"Specifically, as liters per minute increases, the more difficult it is to keep the mouth closed and relaxed while managing a bolus! I truly enjoyed seeing the video of Rory with the HFNC and her description of how it was impacting her overall oral phase and swallowing process. In addition, I will be doing more Modified Barium Swallow Studies on the patient's who are really involved, requiring high flows and high amounts of FIO2. This course confirmed that I have been evaluating & treating these patients requiring high liters per minute/FIO2 as patient specific in regards to their overall picture to decide whether or not patients are appropriate for clinical assessments/instrumental assessments for safety/appropriateness of PO intake." J.G. (Apr. 2024)

"Beneficial support for instrumental studies on patients requiring HFNC. The course was short, evidence-based, and had relevant clinical applications." M.R. (Apr. 2024)

"Understanding the flow versus Fi02 was beneficial. I liked the examples of research and summarizing all of it at the end with suggestions on clinical practice in evaluating swallowing with patients on high flow 02." E.G. (Apr. 2024)

"I enjoyed the review of HFNC research. Very topical and concise course." B.D. (Mar. 2024)

"The research presented, and the way the O2 delivery devices were explained are helpful for decision-making with actual patients. I liked the practical applications." J.M. (Feb. 2024)

"It was beneficial learning how to calculate approximate FiO2. I enjoyed learning about the various oxygen devices and what each of them is best used for." M.D. (Feb. 2024)

"Discussing that it is important to do a VFSS on pts with HFNC. I liked the SLP actually wearing the HFNC and telling us how it felt." B.G. (Feb. 2024)

"Identifying the various oxygen therapies was beneficial. This content is very applicable to everyday clinical practice." A.H. (Jan. 2024)

"It was helpful just knowing the difference between O2 flow and FiO2! I really liked the subjective description of a healthy person swallowing with an increasing O2 flow rate (when the presenter herself received O2). It gave a much clearer idea of why high flow can impact swallowing." W.K. (Jan. 2024)

"The deep dive into HFNC was beneficial. I liked the video in which Rory walked us through what she felt as the flow rate of the HFNC was increased." R.S. (Jan. 2024)

"The research studies were a great reference. I enjoyed the video demonstration." K.H. (Dec. 2023)

"Discussing the important considerations for evaluating patients using HFNC was beneficial. I liked the ease of watching and completing this course." C.C. (Dec. 2023)

"The explanation of FIO2 was helpful. I enjoyed the video." C.V. (Dec. 2023)

"I liked the specific examples and cases provided." M.S. (Dec. 2023)

"Excellent course for hospital-based practice. I liked the videos." S.C. (Dec. 2023)

"The discussion of various oxygen delivery devices and the patient populations they may commonly be used on was beneficial. I enjoyed the video examples and literature review." E.L. (Dec. 2023)

"The course content was all relevant to my practice, especially the HHFNC discussion." K.C. (Dec. 2023)

"Benefits of high flow and research articles were helpful. I liked the patient examples at the end." C.H. (Nov. 2023)

"Understanding the various types of masks and devices and what they do was beneficial. And swallowing considerations of various devices. I liked the ability to take this course at home." J.S. (Nov. 2023)

"Very user-friendly course. I liked the examples of patients, tables to summarize studies, and differences between Flow and FiO2. I loved the classification of O2 needs and when to evaluate or what to suggest replacement with to RT." R.P. (Nov. 2023)

"I liked the combination of subjective experience on HFNC and review of peer-reviewed findings. The review of research in hospital settings was helpful." D.K. (Nov. 2023)

"Learned the effects of flow, delivery, and FiO2 on swallowing function." E.G. (Nov. 2023)

"Everything was applicable. I appreciated the recognition of the need for patient population research assessments." A.C. (Nov. 2023)

"All material was excellent. Found it very practical, especially for the therapist working in ICU or an extended stay hospital." M.P. (Nov. 2023)

"The video of the presenter using a HFNC and hearing her opinion on the effects on her swallowing was beneficial." J.B. (Nov. 2023)

