Abstract
We retrospectively examined complaints and trouble with the apparatus during NIPPV (noninvasive positive pressure ventilation) in 170 patients. There were 381 incidents of complaints or trouble from 141 of the 170 patients (82.9%) whose medical records were examined. Nursing care resolved the problems in 171 incidents (44.9%) while 193 incidents (50.6%) required intervention by a physician. Nursing care was able to resolve such problems as feelings of oppression and discomfort (77 incidents) resulting from the mask, or oral and nasal injury and dryness (43 incidents). Intervention by a physician was needed for such problems as a decrease in SpO2 (54 incidents), uneasiness (34 incidents), and trouble with the apparatus (17 incidents). The nursing staff contacted the physician immediately in such cases and prepared for endotracheal intubation. Positive pressure ventilation with tracheal intubation was needed in 53 incidents.
Since patients treated with NIPPV are conscious and sensitive to pain, the nursing staff must respond to complaints by the patient more carefully and quickly than to patients treated with invasive ventilatory support. It is crucial for the nursing staff to accurately assess whether the condition of the patient requires endotracheal intubation for resolution.
