (nurse/
physiologist) will spend some time with you as you get used to the
sensation of the mask and air blowing on to your face. Most people need
to use the breathing machine throughout the night and some people
constantly for the first 24 hours, with breaks for eating/drinking and
medications. Your timing will be explained to you when you are set up.
You will have been issued the following:
Machine (with power lead)
Filter
Hose
Mask (with headset)
Carrying bag
You will be shown how to set up and use the equipment. The mask
provided has been specifically selected to fit your face and the machine
has been set for your breathing. The physiologist or nurse will set up the
machine and make sure that it is as comfortable for you as possible. They
will also explain to you when you will need to use the machine.
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Benefits of Non-invasive ventilation (NIV)?
NIV can improve sleep quality leading to better energy and concentration
levels during the day. It can also help you feel less breathless. This may
mean you may be able to perform more daily tasks. You may also feel
brighter on waking and headache free if this was a problem previously. It
can also decrease the likelihood of being re-admitted to hospital.
Are there any side effects or risks to the treatment?
NIV can feel a bit strange to start with. However, most people get used to
it fairly quickly. As with any treatment, side effects can occur. However, the
side effects associated with NIV are rarely severe and easily resolved.
Common mask problems include:
Mask seal problems – a small leak from the bottom of the mask
is common and will not affect the performance of the NIV device.
However, a large leak or a leak into the eyes can be problematic. You
can try tightening the headgear straps slightly, but this can cause further
problems. Please contact us on 01268 394033 so that the mask can be
adjusted. It can sometimes take a number of attempts to find the most
comfortable and effective mask.
Soreness on the nasal bridge - soreness on the bridge of the nose is
an indication the mask is too tight at the top or a poor fit. The mask will
either need refitting or replacing as the soreness can become worse
over time. Contact the service immediately for advice – do not wait until
your next appointment.
Throat dryness - a dry mouth is very common when using NIV,
particularly with a mask that covers the mouth. Usually, a glass of water
by the bed is enough to resolve this but in severe cases, humidification
devices are available.
Nasal problems - it is common to suffer from nasal stuffiness, sneezing
and a running nose when you first start treatment. This should settle
on its own. If it doesn’t settle after a week contact your GP and ask
for a prescription for a nasal spray such as Flixonase, Beconase, or
Nasonex.
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Are there any alternatives to NIV?
There are no similar non-invasive alternatives to NIV treatment. It is
unlikely that the oxygen and carbon dioxide levels in your blood will return
to normal quickly without any form of treatment.
Frequently asked questions
Can I survive a night without my ventilator?
Most patients can spend one or two nights off their machine; however,
symptoms of tiredness and headaches may reappear. Rarely, however,
this can be dangerous in some patients. You will be given specific
advice when NIV is started.
Does my ventilator need a service?
Your ventilator and consumables will be checked every 6 - 12 months
at the same time that we see you to assess your treatment. The
tubing, mask and filters will be checked or changed and if there is
a performance problem we may swap your machine for another.
During your annual visits your machine will get serviced by the
Medical Engineers. So please ALWAYS bring your machine to these
appointments to ensure checks and adjustments can be made if
necessary.
My ventilator doesn’t feel comfortable or gives me a breath at the
wrong time. Is this OK?
If your machine doesn’t feel right you should get in touch with us the
next working day and bring your machine and consumables with you
to service at an agreed time. For routine problems on weekdays (9am5pm) please contact us on 01268 394033. Out of hours you can leave
a message with your details and we will get back to you as soon as
we can. For urgent problems out of hours, weekends or bank holidays
please contact Florence Nightingale Ward on 01268 394618.
Do I need to bring my ventilator in the ambulance if I am admitted
to hospital?
Yes. You must insist that your NIV machine, mask and tubing comes
with you if you come to hospital. This is very important. You may need
it as the ventilators used on the wards are different to yours and may
not feel comfortable. More importantly they might not give you effective
ventilation.
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Should I use my ventilator in the daytime?
If you want to have a nap in the day or have a chest infection, it may be
good to use your ventilator during the day as well as at night. You won’t
become dependent on it – but you will benefit from wearing it.
Is there anyone I can contact out of hours if there’s a problem with
my ventilator or breathing?
If you feel your breathing is getting worse, or you feel unwell, call your
GP for medical advice. If your machine malfunctions and you can
manage a few nights without it, contact us on the next working day.
Can I use oxygen whilst on my ventilator?
