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Expert Rev Med Devices. 2018 Nov 14:1-7. doi: 10.1080/17434440.2018.1548276. [Epub ahead of print]

High flow nasal cannula in the emergency department: indications, safety  and effectiveness.

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a Paediatric Intensive Care Unit , Royal Brompton Hospital , London , UK.
b Children's Emergency , KK Women's and Children's Hospital , Singapore , Singapore.
c Children's Intensive Care Unit , KK Women's and Children's Hospital , Singapore , Singapore.


Heated humidified high flow nasal cannula therapy (HHHFNCT) is emerging as a popular non-invasive mode of respiratory support in adults and children. In recent years, its use has extended beyond the intensive care unit to other clinical areas. This review aims to explore the mechanism of action, indications, safety, and effectiveness of HHHFNCT use in the Emergency Department (ED). Areas covered: The mechanism of action of HHHFNCT, as well as its use in adult and pediatric ED will be discussed in this review. Expert commentary: While there exists increasing enthusiasm in the use of HHHFNCT in the ED, constant monitoring of the patients and an experienced assessment of their response to treatment are critical and may require additional manpower deployment, which may be challenging, in the busy ED environment. Our experience with the use of HHHFNCT in children is still growing. Continual research in this area remains crucial in helping us better understand the patient types and conditions managed in ED that would most benefit from this device.


Heated humidified high flow nasal cannula therapy; asthma; bronchiolitis; emergency department; pneumonia; positive end expiratory pressure

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