High Flow Nasal Oxygen (HFNO)

High Flow Nasal Oxygen (HFNO)

With the number of confirmed COVID-19 cases increasing daily the various medical services in our country play an ever-increasing and vital role, this includes Emergency Medical Services (EMS).

Once SARS-COV-2 virus enters the body, it multiplies and will cause COVID-19 disease. The body will respond by mounting an immune response to fight the virus and in fighting COVID-19 you may experience these common symptoms: Shortness of Breath (SOB), Dry Cough and a Fever.

While most people will only experience mild symptoms, such as a cough and a fever, others may experience severe symptoms. COVID-19 disease can result in the development of a condition known as Acute Respiratory Distress Syndrome (ARDS) where the lungs become stiff and difficult to inflate through normal breathing. ARDS results in fluid leaking into the alveoli (air sacs) in your lungs and this prevents oxygen from getting to the body.

People who experience severe symptoms from COVID-19 will require medical treatment and hospitalisation.

Relay EMS provides a pivotal service in responding to and providing patients with emergency medical treatment and transport to medical facilities.

As water builds up in-between the air sacs of the lungs, the lungs become stiff and difficult to inflate. “When arriving on scene there are a few forms of treatment, we can provide to patients with ARDS”, says Relay EMS Operations Manager, Richard Moodie. “Besides oxygen therapy through a face mask, we can perform endotracheal intubation. Endotracheal intubation requires the insertion of an endotracheal tube (ET) through the patient’s mouth into their airway, the patient is then placed on a ventilator to assist their breathing. Intubation is an invasive procedure with the patient requiring sedation and the process of ventilation can result in a prolonged stay in the ICU along with the development of other complications. High flow Nasal Oxygen (HFNO), which is a non-invasive procedure allowing patients to receive various percentages of breathable oxygen delivered at a high flow rate is preferred over intubation for patients, requiring respiratory support.”

Recent studies at Groote Schuur and Tygerberg Hospitals in the Western Cape, show that HFNO is an effective non-invasive treatment option for patients, providing better results and patient recovery compared to intubation in patients with COVID-19 disease.

The AIRVO 2 is a humidifier with an integrated flow generator, the machine uses a combination of room air with oxygen to provide patients with high flow warmed and humidified respiratory gases. The AIRVO 2 provides patients with a high rate of oxygen, up to 60L per minute, increasing oxygenation and allowing patients to breathe a high concentration of oxygen.

With our AIRVO 2, Relay EMS can provide hypoxic patients (low oxygen levels), High Flow Nasal Oxygen (HFNO) whilst transporting the patient to the hospital.

“The AIRVO 2 is generally used within the hospital environment, using the AIRVO 2 within the EMS environment presented us with some unique challenges,” says, Richard. The AIRVO 2 needed to be mounted to use within as well as outside the ambulance and the unit needed to have a continuous supply of power. Solving these took a team approach, with collaboration between Relay EMS, our internal IT team and Neptune Engineering in Port Elizabeth. The solution was the design and manufacturing of specialised brackets enabling us to attach the AIRVO 2 on our Stryker stretchers, our IT team researched and tested uninterrupted power supply for the unit and us then testing the unit within the EMS environment.

We are now able to provide our patients with HFNO, via the AIRVO 2 inside and outside of our ambulances without interrupting the delivery of this lifesaving treatment when transporting patients between facilities or over long distances.

Relay EMS continues to offer the RIGHT people, training, equipment & response with professionalism, clinical excellence, compassion, innovation and integrity.

For all medical and trauma-related emergencies, contact Relay EMS on 0861 061 061.