"Loved the videos! The review of the studies helped me learn general principles to apply when seeing patients." K.W. (Nov. 2023)

"Functional course. The swallow evaluation was beneficial." S.H. (Nov. 2023)

"Great videos of actual patients, and seeing the speaker in the smaller window was great. It was beneficial to discuss HFNC with impact on swallowing, not a barrier necessarily." A.Z. (Nov. 2023)

"This course will assist me with educating my students." C.Q. (Nov. 2023)

"I liked the recommendations for swallow evaluation with high flow nasal cannula." N.L. (Sep. 2023)

"We have periodically had consumers discharged from the hospital back to their residences on oxygen or some individuals who have COPD exacerbation. It has always been a question as to how much (either positively or negatively) this would impact swallow. This course will help with providing me with the necessary background information I was lacking and help to differentiate masks, etc. I liked the video of presenters testing out the high flow nasal cannula." D.C. (Sep. 2023)

"Detailed explanation of LPM vs FiO2 and the amount delivered by the different masks and nasal cannulas." E.C. (Aug. 2023)

"Succinct presentation! The instruction on how to determine candidates for swallow evaluations based on respiratory state/acuity was helpful." S.K. (Aug. 2023)

"Need of instrumental ax with HFNC patients was a beneficial topic. I liked that the presenter took time to explain respiratory parameters." A.C. (Jul. 2023)

"Discussion of HFNC and its effect on swallowing was beneficial. I liked the pictures, video examples, and case studies." D.K. (Jul. 2023)

"I liked that this course went through each type of supplemental oxygen device with pictures. I also particularly liked the chart highlighting the HFNC research. And clinical practice with HFNC and need for instrumental swallow study with specific statistics highlighting the importance of an instrumental." K.L. (Jun. 2023)

"Discussing the different types of devices was beneficial. I liked the example videos." A.G. (May 2023)

"Clear delineation of devices and specific purpose. Great literature support." J.S. (May 2023)

"This course was excellent. I liked the example of the therapist using high-flow nasal cannula and describing what she was feeling as the flow rate was increased. She described what she felt as she swallowed sips of water. Great visual!! This was useful information that will help me as I work in a LTACH. I can use information learned to better educate colleagues and patients/family." S.D. (Apr. 2023)

"Understanding different oxygen therapies and deliveries. I liked the patient case studies and review of evidence." R.P. (Apr. 2023)

"Possible implications of HFNC on swallowing and the need to push for instrumentals in this population. I liked the research review." A.D. (Apr. 2023)

"I liked the discussion of different types of oxygen devices. And that the course was at my own pace and when I had time." J.K. (Apr. 2023)

"The literature review and the impacts of HFNC in patient populations was beneficial. I liked the explicit review of the literature and the quality of the evidence." M.B. (Apr. 2023)

"The information about oxygen settings and the need for instrumental swallowing evaluations was beneficial. I liked the slides and especially the video." J.K. (Apr. 2023)

"Research showing the implications of HFNC on patients and the percentage of patients with dysphagia requiring diet modifications. Relevant to my practice in the ICU. Slow, clearly presented information allowing more time to process. A good amount of information in a short period of time." N.B. (Mar. 2023)

"Well presented, straightforward, and very clinically relevant. It was beneficial to learn the need for instrumentals on hi flow." A.K. (Mar. 2023)

"Course took complex ideas and broke it into pieces. Great details about the most current research and best practices (EBP). Included background knowledge, basic understanding of air intake/management as they impact dysphagia assessments and treatment models." S.V. (Mar. 2023)

"I liked the statistics regarding the percentage of patients on HFNC who ended up with dysphagia diets or findings of silent penetration or aspiration per instrumental swallow evaluation. And comparison of research study results with healthy populations to patient populations." L.M. (Feb. 2023)

"I found this course very helpful to have a better understanding of FIO2 and flow. I liked the presenters." L.M. (Feb. 2023)

"Explanation of the different oxygen devices was beneficial. I liked the explanation of flow vs FI02." R.K. (Feb. 2023)

"Direct application to swallow assessment. Understanding flow rate vs FiO2, timing of assessment, review of literature." R.B. (Jan. 2023)

