How to start non-invasive ventilation for COPD-associated type 2 respiratory failure

RATIONALE AND KEY POINTS: Exacerbations of chronic obstructive pulmonary disease (COPD) can result in type 2 respiratory failure, which can be effectively and safely treated with non-invasive ventilation (NIV). NIV involves delivering oxygen to the patient via a mask and ventilator, so it does not require the use of an endotracheal tube. NIV is commonly used in the emergency department for patients presenting with type 2 respiratory failure caused by a COPD exacerbation. It is important that emergency department nurses are confident in the steps required to start patients on NIV. • NIV can feel overwhelming for patients, who are often critically unwell, so nurses must explain NIV to patients and provide reassurance. • NIV constitutes level 2 care, so frequent and careful monitoring is vital for ensuring patient safety and optimal outcomes. • It is important to treat patients holistically, including when monitoring the effectiveness of NIV. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How the article can improve your practice when starting patients with COPD-associated type 2 respiratory failure on NIV. • How you could use this information to educate nursing students or colleagues on the appropriate technique and evidence base for starting patients presenting with COPD-associated type 2 respiratory failure on NIV.