Making Adjustments to a High-Flow Nasal Cannula (TMC Practice Question)

Do you know how to make adjustments to a high-flow nasal cannula (HFNC)? Watch this video for a sample TMC Practice Question.

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➡️ A 64-year-old male patient who is recovering from post-abdominal surgery has been on a high-flow nasal cannula at 20 L/min for three days. The patient’s ABG results are as follows:
pH 7.39
PaCO2 43 torr
PaO2 157 torr
SaO2 99%
HCO3 24 mEq/L
BE +2
Which of the following is the best action to take at this time?
A. Decrease the flow
B. Decrease the FiO2
C. Decrease the flow and FiO2 together
D. Switch to a standard nasal cannula

The first thing you need to do is interpret the patient's ABG results. We can see that the acid-base status is normal because the pH, PaCO2, HCO3, and BE are all within their normal ranges. However, the PaO2, on the other hand, is increased. So this tells us that we need to decrease this value and we can do so by decreasing the FiO2 setting.
 
In general, for a high-flow nasal cannula, you need a flow of at least 20-30 L/min in order for it to function properly and deliver the set FiO2 to adult patients. So if you were to decrease the flow below 20 L/min, it’s not going to provide the set FiO2 adequately. And in general, you should usually avoid adjusting two parameters at the same time.

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🚑MEDICAL DISCLAIMER
Medicine and Respiratory Therapy are continuously changing practices. The information in this video is for educational and entertainment purposes only. For medical advice, please consult with a physician or qualified medical professional.

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⏰TIMESTAMPS
0:00 - Intro
0:25 - Practice Question
1:19 - Explanation
2:25 - Correct Answer

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