"The whole course was very applicable to my daily practice. The subject matter was perfect for my needs." K.A. (Jan. 2023)

"This course was convenient. Learning about the clinical implications that increased flow rate has on cognitively impaired individuals who are unable to spontaneously utilize compensatory strategies was beneficial." A.W. (Dec. 2022)

"I liked the supplemental videos of the equipment in use. Currently I work on acute rehab and we see very few patients on FiO2 or HFNC, but, it's relevant for patients who come from acute floors and/or have a history of ARDS, etc. Very useful information to know." R.H. (Dec. 2022)

"I found the information regarding various respiratory support devices helped me to understand severity of respiratory health and when a clinical swallow assessment was/was not appropriate. I liked learning about devices to assist with respiratory support." E.B. (Dec. 2022)

"All of the information was beneficial. Short and direct." R.D. (Dec. 2022)

"The organization of the subject matter was good. Importance of instrumental evaluation for ALL HFNC patients." O.N. (Dec. 2022)

"I liked all of it. Thorough coverage of information with practical application." D.R. (Dec. 2022)

"I found the portion dedicated to decision-making about how and when to proceed with SLP exam to be very beneficial. The video demonstrations were powerful and a very helpful addition to the written and research information." K.C. (Dec. 2022)

"All of it!!!! This should be a required course at the graduate level for those programs trying to focus their programming on Medical Speech Pathology." S.A. (Nov. 2022)

"Good explanation of the different mask types and whether or not they are a barrier to the swallow eval and why. I liked the actual videos and chart summarizing the studies." E.D. (Nov. 2022)

"Knowing the different types from least to most supportive and when to complete a clinical evaluation or not was beneficial information. The course was professional, informative, and sequenced well." V.S. (Nov. 2022)

"I loved the research and the stats. Lots of why and why not. Great rationale." J.C. (Nov. 2022)

"Good review of current studies. Liked the format of discussion with examples." S.Y. (Nov. 2022)

"Clear descriptions of various oxygen support devices and how they affect swallow studies. Learning when SLP's should consult with respiratory therapists and why." M.T. (Nov. 2022)

"It was a good starter course to understand the basics and gave good information regarding clinical decision making for when to evaluate or not." T.M. (Nov. 2022)

"I liked the video examples. And differentiating between the uses of masks and if swallow evaluation can be performed." B.S. (Oct. 2022)

"Thorough and easy to follow." M.W. (Oct. 2022)

"Learning when to evaluate and when not to evaluate was new information for me." D.P. (Oct. 2022)

"The discussion of HVNC and clinical relevance was good." J.R. (Oct. 2022)

"I liked the review of recent studies and review comparison of FIO2 and Flow. Good use of mixed media - slides, videos." M.F. (Oct. 2022)

"I appreciated the breakdown of different oxygen therapies as well as recommendations for whether bedside swallow evaluation is indicated for each one." M.B. (Oct. 2022)

"I liked the explanation of high vs normal flow and various oxygen applications." M.V. (Oct. 2022)

"I have a better understanding of O2 rates and the definition of terms. I liked that I could stop and start course when I needed." S.B. (Sept. 2022)

"The presentation was clear and well-founded. The slides and videos added to my understanding. Helped me with troubleshooting self-feeding/oral intake issues with patients on HFNC." S.S. (Sept. 2022)

"The videos were very informative, the photos of the types of cannulas and masks were helpful. And learning the different types of oxygen deliveries and applications." G.S. (Sept. 2022)

"The case studies, visuals, such as videos and photos, were helpful. The information was clearly presented and explained." E.G. (Aug. 2022)

"Highlighting the need for instrumental swallow evaluation with patients O2 dependent was beneficial." A.S. (Aug. 2022)

"I liked how it really made me realize how important the MBS is in this population given 86% needed modified diets. I also thought it was interesting how there really is no obvious "cut off" for flow rate on HFNC given results of research. It was a nice review of the devices and I liked how they discussed what is a likely comparable option to discuss with mask delivery method. I think it will open good conversations with my RTs." J.F. (Aug. 2022)

