Creating a High Flow Nasal Cannula (HFNC) AirvoTM Protocol in Beaumont Hospital

Title: Creating a High Flow Nasal Cannula (HFNC) AirvoTM Protocol in Beaumont Hospital
Author(s): S. Toland C.D. Campbell
Institution: Beaumont Hospital
Poster: Click to view poster
Category: General Respiratory and Sleep
Abstract: HFNC oxygen therapy (AirvoTM) delivers humidified and heated air at flows up to
60litres/minute and FiO2 from 21% to 100%. Its use in critically unwell patients with
respiratory failure has been increasing rapidly. HFNC reduces the anatomical dead space,
provides a mild positive end-expiratory pressure, maintains consistent FiO2 and
humidification. HFNC has been shown to be efficacious in hypoxic and hypercapnic
respiratory failure, weaning from NIV and reducing the need for reintubation in the ICU.

We conducted an NCHD wide survey assessing their knowledge of HFNC particularly looking at indications/contraindications as well as their overall confidence in initiating HFNC prior to implementing a hospital wide policy.

59 NCHDs from all disciplines completed the survey. 26 (44.07%) had previously commenced a patient on HFNC, 33 (59.03%) had not. 12 ( 20.34%) reported they felt confident in initiating a patient on HFNC ,16 ( 27.12%) reported knowledge of the required settings. 57 (96.6%) of respondents reported they would feel more confident initiating HFNC if there was a policy available.

Based on the results of our study, a hospital wide policy on the use of HFNC was
implemented, including clear indications/contraindications, infection control measures, appropriate settings and a flow diagram outlining monitoring and escalation of care. We will re-audit in three months time.