One thought on “Who should be responsible for the NIV service?

  1. Arti says:

    This person will have responsibility for identifying an area where NIV is to be based, and ensuring that the appropriate equipment is available and maintained. The skills required are easily learnt and the equipment required is relatively inexpensive. If an acute NIV service is not provided, the shortage of ICU beds means that a few patients will die becaus a few studies have only used NIV during the day, but if it’s to be used outside normal working hours, nurses or physiotherapists will probably need to be involved. They must organise training for staff and ensure that audit’s undertaken on a regular basis. ICU staff, doctors, physiotherapists, lung function technicians, clinical scientists and nurses have all been reported to set up and maintain NIV successfully. In the 1997 UK survey setting up was reported to be by nurses in 15%, physiotherapists in 9%, doctors in 33%, and a combination in 41% . This will usually be a respiratory physician, but might also be a consultant nurse specialist or clinical scientist. 94 In the largest multicentre study trained nurses set up NIV in almost all hospitals. Outside the ICU or HDU the on-call medical staff will probably not have the time to set up NIV. There have been no studies comparing the success of any of these groups in setting up. There should be a named consultant who has overall responsibility for the acute NIV service.

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