High-flow nasal cannula serves as a viable, non-inferior alternative to non-invasive ventilation for managing respiratory distress in patients with COPD, pulmonary edema, and non-immunocompromised ARDS. The RENOVATE trial demonstrates that this modality significantly improves patient tolerance compared to traditional BiPAP masks, which frequently induce claustrophobia. To support clinicians in the emergency department, ACEP has developed an accessible, web-based respiratory distress tool that provides clear guidance on equipment settings, escalation, and troubleshooting. By implementing these evidence-based strategies, emergency physicians can effectively manage hypoxic patients, improve comfort, and optimize resource allocation by reducing unnecessary ICU admissions and invasive intubations. This approach empowers providers in community settings to navigate complex respiratory cases with greater confidence and precision, particularly as seasonal surges increase patient volume and demand for effective, non-invasive airway management options.
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