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Table 5 Safety considerations for Noninvasive Respiratory Support (NIRS) in COVID patients

From: Noninvasive respiratory support for COVID-19 patients: when, for whom, and how?

Safety Considerations for Noninvasive Respiratory Support in COVID patients

1) Isolated negative pressure environment (room, hood, tent) [44]

  a) Preferably with anteroom and private bathroom

2) Full contact, droplet, and airborne isolation precautions [44]

3) Full PPE that includes PAPR or N-95, gown, gloves, and face/eye shield [4]

4) Escalation of care to ICU for rapidly increasing O2 requirement or patients on NIV

5) NIV with helmet and tight air cushion or unvented oronasal mask [9]

  a) Dual limb circuit over single limb circuits when utilizing CPAP or NIV

6) For single limb circuit, filter over leak port

7) Viral–bacterial filter between mask and exhalation port [4]

8) Staffing that allows for close monitoring to assess for deterioration

9) Sterile equipment nearby in preparation for emergent intubation in the event of rapid deterioration

10) Daily monitoring of HCW for symptoms[1]