In which of the following situations would NIV be tried?

a. Patient in whom blood pressure is 65/35, heart rate is 150 beats/min, and respiratory frequency is 34 breaths/min
b. Patient who nearly drowned who has co-pious amounts of white, frothy secretions
c. Patient with chronic obstructive pulmo-nary disease (COPD) and right lower-lobe pneumonia with respiratory acidosis and increased work of breathing (WOB)
d. A 5-year-old child who has aspirated a piece of chicken and is having trouble breathing

ANS: C
In many cases, clinicians prefer using noninvasive positive pressure ventilator support in the form of bilevel positive airway pressure (bilevel PAP) rather than CPAP for patients with Raw-induced auto-PEEP. Bilevel PAP also is the method most often used to treat acute-on-chronic respiratory failure.