nCPAP for neonatal respiratory distress at the district hospital is feasible, safe and offers the potential for significant cost savings.

Introduction This case report discusses the successful use of an improvised bubble continuous positive airway pressure (CPAP) apparatus made using items commonly available in a poorly resourced district hospital. Case presentation A 64-year-old female with no co-morbidities presented with respiratory failure due to pulmonary tuberculosis and was not accepted into the regional Intensive Care Unit (ICU) on referral. She required 8 days of improvised bubble CPAP to maintain adequate oxygen saturation before weaning and eventual discharge. Discussion Improvised bubble CPAP is commonly used in neonatal care in developing countries and well described in literature however, there are no reports of its successful use in adult patients. In the absence of access to ICU or other Non-invasive ventilation (NIV) equipment, improvised bubble CPAP may provide some therapeutic benefit.