Recommendation for high flow nasal cannula oxygen therapy order set for Intubations

Intubation in children is most often carried out as the consequence of accidents while attempting to obtain a tracheoscope. The most typical indications for intubation in children are as follows: inability to eat, and a lack of activity, especially the inability to sleep. In infants, indications for intubations are as follows: cardiorespiratory arrest, lack of feeding, respiratory failure, and a lack of movement.

Intubations are not a cure for [lung cancer](https://www.withpower.com/clinical-trials/lung-cancer). Intubations, often done as a routine in the first week after an operation, do not appear to prevent a cancer relapse. This could be because of a poor response to an operation in lung cancer, rather than an operation being bad by itself. The long term effect of intubations may be a greater effect on cancer relapse and treatment. It may be best to check the patient, and if there is relapse to re-intubate again.

Tracheal intubations are commonly required in many areas for treatment of respiratory arrest or bronchopleural emphysema. Complications are relatively infrequent and usually minor. In most cases, laryngoscopy, cuffed or wire-assisted tracheal intubation, and rapid sequence induction (RSi) procedures are used for the procedure.

[In the United States in 2011, 20,650 people received an intubation in the hospital.[1] The majority (57%) received the procedure during hospitalization (see table, below)]intubations can occur outside of the hospital (i.e., at home or in the field).[2] Most intubations are performed by internists or pulmonologists or both according to a patient's specific circumstances. The vast majority of intubations (95%) are performed without anesthesia, because of non-medically necessary reasons or when the patient has no medical requirement for an intubation (e.g., for an endotracheal tube).

The airway is a critical site for a wide variety of infections. The intubation of patients with upper airway pathology is often complicated by these opportunists. Appropriate infection control practices are essential to ensure the success of such procedures.

The first, and primary, goal of airway management is to clear secretions and permit secure endotracheal and nasopharyngeal tube placement in a patient with a decreased level of consciousness. The most common complications of airway management include tracheomalacia, ventilator mediated pneumonia, and hypoxia. Tracheal tube insertion in children and adults may sometimes be done with greater success. In most cases, however, the first line is still mechanical ventilation for airway management. Many patients on a mechanical ventilator are transferred, for various reasons, to an ICU bed to continue mechanical ventilator support.

Based on our experience patients experienced a variety of side effects related to using a high flow nasal cannula. Many of these side effects are predictable however some of these side effects could lead to a higher level of anxiety. Findings from a recent study suggests the need for more education on the use of high flow nasal cannula oxygen therapy and the need for the development of order sets that will reduce some of these side effects.

There is wide variation in how high flow nasal cannulae oxygen therapy (HFNCO2) is recommended after uncomplicated mechanical ventilation and/or respiratory/bronchoscopic intervention. Recommendations for supplemental oxygen in some patients may result in lower oxygen saturations than currently utilized in other patients.

The last few years have seen an increase in the number of new studies in intubations that have been carried out by various medical specialities. These improvements have been spurred by a focus to use a less invasive intervention to minimize post-intubation complications. At the same time, there has also been an increase in the research in to use less invasive methods of intubating, which have come into being through the use of the videolaryngoscope and also from new models of laryngoscopes that enable an easier and more effective approach to intubation.

Intubation in adults is associated with a wide range of age (24 years to 93 years), gender, and indications. This information should assist with the planning of an intubation plan.

While we are aware of no other high profile trial for oxygen therapy using the FNC, we did not have any other study showing that HFNC is beneficial for people with ARDS.