O’Driscolls’ otherwise helpful, thoughtful and comprehensive review of emergency oxygen administration makes no mention of High Flow Nasal Oxygen delivery devices . These devices deliver humidified oxygen at between 40 -70 l/min, and the achieved FiO2 (around 0.9) is substantially more than traditional ‘high flow’ methods such as non-rebreathing (‘trauma’) masks, at around 0.7 . They may also provide a small amount of continuous positive airway pressure.
This method of oxygen administration is very well tolerated. In patients with severe hypoxaemia, who are not hypercapnic or exhausted, these devices may avoid the need for mechanical ventilation.
Pamela Dean, Martin Hughes and Prof. John Kinsella.
1. O’Driscoll R. Emergency oxygen use. BMJ 2012;345:e6856
2. Sim MA, Dean P, Kinsella J, Black R, Carter R, Hughes M. Performance of oxygen delivery devices when the breathing pattern of respiratory failure is simulated. Anaesthesia 2008;63(9):938-40.