AIRVO 2 High Flow Humidified Circuit

AIRVO 2

Where to find it

  • There are four AIRVO 2 units located between T20 and R1.
  • The single use circuits and water are kept in the storeroom. 

General considerations

  • High flow nasal cannula (HFNC) therapy is increasingly being used a bridging step between low flow supplemental oxygen and non-invasive ventilation or intubation.
  • Patients receiving high flow therapy require a higher level of observation and monitoring from an appropriately skilled staff.
  • The high flow system not only blends and humidifies the gas mixture, but also generates a modest amount of positive end-expiratory pressure (PEEP).
  • There is a risk of serious barotrauma (eg. pneumothorax, pneumocephalus) if used inappropriately. Review the local protocols on Prompt if you are unfamiliar with its use.
  • The AIRVO 2 must complete a self-cleaning operation after every patient use.

How to set it up

  1. Remove the blue caps from the single use water chamber and unclip the coiled water supply tubing from the rim of the chamber.
  2. Fit the adaptor over the two vertical ports on the top of the chamber.
  3. To install the water chamber, push down the blue finger guard at the front of the unit and slide the water chamber onto the silver heating plate. Take care to align the blue ports with the chamber adaptor. An audible ‘click’ will be heard when the chamber has been pushed in far enough.
  4. Connect the water supply by spiking a sterile water bottle. The water should fill below the black line on the chamber. If the water level is above the black line then replace the water chamber with a new one.
  5. Connect the heated breathing tube to the top of the unit by pulling back on the blue sleeve at the end of the tube to expose the connector. 
  6. Fit the appropriate sized nasal cannula to the patient. Be careful to allow a small gap between the tube and the rim of the nostril to prevent gas trapping. 

How to use it

AIRVO2-instructionsStep1
Step 1: Turn on the AIRVO 2
  • Plug in the power cord to both the unit and wall.
  • Press the AIRVO2-buttonPower button.
AIRVO2-instructionsStep2
Step 2: Startup
  • The unit will check it is clean and safe for use with a new patient.
    AIRVO2-screenGreenLight  = clean and ready for new patient
    AIRVO2-screenYellowLight = not ready for new patient
AIRVO2-instructionsStep3
Step 3: Set the humidification

  • The humidification settings are locked by default.
  • To unlock, hold the  and  buttons.
  • The warming target can now be changed using the  or  buttons.
  • Press  to confirm the chosen settings.
AIRVO2-instructionsStep4
Step 4: Set the flow
  • The flow settings are locked by default.
  • To unlock, hold the  and  buttons.
  • The flow target can now be changed using the  or  buttons.
  • Press  to confirm the chosen settings.
AIRVO2-instructionsStep5
STEP 5: ADJUST THE blend
  • The FiO2 is adjusted at the wall oxygen flow meter, similar to when using low flow nasal prongs or Hudson masks.
  • Connect oxygen tubing from the wall oxygen supply to the blue intake port on the side of the unit.
  • Adjust the flow meter at the wall to increase or decrease the amount of oxygen being delivered. The unit will calculate what FiO2 is being delivered and will display the percentage on screen.
  • In other words, the FiO2 is not set using the buttons on the machine, but rather by using the flow meter on the wall. 
AIRVO2-instructionsStep6
STEP 6: Connect to the patient
  • Once the AIRVO 2 has achieved the target settings, it will display a AIRVO2-screenTick icon. 
  • Once this tick icon is shown, the breathing tube can be connected to the nasal prongs

How to unlock the screen

  1. Hold the  and  buttons for 3 seconds.

How to change to paediatric mode

  1. Paediatric mode is a safety feature which limits the settings to a maximum flow of 25L min-1 and a maximum temperature of 34°C.
    It must be activated when using the OPT316 and OPT318 paediatric nasal prongs.
  2. To activate paediatric mode, press and hold the  button for 5 seconds.
  3. The  and  images will appear on the screen indicating that paediatric mode is activated.
  4. To turn off paediatric mode, press and hold the  button for 5 seconds.

How much flow to use

The following are the maximum flow rates for adults and children. Exceeding these limits may result in barotrauma to the patient.

For adults between 30L min-1 and 60L min-1
For children under 10kg 2L kg-1 min-1
For children over 10kg

2L kg-1 min-1 for the first 10kg
PLUS
0.5L kg-1 min-1 for each kg above that

NB. Do not exceed 50L min-1 in a child.

  • For example, a 22kg child = 20L (2 x first 10kg) + 6L (0.5 x 12kg) = 26L min-1.

How to clean it

  • The AIRVO 2 must be both cleaned and disinfected between patients.
  • Cleaning involves wiping the external surfaces with 70% alcohol wipes.
    • Use 70% alcohol wipes to wipe down all surfaces of the unit.
    • It is particularly important to clean inside the outlet on top of the unit as well as the right-hand port above the warming plate.
  • Disinfection is performed by the machine itself when connected to the red thermal disinfection tube.
    • Connect the blue end of the red disinfection tube to the top outlet where the breathing top usually goes. 
    • Connect the other end of the red disinfection tube to the left-hand port above the warming plate. 
    • Cover the right-hand port firmly with the blue cap attached to the red tube. 
    • Press the AIRVO2-buttonPower button. After turning on it will run checks and automatically commence a 55 minute thermal disinfection cycle
    • Once the cycle has completed the unit must be turned off again.

What the evidence says about it

Manuals and documentation

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Page last updated: 18 May 2017
© 2018 Emergency Department, University Hospital Geelong