Bipap/Cpap

[%)]

Hello all,

I'm just wondering if Bipap/Cpap are considered vents?

[EricJRN, MSN, RN]

They're modes of respiratory support. Sometimes ventilators are the machines used to deliver BiPAP or CPAP. Can you elaborate on the question?

[CCRNCMC11]

No they aren't. A ventilator patient is only someone who is intimated with an endotracheal tube or who is receiving mechanical ventilation via tracheostomy. While cpap is a setting on the ventilator. Typically cpap and bipap are delivered via facemask. Cpap is a common home machine used for sleep apnea. Bipap is a last line of treatment for resp failure before someone is tubed but is not considered a vent.

[CCRNCMC11]

Intubated* not intimated.

[%)]

Ok, let me see if I'm undertanding this. So, BIPAP/CPAP are considered settings on a ventilator. but someone is not considered on a vent unless they are intubated? By the way, thanks for taking the time to explain this!

[Sun0408, ASN, RN]

Yes that is pretty much correct.. Intubated pts that we are trying to extubate, we will place them on pressure support or CPAP setting within the vent settings, they do most of the work in this mode to see if they are ready for extubation.. Pts can be on CPAP/BiPap without being intubated for resp distress,CO2 issues,or for sleep apnea,etc.. It is a similar machine usually smaller in size, the flow is delivered by face mask or nasal mask. Some wear it for several days to hours while others wear it PRN or qHS.

[TraumaSurfer]

It depends on the level of support. V60s are considered BiPAP machines and ventilators. They can be hooked up to an ETT, trach or face mask. The Vision and most BiPAP or CPAP machines can be also attached to trachs. Many people in home care and long term care are dependent upon BIPAP machines for ventilation and would die without it. This includes ALS, MDS and many other respiratory compromised patients for whatever reasons including neuro and cardiac. The long term ventilations can be through a trach or a mask. Many children are in the home setting with a trach attached to what some would consider just a sleep apnea machine but they do provide enough support to keep the patient's CO2 and O2 within a normal range. Some patients such as those with ALS know their life expectancy is not long and prefer not to be trached. They can still be very "vent" dependent with a BiPAP machine. Even those with a trach are dependent on the ventilator support of a BiPAP machine. CP children and adults are also dependent on BiPAP and CPAP machines to keep their airways open when they are prone to obstruction. Some are also trached and must be on ventilation with a BiPAP machine due to hypoventilation from some form of restrictive disease. Patients with CCHS or Congenital Central Hypoventilation Syndrome (formerly Ondine's Curse) might use a BiPAP machine with or without a trach to maintain life when they sleep.

Depending upon the settings some hospitals will consider a BiPAP machine the same as a ventilator which is why they must be moved to tele, a stepdown or an ICU. Check you hospital's policy to see at what point a BiPAP machine is crossing the line of support or when some patients must come off the BiPAP and onto a ventilator.

[pmath_RRT]

BiPAP is considered "non-invasive ventilation". Therefore it is a ventilator.

[lovingtheunloved, ASN, RN]

CPAP and BiPAP is considered NIPPV, or "non invasive positive pressure ventilation."