Management

1. Measure blood gases, monitor haemodynamic variables and respiratory rate.

2. Prepare 'T' piece circuit with a 5cmH2O CPAP valve on the expiratory limb. Connect inspiratory limb to flow generator/large volume reservoir bag. Adjust air-oxygen mix to obtain desired FIO2 (measured by oxygen analyser in circuit). Use a heat-moisture exchanger to humidify the inhaled gas. If not intubated, consider either nasal or face CPAP. Attach mask to face by appropriate harness and attach 'T'piece to mask. Ensure no air leak around mask. If using a nasal mask, encourage the patient to keep their mouth closed.

3. Measure gases, respiratory rate, and haemodynamics after 15-20min.

4. Consider further changes in CPAP (by 2.5cmH2O increments)

5. Consider need for (i) fluid challenge (or vasoactive drugs) if circulatory compromise and (ii) nasogastric tube if gastric atony present.

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