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Choosing Your Oxygen Delivery Device: Nasal Cannula vs. Portable Oxygen Mask

Lady in Red, Inogen Oxygen Testimonialyoung girl wearing nebulizerIf you or a loved one has just been prescribed oxygen therapy, you probably have a lot of questions. One of the first questions people ask is what they will have to wear during oxygen therapy. Whether you need to use a portable oxygen mask or a nasal cannula for your oxygen delivery, let’s explore why and how you use each one. 

What Is the Difference Between Nasal Cannulas and Portable Oxygen Masks?

Both a nasal cannula and a portable oxygen mask can be used to deliver supplemental medical oxygen to patients. They attach to the oxygen delivery device—typically an oxygen concentrator or oxygen tank—via tubing to improve oxygen intake. A nasal cannula is a flexible tube with two prongs that go inside the patient’s nostrils, while a portable oxygen mask is a plastic, rubber or silicone mask that covers the nose and mouth. There are several different kinds of oxygen masks, depending on what the patient needs.

The most notable difference is that an oxygen mask fits over the patient’s nose and mouth, making it difficult for the patient to talk while receiving oxygen therapy. A nasal cannula, on the other hand, fits directly into the nostrils, allowing the patient to receive oxygen therapy while carrying on a conversation, eating, drinking and more. Nasal cannulas are significantly less obtrusive, so most health care teams opt for a nasal cannula whenever possible.[1] However, for patients who need a constant, predetermined level of oxygen, a portable oxygen mask called a Venturi mask is the most common choice. A Venturi mask is able to provide an accurate concentration of oxygen by mixing high-flow oxygen with room air. A Venturi mask is also able to prevent carbon dioxide retention, which can help avoid hypercapnia and the suppression of the respiratory drive.[2] 

What Is the Advantage of Using an Oxygen Mask vs. a Nasal Cannula?

Nasal cannulas offer the advantage of being significantly less intrusive, allowing patients to eat and speak during oxygen therapy. They are also more comfortable to wear since the cannula itself consists of just one small tube and two prongs inside your nostrils. The tubing can sit over your ears or at the back of the head, so you can adjust the fit in a number of different ways. Some patients can experience nasal dryness, which can generally be resolved with a topical water-based lubricant. A portable oxygen mask, on the other hand, sits over the top of both your nose and mouth with a strap around the back of your head. The mask itself can impede your ability to speak easily, and it is not possible to eat or drink while wearing an oxygen mask. Oxygen masks can also be drying when tightly sealed, and can make coughing difficult as well.[2] Moreover, many patients find oxygen masks extremely uncomfortable. In fact, many people report feeling hot and claustrophobic while wearing masks, including oxygen masks, which can make patients resistant to wearing them.[3] 

However, in some cases, using a portable oxygen mask is necessary, even if it is less convenient. For example, if a patient requires a higher concentration of oxygen or a precise concentration, nasal cannulas may be unable to accommodate the prescription. Additionally, patients who are prone to retaining carbon dioxide (hypercapnia) or who have experienced a suppressed respiratory drive may require a portable oxygen mask called an air-entrainment mask (another name for a Venturi mask) to help ensure they get the correct concentration of oxygen at all times without becoming over-oxygenated.[4][5]  

How Much Oxygen Can You Use with an Oxygen Mask vs. a Nasal Cannula?

Typically, your doctor will be the one to choose whether you use a portable oxygen mask or a nasal cannula, since it is generally dependent on your prescribed flow rates and oxygen concentration requirements. That said, each delivery device can provide a different flow rate, or number of liters per minute. There are low-flow options and high-flow options, which have differing abilities to provide controlled amounts of oxygen to the patient. Below, see how much oxygen you can use with each of the most commonly used oxygen delivery devices for oxygen therapy.[6]

  • Nasal Cannula: Able to deliver approximately 24-35% oxygen, and up to 6 liters per minute to the patient[2]
  • High Flow Nasal Cannula: Able to deliver approximately 21-100% oxygen, and up to 60 liters per minute of warmed, humidified oxygen to the patient[7]
  • Simple Oxygen Face Mask: Able to deliver approximately 21-60% oxygen, and up to 10 liters per minute to the patient[8][9]
  • Venturi Mask: Able to deliver approximately 24-60% oxygen, and up to 15 liters per minute to the patient, depending on which color/type of Venturi mask you use[5]
  • Non-Rebreather Mask: Able to deliver approximately 85-90% oxygen, and up to 15 liters per minute to the patient

When Should You Switch From Nasal Cannula to Oxygen Mask?

