High Flow Cannula Case Study

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Utilizing High Flow Nasal Cannula During the First Five Minutes of Cardiac Arrest

Statement of problem
Cardiac arrest is the most serious and urgent medical emergency faced by EMS providers. Due to this fact, paramedics are granted the ability to perform advance life support procedures typically reserved for only physicians. Unfortunately, due to inherent nature of EMS, initial personnel arriving on scene in the first 5 minutes of cardiac arrest after initial patient contact is severely limited. Usually as little as two rescuers before additional personnel arrive.
Cardiac arrest cannot be converted to a perfusing cardiac rhythm without advanced life support (ALS) procedures. These include: IV access, drug administration, and advanced airway
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Instead of an oxygen flow rate of 1-6LPM, flow rates of 25-70LPM are used instead for patients in acute respiratory failure (not breathing). HFNC is currently used in a variety of ways. In patients requiring intubation, traditional oxygen sources must be removed while the physician attempts the procedure. This is sometimes time consuming, allowing the patient’s blood oxygen levels to rapidly fall below the acceptable 93% threshold in less than a minute. When coupled with proper pre-oxygenation procedures, such as mechanical ventilation, before the intubation attempt, applying HFNC, and stopping mechanical ventilations, has been shown to maintain appropriate blood oxygen levels for up to 100 minutes (Nickson, 2016). This is fairly remarkable given no air is being forced into the lungs through traditional breathing or mechanical ventilations. HFNC is also used for patients requiring high concentrations of oxygen when other forms of administration are not ideal. These other forms typically always require the user to wear a mask over their face, as opposed to the unobtrusiveness of a nasal cannula. HFNC has been adapted for long term care with specialized medical devices to heat and humidify the incoming oxygen in order to prevent complications such as nose bleeds and discomfort (Miller, 2013). However, these complications won’t be considered in this study due to the patient criticality and the short timeframe being

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