Use of High Flow Nasal Cannula for COVID/PUI

High flow nasal cannula can be used safely under the following conditions:

• Patient in a negative pressure room

o Patients cannot be transported on high flow nasal cannula
• Patient wears surgical mask over high flow device

There is the theoretical concern that high flow nasal cannula will result in aerosolization of
infected droplets. However, with the above precautions in place, risk to clinicians should be low.

The use of high flow nasal cannula in COVID patients is supported by the American Association
of Respiratory Care and the Society of Critical Care Medicine.

No limits are placed on the flow rates to be used for these patients. However, use of rates
>30L/min should prompt consideration of intubation in patients who are not do-not-intubate
(DNI) status.

ICU consultation should be obtained for all non-DNI patients being placed on HFNC.

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reviewed Feb. 2021