Positive End Expiratory Pressure (PEEP) Valve

Question 1

What does PEEP stand for

Answer 1

Positive End Expiratory Pressure

Question 2

What are the indications for a PEEP valve?

Answer 2

• All patients recieving intermittent positive pressure ventilation (IPPV) WITH a cardiac output
• All neonatal patients recieving IPPV

Question 3

What are the contraindications for a PEEP valve?

Answer 3

• Adults and Paediatric patients in cardiac arrest “NO PULSE, NO PEEP”

PEEP is indicated in neonatal cardiac arrest to establish and maintain l

Question 4

What are the precautions for a PEEP valve?

Answer 4

Patients with any of the following should be closely monitored for haemodynamic compromise or tension pneumothorax following the application of PEEP. The relative benefit of PEEP should be considered
* Hypovolaemia/severe hypotension
* Tension pneumothorax (current or post chest decompression)
* Elevated intracranial pressure
* Right ventricular failure

Question 5

What are signs of a tension pneumothorax?

Answer 5

🚨 Key Signs and Symptoms of Tension Pneumothorax:

Respiratory
* Severe dyspnoea (shortness of breath)
* Tachypnoea (rapid breathing)
* Decreased or absent breath sounds on the affected side
* Hyper-resonant percussion note on affected side (if assessed)
* Hypoxia (low SpO₂ despite oxygen)
* Tracheal deviation away from the affected side (late and unreliable sign)

Cardiovascular
* Tachycardia
* Hypotension (due to impaired venous return and reduced cardiac output)
* Distended neck veins (JVD – due to increased intrathoracic pressure)
* Poor perfusion signs:
* Pale, cool, clammy skin
* Delayed capillary refill
* Altered consciousness (due to hypoperfusion)

Chest wall findings
* Chest asymmetry (reduced chest wall movement on affected side)
* Possible subcutaneous emphysema

Question 6

What are the signs of right ventricular failure?

Answer 6

💔 Key Signs and Symptoms of Right Ventricular Failure

Systemic Congestion
* Peripheral oedema (especially ankles and lower limbs)
* Jugular venous distension (JVD)
* Hepatomegaly (enlarged, tender liver)
* Ascites (abdominal swelling from fluid accumulation)
* Weight gain (from fluid retention)

Cardiac and Perfusion
* Tachycardia
* Hypotension (in advanced cases)
* Fatigue (due to reduced cardiac output)
* Palpitations

Respiratory (secondary to congestion)
* Dyspnoea on exertion
* Orthopnoea (if concurrent left-sided failure)
* Clear lung fields (in isolated RV failure – unlike left-sided failure)

Question 7

What equipment do you require for PEEP valve

Answer 7

• BVM
• oxygen source
• PEEP valve
• HME filter

Question 8

What is the procedure of using a PEEP valve?

Answer 8