HFNC - Respiratory

Question 1

What are the 3 indications for HFNC as per the MDSO?

Answer 1

1. Refractory hypoxemia despite optimized NC +/- NRB therapy for a pt with an intact acceptable resp. drive (<90%)
2. COPD/CHF exacerbation requiring minimal amt. of PEEP
3. Palliative resp. support when no intubation or NIPPV support is in the care plan

Question 2

What are the 3 contraindications and 1 complication for HFNC per the MDSO?

Answer 2

1. Need definitive airway for airway protection +/- resp. support for acute respiratory acidosis
2. Complete nasal airway obstruction
3. Caution in history of facial trauma, acute sinusitis or otitis

Complication: unmeasured PEEP may result in pneumothorax or lung hyperinflation

Question 3

As per the MDSO you can initiate then patch for HFNC at what initial treatment settings?

Answer 3

Initiate at 30 litres/min and titrate flow and FiO2 to acheive SpO2 >94%

Question 4

Prior to transport with HFNC a CCP should perform a 10 minute trial period to determine pt. tolerance when AC power is not available. How is this done, and what is considered a success?

Answer 4

Put a pt on an NRB + NC for 10 min. to simulate lack of AC power between hospital to ambulance and vice versa
A successful trial is confirmed by pt SpO2 >88%