Vapotherm

RickyRescueRN, BSN, RN · May 14, 2018

Hi there, the biggest problem and obstacle to using High Flow Nasal Cannulae O2 therapies is that in transport your oxygen source and supply is limited and also running flows as high as 50-60lpm often will cause the O2 supply pipes to freeze resulting in the system shutting down. Using LOX (liquid O2) even with NIVPPV (BiPAP) with very high flow rates has become impossible as the supply source has not being designed to run that high continuously.

jeshelby · May 14, 2018

Thank you for your reply. I was under the impression that this was being done on the west coast and used a blend of oxygen and medical air. For our purposes we are looking at ground transports less than 30 minutes in most cases.

PeakRN · May 15, 2018

The flow rates on adults just aren't conducive to transport, you will run tanks dry faster than you can imagine (a D tank can easily run dry in less than half an hour, and that's not even considering the minimum pressure/flow you will need to support the system). On smaller kids it might be feasible, but we still don't do it.

Can the patient tolerate a mask or CPAP/BiPAP during transport? Typically we will either put them on a NRB for very short transports assuming it will support them enough, or place them on BiPAP. If they aren't tolerating the mask well we can certainly give them some meds, we tend to do a small dose of versed/ativan and sub-dissociative dose of ketamine to adults or start precedex on kids.

jeshelby · May 15, 2018

This our current practice, using NRB or bipap. Some of our surrounding facilities, have asked that we look into the possibilities of maintaining this kind of unit.

RonRN18 · Oct 24, 2018

This has been a problem for us. On adults, our choices are generally non-rebreather mask, BiPAP or intubation. On small children/infants with severe respiratory distress due to bronchiolitis, we are trying a Neo-Tee for setting a PEEP and a Neotech RAM cannula as a step to try to try to minimize the need for intubation. It is somewhat of a hokie replacement, but I'm told it helps. We got the equipment in mid-spring and I've not had an opportunity to try it, although while we were talking about what we would do, I ran several calls where I would have tried it had I had the equipment.