Non-invasive ventilation (NIV) has been shown to be beneficial for chronic obstructive pulmonary disease (COPD) patients with persistent respiratory acidosis during acute exacerbations. This clinical study described the experience of implementing an NIV program in the emergency department for COPD patients. Methods: In the pre-implementation phase, patients who presented to the emergency department were transferred to the intensive care unit for NIV. Following the NIV program, patients had NIV commenced in the emergency department. We reported the change in hospital outcomes pre and postimplementation. Results: A total of 153 patients received NIV, 34 in the pre-implementation phase and 119 patients in the post-implementation phase. The mean pH was 7.220.07 and the Acute Physiology and Chronic Health Evaluation (APACHE) II score was 18.94. Hospital mortality was lower in the post-implementation phase (1.7% versus 11.8%; p=0.008). The median door-to-NIV time was shorter in the post-implementation phase (64 minutes; interquartile range [IQR] 35-113) versus (457 minutes; IQR 143-1320). Conclusions: NIV program in the emergency department is feasible and is associated with better hospital outcomes in patients with COPD. (Hong Kong j.emerg.med. 2014;21:140-147) 簡介：無創通氣(NIV)，已被證明對慢性阻塞性肺疾病(COP D)急性發作持續性呼吸性酸中毒 患者是有益的。本臨床研究旨在描述，在急診科為 COPD 患者實施 NIV 方案的經驗。方法：在實施前 的階段，急診病人被轉入深切治療部施行 NIV 。 NIV 方案實施後，在急診室開始為患者施行 NIV 。我 們報告 NIV 方案實施前和後病人在醫院治療結果的變化。結果：共有 153 例患者接受 NIV ， 34 在 NIV 方案實施前， 119 名患者在實施後階段。平均 pH 值為 7.22  0.07 ， APACHE Ⅱ評分為 18.9  4 。實施後 階段住院死亡率明顯較低(1.7% 對 11.8% ， p=0.008)。從到診到 NIV 所需時間中位數在實施後階段 較短(64 分鐘；四分位數範圍 [IQR]35-113)與(457 分鐘； IQR143-1320)。結論：在急診科實施 NIV 方案是可行的，並與 COPD 患者更好的治療結果有關。

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