Before starting NIV

This section discusses how to support people prior to starting NIV, including monitoring for signs and symptoms, carrying out and interpreting respiratory function tests and discussing respiratory treatments that might be offered.

All patients with MND should be monitored for signs and symptoms of respiratory dysfunction combined with objective assessments and how these are changing over time. Monitoring respiratory function and discussions about it’s management should start around the time of diagnosis and continue regularly. This enables problems to be identified early and helps give time to prepare patients and their families and avoid delays in starting NIV when it is needed.

All healthcare professionals have a role to support this process. Staff should be alert to patients complaining of symptoms or signs that might be caused by respiratory dysfunction and be able to explain to the patient why they need additional assessments.  

Start by testing your knowledge or explore the following sections to learn more about the different aspects of assessment. Look at the FAQs for a summary of the important points.

Monitoring respiratory function

Signs and symptoms of respiratory insufficiency

Respiratory muscle testing

Blood gas sampling and additional testing

Considerations for testing patients with bulbar impairment

Discussing respiratory support and NIV

When a patient declines NIV

Before starting NIV - FAQs