The transparent flexible helmet for NIV (Rüsch 4-Vent, Teleflex Medical Europe, Athlone, Ireland) is fixed with two straps passing through each armpit. The braces are protected by hydrocolloid strips to prevent axillary decubitus. It is important to chose the right size of the helmet to avoid air leakages in the neck region. Two filters in the in- and expiratory way are necessary to reduce noise.