BiPAP Chalana - Poori Guide (Hindi)

BiPAP Kya Hai?

• IPAP (Inspiratory Positive Airway Pressure) - Saans andar lete waqt pressure
• EPAP (Expiratory Positive Airway Pressure) - Saans bahar lete waqt pressure

Equipment Check (Shuru karne se pehle)

Step-by-Step BiPAP Setup

Step 1 - Machine Setup

• Machine ko flat surface par rakhein, patient ke level ke paas
• Power cord lagaein
• Humidifier mein distilled water bharen (aam paani nahi!)
• Circuit tubing ko humidifier se aur phir mask se connect karein

Step 2 - Mask Selection

• Full Face Mask - Naak aur muh dono cover karta hai (emergency/ICU mein zyada use)
• Nasal Mask - Sirf naak cover karta hai
• Nasal Pillows - Sirf nasal opening mein fit hota hai

Sahi size select karein - na bahut tight, na bahut loose. Leakage minimize honi chahiye.

Step 3 - Initial Settings (Doctor ke orders ke anusaar)

IPAP aur EPAP ka difference kam se kam 4-5 cm H₂O hona chahiye.

Step 4 - Mask Lagana

1. Patient ko explain karein - woh ghabra sakta hai
2. Mask pehle haath mein hold karein, patient ke chehre ke paas laein
3. Harness/straps se secure karein - itna tight ki leakage na ho, lekin chehra dabbe nahi
4. Machine on karein
5. Air flow feel hone par patient ko calm karein aur saath saans lene ko kahen

Step 5 - Monitoring (Lagane ke baad)

• ✅ Respiratory Rate - Kam honi chahiye (normal 12-20/min)
• ✅ SpO₂ - 88-92% (COPD mein), normal patients mein >95%
• ✅ Patient comfort - Patient mask tolerate kar raha ho
• ✅ Chest rise - Proper aur equal
• ✅ Air leakage - Minimize karein

Step 6 - Pressure Titration (Zarurat padne par)

• IPAP 2-3 cm H₂O har 2-3 minute mein badhaein
• Maximum IPAP: 25 cm H₂O

Kab BiPAP Lagayen (Indications)

• Respiratory acidosis (PaCO₂ ≥45 mmHg, pH ≤7.35)
• COPD exacerbation
• Acute pulmonary edema
• Sleep apnea
• Severe dyspnea with accessory muscle use

Kab BiPAP NAHI Lagana Chahiye (Contraindications)

• ⛔ Patient actively vomit kar raha ho (aspiration risk)
• ⛔ Respiratory arrest
• ⛔ Facial trauma
• ⛔ Depressed consciousness (high CO₂ se nahi - woh ठीक hai)
• ⛔ Hemodynamic instability

NIV Failure ke Signs (Intubation consider karein)

• pH improve nahi ho rahi 1-4 ghante mein
• Respiratory rate badh rahi hai
• Consciousness decrease ho rahi hai
• SpO₂ maintain nahi ho rahi
• Patient mask tolerate nahi kar pa raha

Video Tutorials

Yaad Rakhne Wali Important Baatein

1. Patient ko samjhaein - Anxiety common hai, mask lagana uncomfortable lagta hai
2. Leakage check karein - Zyada leakage se therapy fail hoti hai
3. Humidifier - Hamesha use karein, warna airway dry ho jata hai
4. Monitoring - Sirf lagakar mat chhodo, regular assessment karein
5. Doctor ke orders - Settings hamesha prescribed values ke hisaab se set karein

Note: Yeh guide clinical knowledge ke liye hai. Actual patient par BiPAP sirf trained healthcare professional (doctor, nurse, respiratory therapist) ki supervision mein lagaein. Settings hamesha treating physician ke order ke mutabiq honi chahiye.