High-Flow Nasal Cannula Note

Event Details

Date/Time of Event: [Date and time of event]

Author: [Name and role]

Location: [Unit/Bed]

Event Type: [Initiation / Adjustment / Wean / Discontinuation]

Reason for Note: [Brief reason for this HFNC event]

Clinical Context

• [HFNC indication] (State the clinical indication driving HFNC use now.)
• [Target SpO₂ range per order] (If unknown, state unknown.)
• [Baseline oxygen/ventilatory support immediately prior] (Specify device and settings.)
• [Pertinent risk flags] (Include only if relevant: hypercapnia risk, aspiration risk, hemodynamic instability, DNI status, etc.)

HFNC Settings

Flow: [Flow in L/min] | FiO₂: [FiO₂] | Temp: [Temperature in °C]

Cannula Size: [Size] | Per: [provider order / RT protocol / standing order]

[Interface fit and positioning assessment]

[Skin/mucosa assessment at nares, septum, and pressure points; protective dressings if applied] (If breakdown present, include action in Plan.)

(Never infer settings from defaults; if not directly observed, document as unknown.)

Assessment

Baseline (pre-intervention): [SpO₂, RR, HR, work of breathing descriptors, mental status, subjective dyspnea/tolerance] (If any datum unavailable, document "not measured" with brief reason.)

Response ([Time interval] post): [SpO₂, RR, HR, work of breathing descriptors, mental status, tolerance] (Include brief clinical interpretation of response; note any adverse effects such as epistaxis, nasal discomfort, or agitation.)

Plan

• Titration/Weaning: [Target SpO₂; titration approach; weaning criteria if applicable; planned step-down destination]
• Monitoring: [Reassessment frequency; continuous vs intermittent pulse oximetry; ABG/VBG plan if hypercapnia risk flagged]
• Escalation: [Explicit triggers for escalation; corresponding actions; provider notification status and time if criteria met or settings changed significantly]