Translational simulation in action: using simulation-based multidisciplinary teaching to introduce ward-level high-flow oxygen care in bronchiolitis

Acute bronchiolitis is the most common respiratory condition under 1 year of age. In the UK and Ireland, approximately one in three infants will develop bronchiolitis in the first year of life and ~2%–3% of all infants require hospitalisation.1 In severe cases, children are admitted to paediatric intensive care (PICU) for ventilation and supportive treatment. An admission to a critical care unit is an extremely stressful time for children and their families. It also has significant implications on workload and resources.

High-flow nasal cannula oxygen (HFNCO) is a treatment where oxygen is delivered at high rates via a tight-fitting nasal mask. This treatment has recently been increasingly used to manage bronchiolitis. Recent evidence has suggested that this may have a role as rescue therapy to reduce the proportion of children requiring high-cost intensive care.2 Prior to this initiative, this treatment option was only available in PICU in our trust.