Ultimately, only your health care providers can decide whether you need to switch from a nasal cannula to an oxygen mask. However, that decision is likely to be based on how much oxygen you need at any given time. Typically, patients who need higher or more precise concentrations of oxygen are more likely to need to use a portable oxygen mask like a Venturi mask. Your health care team will consider which delivery device will provide you with the correct amount of oxygen for your needs. They will also take into account whether you have had any complications during oxygen therapy, including carbon dioxide retention or suppressed respiratory drive, which can occur if you receive more oxygen than necessary. Finally, patients who struggle to breathe through their noses, or patients requiring oxygen while they sleep who tend to breathe through their mouths, may need to switch to an oxygen mask. Patients who are titrating down from higher oxygen prescriptions may be able to switch from a portable oxygen mask to a nasal cannula. Before making a final decision, your health care team will carefully monitor your oxygen levels, as well as the way your body responds to your oxygen therapy and your oxygen delivery device. They will also talk to you about what you struggle with when it comes to oxygen therapy, because your comfort does play a part in the success of your oxygen therapy. Your health care providers will make any decisions and adjustments to your oxygen delivery device based on information about your overall respiratory health. 

Adjusting to Your Nasal Cannula or Portable Oxygen Mask

The fact is that oxygen therapy, and the required oxygen equipment, does take a little getting used to at first. Whether you are getting accustomed to wearing a nasal cannula or a portable oxygen mask, there will be times you experience frustration as you get used to wearing them comfortably throughout the day and navigating around the tubing. However, the benefits of wearing these oxygen delivery devices and getting the oxygen you need are well worth the adjustment

If you have questions about your oxygen delivery device, or are interested in exploring a different kind of portable oxygen mask or nasal cannula, talk to your doctor today. The right oxygen delivery device is essential for helping to make your oxygen therapy as successful as possible. 

Sources Cited in Blog

[1] Heitz, David. “Nasal Cannulas and Face Masks.” Healthline, Healthline Media, 8 July 2017, www.healthline.com/health/nasal-cannulas-and-face-masks.

[2] “Oxygen Administration: What Is the Best Choice?” RT Magazine, MEDQOR Media, 12 Oct. 2015, www.rtmagazine.com/products-treatment/monitoring-treatment/therapy-devices/oxygen-administration-best-choice/.

[3] Gold, Jessica. “Feeling Anxious About Wearing A Mask? Here Are 5 Ways To Overcome It.” Forbes, Forbes Magazine, 1 July 2020, www.forbes.com/sites/jessicagold/2020/07/01/feeling-anxious-about-wearing-a-mask-here-are-5-ways-to-overcome-it/#65d89b2c4629.

[4] King , Joan E. “How Do I Choose a Supplemental Oxygen Delivery Device? : Nursing2020.” Nursing, LWW Journals, Dec. 2003, journals.lww.com/nursing/Fulltext/2003/12000/How_do_I_choose_a_supplemental_oxygen_delivery.24.aspx.

[5] “Oxygen – Delivery Devices.” Oxford Medical Education, Oxford Medical Education, 18 Apr. 2016, www.oxfordmedicaleducation.com/prescribing/oxygen-delivery/.

[6] Doyle, Glynda Rees, and Jodie Anita McCutcheon. “5.5 Oxygen Therapy Systems.” Clinical Procedures for Safer Patient Care, BCcampus, 23 Nov. 2015, opentextbc.ca/clinicalskills/chapter/5-5-oxygen-therapy-systems/.

[7] Sharma, Sandeep. “High Flow Nasal Cannula.” StatPearls [Internet]., U.S. National Library of Medicine, 25 Feb. 2020, www.ncbi.nlm.nih.gov/books/NBK526071/.

[8] “Simple Oxygen Face Mask in Oxygen Therapy.” General Practice Notebook, General Practice Notebook, 6 July 2020, gpnotebook.com/simplepage.cfm?ID=x20120617143029428699.

[9] “Oxygen Delivery Methods.” Time of Care, 21 May 2019, www.timeofcare.com/oxygen-delivery-methods/.


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