Initiation of NIV
Deciding on the mask interface
There are a variety of mask interfaces on the market to suit a range of patient needs.
All patients should be given a minimum of two mask interfaces and an individualised approach should be taken when choosing the mask interface as the most appropriate one will depend on patient choice, need and safety.
Nurse presenting a variety of mask interfaces
It is key that there are a range of mask interfaces available to choose from. These should be available in a range of sizes to allow patients options to choose the one that suits them the best. Certain things to consider include:
Trialling a total face mask for patients who are unable to close their mouth.
Trialling a nasal pillow or mask with a chin strap for patients who have difficulty removing the mask and could be at risk of aspiration, and those who cannot tolerate a total face mask.
Trialling a mouthpiece in the daytime for patients with adequate bulbar function to allow for adjuvant cough augmentation.
Patient wearing an oronasal mask
Patient wearing a nasal mask
If necessary, the patient will need to trial a range of mask interfaces in order to find the most suitable one.
In the following video, Julie talks about her first time trialling NIV and how she did not like it because she found the mask overbearing. This highlights the importance of variety and trialling a range of masks. Because the healthcare professional explained that Julie can trial other masks, Julie was able to find one that suited her preferences and needs and, therefore, continued using NIV.
Good practice points
An individualised approach should be taken when deciding on the mask interface.
A range of mask interfaces in different sizes should be available and trialled to find the one that suits the patient the most.