Last Monday I had a fairly major attack at work; unusally for me I failed to respond particularly quickly to IV amino etc, and got progressively more exhausted throughout the day, until eventually I was put on non-invasive ventilation (BiPAP). I've seen it done to others many times and have always thought that I would never tolerate it, but I was really surprised at how much it helped. I honestly believe it saved me from a tube on this occasion, but as well as that it made the whole experience easier to tolerate, eased the horrible chest wall aching and helped me move a lot more air with each breath. I did find the tight mask claustrophobic and had to take it off for a few minutes every half hour or so, then put it back when started to tire and sats took a dip!
I know that for me it's not the answer to always avoiding intubation, as usually when I get tubed I'm too unwell on arrival (eg unconscious or stopped breathing) for them not to tube me, but I can think of 2 or 3 occasions in the past when it might have saved me from a tube. Since I loathe intubation (as I guess everyone does!) I'm very interested in the possibility of having NIV added to my protocol for the more slow onset, progressing to exhaustion, type attacks I seem to be getting these days.
I just wondered what experiences others had had with NIV as an alternative to intubation, and how hospitals tend to handle it. I know a lot of hospitals don't have much experience using NIV for asthma as opposed to COPD, and I'm a little worried that if it was on my protocol I might just get stuck on it on the ward without someone around who could intubate if necessary.
Any thoughts, ideas, stories welcomed!