administration of high-flow nasal oxygen is the biggest barrier to wide-
spread implementation of the practice."
Dangerous levels of CO2 are unlikely to accumulate during the time
it takes to intubate a patient, according to Dr. Aziz. "The practice can
prolong intubation times and potentially improve management of
anticipated difficult airways," he says.
Administering humidified high-flow nasal oxygen during intubation,
instead of preoxygenating with a facemask, significantly prolongs the
time it takes a patient to desaturate. "Patients typically begin to desatu-
rate in three minutes with facemask preoxygenation," he says.
"Administering high-flow nasal oxygen can extend that time to 20 min-
utes, which gives providers the flexibility to perform multiple attempts
to intubate the patient or retrieve additional airway equipment if it's
