Use of humidified High Flow Nasal Cannula (HFNC) for bronchiolitis during the COVID-19 pandemic​​

Follow local guidelines where available.​

When using HFNC in a patient with suspected or confirmed COVID-19:

  • use contact, droplet and airborne precautions
  • perform in a negative pressure or single room​.​​

​​​When to use ​HFNC

  • Objective criteria for HFNC
    • use only after a failed trial of low-flow oxygen including appropriate positioning and nasal suctioning and
  • Saturation <92%
    • and/or increasing respiratory work with increasing tachycardia, or grunting and signs of fatigue
  • ​​Senior Doctor REVIEW or contact NETS prior to commencing HFNC.


Always start at 2L/ kg/ min​.


Regular review.


Do not use HFNC below 2L/ kg/ min. Change to low flow oxygen.

For more details, access guidelines here: NSW Bronchiolitis CPG​.

​​​Document information

Developed by

NSW Health: Paediatric COVID-19 Respiratory Working Party​ (convened by the ACI on behalf of the Ministry). 


Community of Practice:

Endorsed by

Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning, NSW Ministry of Health.

Reviewed by

Matt O’Meara, Chief Paediatrician.

For use by

NSW Health staff who provide care to infants, children and young people in a clinical setting.​​​​​​​​​​​​​​​​​​

Current as at: Wednesday 12 August 2020
Contact page owner: Health Protection NSW