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Inotrope's picture
by on Thu, 2019-03-21 22:05

Pharmacy discovered we’d stockpiled 20 cylinders of Heliox21 in a broom cupboard somewhere which seemed a bit excessive ;)
We’re reducing that, but I thought I’d write a guideline for it, as anecdotally its been felt to be useful (there’s a small evidence base for it as a temporising measure in non-hypoxaemic upper airway obstruction (as well as asthma / COPD although I’m not interested in that). We’re a big centre with ENT / H&N / Thoracics etc so expert anaesthetic (and surgical!) skill is never far away, so I’m not worried about it being used in lieu of a tube or hole in the neck.

If any of you have it, could you have a look at the flowmeter and let me know:
- If it’s calibrated for He or Oxygen.
- If it’s a 0-8 or 0-15lpm range.

I’d love a copy of any guideline anyone has (I’ve got the St George’s one via google, which advocates 10-15lpm, which fits with the small evidence base).

Our headache is our He calibrated flow meters are 0-8lpm; we could get BOC cylinders with an integral 0-15lpm flow rate but they are 4x the cost of our AirLiquide cylinders and our flowmeter supplier doesn’t have a He calibrated 15lpm version (although they are available in the US).
We could attach an O2 flowmeter and recommend a 6-8lpm flowrate (which is around 10-15lpm Heliox21), as the correction factor from O2 to He is 1.8. (This is all good quality Primary stuff!)

Although its rarely used, I’d like to create a guideline so it would be used safely on those rare occasions...

[Don’t tell me to get rid... I’m sorely tempted]