• Low flow conventional oxygen therapy is sufficient for most adult patients with SpO2<92%. Lower thresholds should be used in patients at risk of hypercapnic respiratory failure (SpO2 88–92% – see TSANZ Oxygen guidelines for acute oxygen use in adults​).
• Its use in the treatment and management of patients with COVID-19 can be reviewed in the Australian guidelines for the clinical care of people with COVID-19​​
• HFNPO₂ still remains an appropriate therapy for some people with respiratory failure.
• When starting HFNPO₂, please document a detailed management plan for review, escalation of care and cessation of HFNPO₂ – including end of life planning when appropriate.
• When HFNPO₂ is the only appropriate therapy and a respiratory viral infection is suspected or confirmed, administer in a negative pressure or single room using contact, droplet and airborne precautions. If this is not possible then efforts should be made to move the patient to a negative pressure or single room as soon as possible.
• Any room which has had an aerosol generating procedure in it requires airborne precautions for a minimum of 30 minutes after. The exact time depends on air changes per hour. For more information, see Infection Prevention and Control Novel Coronavirus 2019 (2019-nCoV) – Hospital setting from the Clinical Excellence Commission.
• Local sites should also consider local COVID-19 screening questions and processes in the context of local prevalence data when using HFNPO₂.​

Document information

• Professor Peter Wark
• Dr Matthew Peters
• Dr Paul Hamor
• Nick Yates (NP)
• John Harrington (CNC)
• Helen Kulas (ACI Respiratory Network Manager).