Respiratory Cloud Clinical Skills Library

Clinical knowledge review

Contraindications

Use these educational prompts with current orders, protocols, patient assessment, facility policy, and supervising-clinician direction.

Skill

Intermittent Positive-Pressure Breathing (IPPB)

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Contraindications Conditions identified as reasons to avoid or defer the procedure pending authorized clinical review. View list Relative contraindications Factors requiring individualized risk-benefit assessment, added precautions, or a modified approach. View list

Contraindications

Review these conditions before proceeding and follow current orders, protocols, facility policy, and supervising-clinician direction.

  • Untreated tension pneumothorax.

Relative contraindications

Use individualized risk-benefit assessment, added precautions, or a modified approach as authorized for the patient and setting.

  • Intracranial pressure greater than 15 mm Hg
  • Hemodynamic instability
  • Recent facial, oral, or skull surgery
  • Tracheoesophageal fistula
  • Recent esophageal surgery
  • Active hemoptysis
  • Nausea or vomiting risk
  • Significant air swallowing
  • Active untreated tuberculosis
  • Radiographic bleb or bullous disease
  • Persistent hiccups.

Sources

Supporting sources include peer-reviewed research, evidence-based clinical practice guidelines, professional standards, and foundational respiratory care references, as applicable to the skill.

  1. Sorenson HM, Shelledy DC. AARC clinical practice guideline. Intermittent positive pressure breathing--2003 revision & update. Respir Care. 2003;48(5):540-546. PMID:12778895.