High Flow Nasal Cannula
High Flow Nasal Cannula with Dr. Jessica Whittle
August 15, 2020
In this episode of EMRA*Cast, Dr. Jessie Werner and Dr. Jessica Whittle discuss high flow nasal cannula. Unsure of the difference among nasal cannula, a venti mask or a non-rebreather? Sick asthmatics? Pedi patients? Pneumonia? Learn when to use this modality to improve patient comfort and help stave off intubation.
Host
Jessie Werner, MD
University of California San Francisco – Fresno
Fellow - Emergency Medicine Education
@JessWernerMD
EMRA*Cast Episodes
Overview:
In this episode of EMRA*Cast, Dr. Jessie Werner and Dr. Jessica Whittle discuss high flow nasal cannula. Unsure of the difference among nasal cannula, a venti mask or a non-rebreather? Sick asthmatics? Pedi patients? Pneumonia? Learn when to use this modality to improve patient comfort and help stave off intubation.
Key Points:
- Regular nasal cannula goes up to 15L/min but patients are really only getting about 6L/min because of outside air mixing in
- The progression of FiO2 goes nasal cannula🡪venti🡪non-rebreather
- High flow nasal cannula goes up to about 40L/min of flow and is humidified so it’s more comfortable for patients
- Evidence points to a mortality benefit using high flow nasal cannula in pneumonia patients
References:
- Jentzer, Jacob, Cameron Dezfulian, and Lillian Emlet. "High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure: the FLORALI study." F1000Research 5.41 (2016): 41.
- Frat, Jean-Pierre, et al. "Preoxygenation with non-invasive ventilation versus high-flow nasal cannula oxygen therapy for intubation of patients with acute hypoxaemic respiratory failure in ICU: the prospective randomised controlled FLORALI-2 study protocol." BMJ open 7.12 (2017): e018611.
- Milési, Christophe, et al. "High flow on the rise—pediatric perspectives on the FLORALI trial." Journal of thoracic disease 7.8 (2015): E230.
Related Content

Feb 04, 2021
A Peculiar Case of Pediatric Subdural Empyema
Subdural empyemas are associated with significant morbidity and mortality if not recognized and treated promptly. The condition leads to purulent fluid collections between the dura and arachnoid mater. In infants, meningitis is the most common cause; in older children, sinusitis and otitis media are typically the primary sources.


Dec 29, 2020
Financial Impacts of ED Observation Units: Literature and Strategies Review
The emergency department observation unit (EDOU) is a specialized unit designed for efficient, ongoing medical treatment, assessment, and reassessment of patients before the decision can be made to discharge or admit. Do they end up costing patients more?