Is high-flow oxygen the best method for treating pediatric patients?

Heated, humidified, high flow nasal cannula oxygenation has a number of benefits that could be useful in a prehospital setting

By Jonathan Lee

Respiratory complaints are a common occurrence in 911 calls involving children. But managing pediatric airways and respiratory distress present several unique challenges, especially relative to adult care. Paramedics tend to have lower levels of exposure to pediatric patients, and often lack confidence in their management. This is often compounded by inadequate access to pediatric versions of equipment, such as supraglottic airways and continuous positive airway pressure (CPAP). Finally, pediatric patients are notoriously sensitive to hypoxia.

Within the last several years, a new option for managing respiratory distress has emerged and is gaining popularity. Heated, humidified, nasal cannula oxygen (HHNC) is becoming an increasingly common form of therapy for respiratory distress in pediatrics.

A working knowledge of high-flow (as it is frequently referred to) is important for prehospital providers for a number of reasons. First, it may be seen in the emergency department as an escalation of care for their patients. Second, it may be applied prior to transfer to a tertiary pediatric center. Finally, as the technology and the research matures, it is possible that it may enter the world of prehospital care.

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