Prehospital Noninvasive Ventilation: An NAEMSP Position Statement and Resource Document

Area of Science:

• Emergency medicine
• Respiratory therapy
• Critical care

Background:

• Noninvasive ventilation (NIV) offers a safe therapeutic option for prehospital respiratory distress.
• Conditions like COPD, asthma, and pulmonary edema frequently present with respiratory failure in prehospital settings.

Purpose of the Study:

• To recommend the use of NIV in prehospital respiratory failure management.
• To emphasize the safety and efficacy of NIV when administered by Emergency Medical Technicians (EMTs).
• To outline essential training and quality improvement measures for prehospital NIV programs.

Main Methods:

• The study is based on recommendations from the National Association of EMS Physicians (NAEMSP).
• It synthesizes evidence regarding the application and safety of NIV in prehospital care.
• It outlines requirements for medical director oversight, including training and quality assurance.

Main Results:

• NIV is a safe and effective intervention for prehospital patients experiencing respiratory failure.
• EMTs can be trained to safely administer NIV, improving patient outcomes.
• Specific training components and ongoing quality assessment are crucial for successful NIV implementation.

Conclusions:

• NIV should be integrated into prehospital care protocols for respiratory failure.
• Comprehensive training and robust quality improvement programs are essential for medical directors overseeing NIV.
• Emerging NIV techniques like high-flow nasal cannula and helmet ventilation warrant further investigation for prehospital use.