Welcome to the Recess Room podcast.

Five, four, three, two, one, fire.

Right, so we're back with part two of our Roadside to Recess series on Asthma.

Make sure you've listened to Part 1 before trawling into this, but here it goes,

the second half, including the critical care stuff, the management of an asthmatic cardiac arrest,

discharge advice, and more. So, Simon, one other thing that comes up in the literature

a fair amount is the talk around the use of NIV and asthma, so non-invasive ventilation.

Could you tell us a bit more about that?

This isn't something I've got a phenomenal amount of experience with, but it is something I've definitely seen a few times, certainly discussed and actually applied in patients.

Now, the theory being, obviously, that these asthmatics are getting absolutely

exhausted once they've been wheezing away for a long period of time. Now, they are a high

risk patient cohort to intubate. They've got high airway pressures and then you're going to take

over that and obviously sort of a risk of the fact that they will be really tight to ventilate

and the fact that that will be difficult, but ventilate and the fact that that will be difficult.

But not only that, but that you might blow a pneumothorax as a result.

Just as we do in CAPD, then the thought comes around supporting this respiration with NIV rather than intubating them.

Now, as I say, I've only seen this a couple of times.

But having spoken to other consultant colleagues about it as well, their experience is the same, I've only seen this a couple of times, but having spoken to other consultant

colleagues about it as well, their experience is the same. They've certainly seen it done.

Now, we can't recommend the fact that NIV is going to be an effective stalling mechanism

and that it's actually supported by a really solid evidence base. Again, Cochran review of this

back in 2013 looked at five trials and that only included

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