"Course was easy to follow. Learning to determine which oxygen treatments need to consult with RT prior to initiating swallow evaluation was good." T.R. (July 2022)

"The course is clear and concise. I liked the explanations of various oxygen therapies." W.W. (June 2022)

"Course was very clear. I understand HFNC better and how it relates to dysphagia." J.G. (June 2022)

"The course was very detailed and informative, I recommend it." Y.C. (June 2022)

"Course was convenient and easy to understand. I liked all the topics discussed." K.S. (May 2022)

"I liked the discussion of clinical decision making regarding swallow evaluation of pts on high flow nasal cannula. Important points were reviewed throughout the course." R.P. (May 2022)

"I liked the overview of the different oxygen devices, and the convenience of being able to pause, stop, and come back to the course." K.H. (May 2022)

"It was informative, but not overwhelmingly long. Understanding flow vs. FiO2 and the impacts that the higher rates may have on swallowing was beneficial." A.D. (Apr. 2022)

"Great detail provided to differentiate types of respiratory support, function, and results." B.S. (Apr. 2022)

"I liked seeing the video of the clinician swallowing water and describing how it felt differently with swallowing when she had high flow nasal cannula." J.S. (Apr. 2022)

"I liked the description of various oxygen delivery options and the research re: PAS and MBSImP as it relates to oxygen delivery and dysphagia." M.H. (Apr. 2022)

"It was beneficial learning about the different types of oxygen and modes they are delivered and how this will affect my swallow evals." J.S. (Apr. 2022)

"I liked reviewing different supplemental O2 delivery systems and the literature on HFNC in acute patients – practical information." M.F. (Mar. 2022)

"Learning even those with a normal swallow were impacted by increased flow, leading us to believe that the swallow of impaired patients would be further exacerbated. Well organized and easy to follow course." R.C. (Mar. 2022)

"I gained more perspective on swallow function w/ patients who require supplemental oxygen. I liked the example videos." B.W. (Mar. 2022)

"I liked the discussion of who is a good candidate for swallow studies based on their oxygen therapy current use or history. I enjoyed the videos shown of the flow on a "healthy" person vs the ones they showed on active patients of theirs." M.V. (Feb. 2022)

"The discussion pointing out FLOW vs FiO2 and what it means for the respiratory status of the pt (work of breathing vs. hypoxia) is beneficial to my daily practice. Loved the hierarchical presentation and discussion of O2 systems. The topics covered including the patient specific determinants and supporting research was so helpful in facilitating critical thinking for managing swallow evals in this population!" G.O. (Feb. 2022)

"Great course all around. Handouts were clear and easy to review." A.A. (Feb. 2022)

"I liked the different types of oxygen delivery and the current research available on HFNC and swallowing evaluations, and learning about the different types of oxygen delivery systems and which present barriers to swallow evals." S.S. (Feb. 2022)

"I liked all the relevant studies and background knowledge. Excellent handouts and videos." C.C. (Feb. 2022)

"I liked the presentation by the speakers and videos of patients with different examples of the cannulas." A.C. (Jan. 2022)

"Enhanced my critical thinking skills for assessment and intervention demands of respiratory compromised patients." D.D. (Jan. 2022)

"Good flow related to content of presentation." K.S. (Jan. 2022)

"I found it beneficial discussing practical recommendations - such as alternate oxygen delivery when someone is placed in a mask. I also thought it was helpful hearing the research initially and at the completion of the session of overall impact on swallow delay, airway protection/closure, etc." K.M. (Dec. 2021)

"This course provided up to date research on swallowing assessments for patients using HFNC that was very functional and helpful to the every day clinician." A.H. (Dec. 2021)

"Very practical information in the era of covid and increased prevalence of HFNC on my caseload."  L.N. (Nov. 2021)

"Thank you for lots of research from actual source articles."  E.K.F. (Nov. 2021)

"I could fit it into my schedule and take several days to complete course. I also found the subject relevant to what I am seeing in practice right now."  S.J. (Nov. 2021)

