patient with (eg, dyspnea, desaturation on pulse oximetry, tachypnea, wheeze, chest pain, palpitations, respiratory distress)

1️⃣For most patients with acute non-hypercapnic, hypoxemic respiratory failure, we typically start with low-flow oxygen devices such as nasal cannulae (1 to 6 L/minute). and targeted spO2>90.
- For patients who are mouth breathers or who cannot receive or tolerate nasal cannulae (eg, patients with nasal packing), we typically use a simple facemask to deliver low-flow oxygen.

2️⃣When oxygen requirements are greater than what can be provided with low-flow oxygen (eg, ≥ 6 L/minute) or breathing is labored, advanced respiratory support is generally needed (HFNC, NIV, or intubation)

☝🏻We prefer an initial trial of HFNC unless there is a separate indication for a different modality (eg, concomitant acute hypercapnia requiring (BPAP) or respiratory distress requiring immediate mechanical ventilation)

✌🏻For those who cannot tolerate or receive HFNC or if HFNC is not available, high flows of oxygen may be delivered through a low-flow system (eg, up to 10 L/minute, sometimes more) using a simple mask (eg, face mask or scoop mask) or a non-rebreather mask