It is important that oxygen is used with the machine if prescribed. You
will be advised on the correct oxygen level when NIV is started or
altered in hospital.
Why does the machine keep alarming?
Usually this is because there is too much air leaking from the sides of
your mask. It is nothing for you to worry about and the staff will try to
address the problem to ensure the alarms are checked and rectified.
I have dropped my ventilator, what should I do?
If you drop your ventilator, even if you think that it is working effectively
please contact us as soon as possible on 01268 394033. Our
maintenance department will need to check its function and electrical
safety as soon as possible.
What should I do if I begin to feel more tired and sleep during the
day or if I am waking up with a headache?
If you are waking with a headache or feeling sleepy during the day, this
could be the first sign that the ventilator is not supporting your breathing
effectively. Please contact us as it could be that the pressure of the
machine needs adjusting slightly or there could be a leak in the mask.
The physiologist/nurse will be able to answer any questions you have
and if a sleep study and a blood test is needed, this can be arranged.
If your breathing is getting worse or you feel extremely unwell, please
contact your GP or, if necessary, call 999.
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If there is a power cut what should I do?
Firstly don’t worry. Unless you are very reliant on the ventilator, you will
not suffer any long term harm if you are unable to use your ventilator
for a few hours or for a night. Speak to the company who supplies your
electricity to notify them you have a power cut.
If you are unable to use your ventilator overnight this a could cause
some daytime sleepiness. If you are affected by tiredness or sleepiness
the next day, please refrain from driving/operating machinery.
I am going on holiday should I take my ventilator with me?
Whenever you travel or plan to stay away from home overnight, you
should take your ventilator with you.
Most machines can be used abroad by using a plug adaptor. If you are
flying please ensure that your ventilator is taken onto the aircraft as
hand luggage to ensure it is not damaged or lost.
Before flying, if you are unsure about travelling please contact us for
advice as occasionally patients who use ventilators need to use oxygen
on board the aircraft and a fitness to fly test is essential.
Cleaning your machine and mask
Machine
Disconnect from power supply before cleaning. Do not immerse the
machine in water. Do not use any cleaning agents on the device. Wipe
the machine with a clean, damp cloth and then dry with a soft cloth. Wait
until the machine is completely dry before reconnecting the power supply.
Daily
It is important to wipe the mask every day with a damp cloth or an
antiseptic wipe. Ensure the wipes do not contain alcohol or Lanolin, as
these substances can damage the silicone of the mask. The more you
look after your mask the longer it will last.
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Weekly
Mask - in addition to the daily wipe, the masks will need a good clean
every week. To do this, start in the morning, separate mask from all
attachments and wash it gently in warm, soapy water (mild detergent
e.g. washing up liquid). Rinse with clean, warm water and paper towel
dry before allowing to air dry prior to using it again. Do not dry near a
source of direct heat.
Before you remove the headgear when cleaning, it is a good idea to
mark a line on the headgear straps with a permanent marker, so you
know where to re attach them after cleaning.
Tube - the same procedure can be used to clean the tube. Shake off
all excess water after rinsing and hang the tubing vertically to allow
the water to drain and dry completely.
IMPORTANT: Masks and tubing must be dried fully before use.
Contact details
For enquiries regarding clinic appointments, clinical care and treatment
please contact:
Pulmonary Physiology & Sleep Medicine Department
(9am – 5pm, Monday – Friday)
Tel: 01268 394033
Florence Nightingale Ward
(weekends and bank holidays)
Tel: 01268 394618
Further information
If you have any questions about non-invasive ventilation, please do not
hesitate to ask any of the people (nurse, doctor or physiologist) involved in
your care. They will be happy to help you.
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Not to be photocopied
Useful sources
British Thoracic Society
www.brit-thoracic.org.uk/
British Lung Foundation
www.lunguk.org
Patient UK
www.patient.co.uk
Neuromuscular Disease Foundation
www.ndf-hibm.org
Motor Neurone Disease Association
www.mndassociation.org
Basildon University Hospital
Nethermayne
Basildon
Essex SS16 5NL
01268 524900
Minicom
01268 593190
Patient Advice and
Liaison Service (PALS)
01268 394440
E [email protected]
W www.basildonandthurrock.nhs.uk
The Trust will not tolerate
aggression, intimidation or
violence directed towards its staff.
This is a smokefree Trust.
Smoking is not allowed in any of our
hospital buildings or grounds.
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