"I liked the examples of the speakers demonstrating the HFNC. Also liked their examples of patients and their dx and clinical numbers.  The review of respiration and ventilation was beneficial for my daily practice."  L.B. (Nov. 2021)

"Information on when to complete an SLP bedside evaluation with supporting information to provide. Completion of instrumental assessment with all patients on high flow NC no matter what the bedside assessment found. Information about the difference between flow and FIO2. Hierarchy of oxygenation and impacts on SLP evaluation benefit my daily practice.  I liked the video of the impact of high flow on the SLP and her descriptions of what she felt with each increasing flow rate. Review of the literature. Conclusions, although still needing more research, were helpful in confirming and supporting our current practice."  C.W. (Nov. 2021)

"I liked to be able to replay video for an unsure topics for better understanding - can watch videos at anytime and anywhere."  N.R. (Oct. 2021)

"The information was excellent!" E.C. (Oct. 2021)

"Learning the various oxygen therapies was good, and when to conduct a swallowing assessment. I liked going over each specific oxygen therapy, as well as the demonstrations." R.M. (Sept. 2021)

"The presenters provided a clear explanation of all of the devices used to provide respiratory support, how they work and the progression of when these would be used based on severity of respiratory disease. The videos made it more relevant and interesting and explanation of what the high flow is doing and how it is adjusted was very helpful. I also appreciated the case studies describing criteria to look for to determine appropriateness of dysphagia evaluation or treatment." J.B. (Sept. 2021)

1. Define various oxygen therapies.
2. Identify risk for aspiration related to respiratory distress and high oxygen requirements.
3. Summarize literature highlighting high flow oxygen requirements and their effects on swallowing.

This program is offered for 0.1 ASHA CEUs (Intermediate Level; Professional Area).

ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.

ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:

• Current ASHA Member
• ASHA Certificate of Clinical Competence (CCC) Holder
• Licensed by a state or provincial regulatory agency to practice speech-language pathology (SLP) or audiology
• Credentialed by a state regulatory agency to practice SLP or audiology
• Credentialed by a national regulatory agency to practice SLP or audiology
• Engaged in a Clinical Fellowship under the supervision of an individual with their ASHA CCC
• Currently enrolled in a master's or doctoral program in SLP or audiology

If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.

Customer Support: Please phone 888.337.3866 or email info@northernspeech.com.

Course Completion Timeframe:

You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.

However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.

Content Access:

Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the My Online Courses tab, and then viewing your desired course.

Certificate of Completion:

On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on Eastern Time Zone, USA/Canada), and number of contact hours (CEUs / CEEs). Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.

ASHA CE Registry Submission:

During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.

Purchase Orders:

Purchase orders are currently not accepted for online orders, if you wish to submit a purchase order please do so at info@northernspeech.com or fax to 888-696-9655.

What is an Online Course?

Our Online Courses consist of video, audio, and/or text content and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any device, via your NorthernSpeech.com online account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%), a printable certificate of completion is presented to you.

Receiving CEUs:

Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for ASHA CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to CEUs earned online. Please note that courses offered for university students are not applicable for CEUs.

Registering for an online course:

You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.

Accessing your purchased course or returning to a purchased course:

You will be able to access your online course by logging into your Northern Speech account and then clicking the My Online Courses tab on your profile screen. Click the course you would like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.

Testing requirements:

Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.

Number of CEUs offered:

We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.

State licensing boards and online CEUs:

NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.

Course formats:

Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page. Most courses include closed captioning.

Course handouts:

Most of our online courses provide a link to download the accompanying handout as a PDF file. 

Group discounts:

Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.

Computer requirements:

For our online courses to function best, we recommend that you update your computer to include the newest version of your Internet browser (Safari, Chrome, Firefox, Edge, Internet Explorer, etc.) and newest version of your computer's operating system. Also a high-speed Internet connection is recommended (cable or DSL). Speakers or headphones will be required for many of our courses as many contain audio components.

Course Cancellation Policy:

A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded. 

Special Needs:

Please click here for any special needs requests, and we will do our best to accommodate them. 

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