Evaluation Breathing is assessed through observation of chest wall movement and auscultation Gas exchange is confirmed by auscultation and monitoring of ETCO2 and pulse oximetry MANAGEMENT Spontaneous Ventilation Supplemental oxygen is administered to the spontaneously breathing ill patient If the patient is not breathing spontaneously, positive pressure ventilation (PPV) is required Though the optimal concentration is not known, it is reasonable to provide 100% oxygen during CPR Hyperoxia is a mediator of postresuscitation injury, thus titration of FiO2 to the minimum concentration to achieve saturation of at least 94% is recommended Oxygen Delivery Devices A variety of oxygen delivery devices are available for use in patients who have patent airways The percent oxygen delivered depends on the child’s size and minute ventilation Nasal Cannulas One hundred percent humidified oxygen is delivered to the nares at a flow of to L/min Due to entrainment of room air, the final oxygen delivery is low, usually 30% to 40% High-Flow Nasal Cannulas High-flow nasal cannula (HFNC) delivers humidified and warmed oxygen/gas at flow rates up to 12 L/min in infants and 30 L/min in children HFNC supports respiration though noninvasive continuous positive airway pressure (CPAP), improved airway mechanics, reduction of metabolic expenditure, and improved clearance of secretions It has been used as an alternative to CPAP devices, especially for infants with bronchiolitis The initiation and management of HFNC requires close monitoring by a team skilled in its use Oxygen Masks There are several types of oxygen masks that offer a wide range of inspired oxygen concentrations