Abstract

Patients with respiratory distress present to the Emergency Department (ED) primarily due to hypoxia, hypoxemia and hypercapnea. These critically ill patients are commonly managed using non-invasive ventilation therapy (NIV), which is comprised of Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BiPAP). In our organization, patients requiring NIV therapy are admitted to the intensive care unit (ICU) or step-down area because of frequent monitoring. In addition, CPAP and BiPAP are considered ventilators, which require orders from providers who are credentialed with ventilator privileges. In analyzing the cost effectiveness of NIV therapy through retrospective chart review, it was identified that there were total of 94 ED patients placed on NIV, who were admitted to ICU in CY2017. The higher level of care was necessitated because of the need for a provider with ventilator privileges. This led the respiratory therapy (RT) and ED nursing teams to implement the use of high-flow nasal cannula therapy that addresses hypoxemia and hypercapnea as effectively as CPAP and BiPAP, but does not require ventilator-privileged provider orders. The purpose of this study is to examine the effect of implementing high-flow nasal cannula therapy on ICU admission of adult patients presenting in ED with respiratory distress/failure.

Author Details

Maureen Lugod, MSN, RN, CEN; Ruth Karales, BS, RRT; Lisa Keller, RRT

Sigma Membership

Non-member

Lead Author Affiliation

Rush Copley Medical Center, Aurora, Illinois, USA

Type

Poster

Format Type

Text-based Document

Study Design/Type

Descriptive/Correlational

Research Approach

Pilot/Exploratory Study

Keywords:

Emergency Care, Respiratory Therapy, Treating Respiratory Distress

Conference Name

Emergency Nursing 2020

Conference Host

Emergency Nurses Association

Conference Location

Virtual Event

Conference Year

2020

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Poster

Additional Files

Abstract.pdf (82 kB)

Share

COinS
 

Implementing high-flow nasal cannula therapy in the emergency department

Virtual Event

Patients with respiratory distress present to the Emergency Department (ED) primarily due to hypoxia, hypoxemia and hypercapnea. These critically ill patients are commonly managed using non-invasive ventilation therapy (NIV), which is comprised of Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BiPAP). In our organization, patients requiring NIV therapy are admitted to the intensive care unit (ICU) or step-down area because of frequent monitoring. In addition, CPAP and BiPAP are considered ventilators, which require orders from providers who are credentialed with ventilator privileges. In analyzing the cost effectiveness of NIV therapy through retrospective chart review, it was identified that there were total of 94 ED patients placed on NIV, who were admitted to ICU in CY2017. The higher level of care was necessitated because of the need for a provider with ventilator privileges. This led the respiratory therapy (RT) and ED nursing teams to implement the use of high-flow nasal cannula therapy that addresses hypoxemia and hypercapnea as effectively as CPAP and BiPAP, but does not require ventilator-privileged provider orders. The purpose of this study is to examine the effect of implementing high-flow nasal cannula therapy on ICU admission of adult patients presenting in ED with respiratory distress/failure.