Non Invasive Ventilation a Threat for Health Care Workers in COVID-19 Outbreak

Coronavirus disease (COVID-19) is a pandemic disease with unknown process and treatment that has affected the population worldwide. Patients with COVID-19 need respiratory support following acute respiratory failure.1 According to severe acute respiratory failure and its symptoms, performing respiratory support using high flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIV), and finally, intubation and the onset of invasive mechanical ventilation will be indicated.2 The oxygen therapy and respiratory support with proper technique in acute respiratory failure syndrome or acute respiratory distress syndrome with less intensity could have a significant role in treating tissue hypoxia.3 One of the effective measures in respiratory support of COVID-19 patients before tracheal intubation and the onset of invasive mechanical ventilation is “non-invasive mechanical ventilation,” which provides positive airway pressure for respiratory support without invasive intubation. One of the positive consequences of NIV is the appropriate effectiveness in the management of acute respiratory failure, reduction of mortality, and ventilator-dependent pneumonia. However, NIV for COVID-19 patients is one of the major concerns for health care workers (HCWs) due to the increased chance of spreading the virus and subsequent infection.3 Providing optimal conditions for safe care is essential to maintain the health of medical staff in NIV.4 To reduce the risk of HCW the patient should be isolated under NIV and hospitalized in a negative pressure environment. HCWs must have all considerations related to personal protection; wearing a mask N95, shield, isolation gown, and gloves must be observed.