Int J Clin Pediatr

International Journal of Clinical Pediatrics, ISSN 1927-1255 print, 1927-1263 online, Open Access

Article copyright, the authors; Journal compilation copyright, Int J Clin Pediatr and Elmer Press Inc

Journal website http://www.theijcp.org

Original Article

Volume 3, Number 4, December 2014, pages 99-104

Risks Associated With Conventional Humidifiers Adapted for High-Flow Nasal Cannula Therapy in Human Infants: Results of a Time and Motion Study

Figures

Figure 1. Comparison of primary effort-related categories and device-related outcomes. The tally of device-related staff interventions was compared between the conventional humidifier (FP) and a purpose built HFNC system (VT). The difference in device-associated staff contacts between platforms was significant for total respiratory therapist (RT) contacts as well as total unscheduled contacts (RT and nurse). Note that the total therapist contacts included routine checks/charting. A breakout of these contacts revealed differences in clearing circuit water, and during these contacts circuit condensate was associated with device-related events only in the FP platform. Data are presented as mean ± SD per 8 h of observation. *P < 0.001.

Figure 2. Breakout of device-related clinical events. Rainout aspiration, and in some cases other device related issues were associated with clinical events. In all cases the data for the purpose-built HFNC platform (Vapotherm) were 0 ± 0. The incidences of events with the conventional humidifier (Fisher & Paykel) are shown here. Some of these values reached statistical significance compared to Vapotherm, but all have clinical relevance. Data are presented as mean ± SD per 8 h of observation. *P < 0.001; **P < 0.01; P < 0.05.

Table

**Table 1.** Categories and Data Gathered on the Case Report Forms (CRF)
Effort codes include: (O) adjust patient setting: oxygen; (T) adjust patient setting; temperature; (F) adjust patient setting: flow; (W) clear condensed water; (S) suction the patient’s airway; (R) refit patient interface; (C) change outpatient interface; (B) change water bag; (M) miscellaneous. *Incident codes include: (W) water in the airway; (D) pulse oximeter desaturation; (I) irritation/crying; (R) need for resuscitation; (B) bradycardic event; (A) apneic event; (M) miscellaneous.
Time	Input the time of day for the interaction
Staff	Check box for the staff member category who was involved in the interaction Check either box or both
Effort	Assign any and all codes* for the staff interaction that took place List the codes in the appropriate box for scheduled check or unscheduled check
Workflow	Check any and all boxes for these conditions that effect workflow: Physician consult (required) Breach of patient environment Patient arousal Patient monitor alerted caregiver
Ancillary	Note relevant circumstances Related event: assign any relevant incident codes** Procedure needed: note any test or procedures ordered related to the function of the HFNC device New supplies: record any device related supplies needed (e.g., suction catheter, replacement patient cannula or circuit, etc.)