October 2020 Vol. 15 No. 10

In an effort to keep readers up-to-date on information related to COVID-19, this issue includes two early release articles—one on the use of high-flow nasal cannulas (HFNCs) to treat adults experiencing the virus’s respiratory effects, and the other on N95 respirator reuse and extended use in the face of PPE shortages. Both topics come with some controversy, but unusual times frequently require us to consider options we ordinarily might not.

HFNCs provide warmed, humidified oxygen at higher FiO₂ levels and flow rates than conventional oxygen therapy, potentially reducing the number of patients who require mechanical ventilation. The controversy related to this treatment stems from limited and inconsistent research as well as aerosolized virus particle risks.

N95 respirators are single-use items that are disposed of after each patient encounter, so they should be available in sufficient quantities to avoid reuse. However, that’s not currently the case, so nurses have been forced to use one respirator for an entire shift or for several days. If proper doffing and redonning steps are followed, current evidence indicates that extended use and limited reuse may be safe.

Other articles in this issue look at pain management, pharmacologic treatment for older patients with type 2 diabetes, healthcare’s environmental responsibilities, digital minimalism, and evidence-based practice adherence.