When a patient first learns that they will require supplemental oxygen to improve their breathing, they are likely to have many questions. Patients often wonder about how to get their oxygen and what steps they will need to complete in order to get the oxygen delivery device they need. If your doctor has recommended supplemental oxygen therapy to you, read on to learn more about where to go from here.
Both a nasal cannula and face 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 face 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. [1]
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 face 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 (elevated carbon dioxide levels) and the suppression of the respiratory drive. [2]
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. [1] 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. [2] A face 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. Some patients find face masks confining and may feel claustrophobic with the mask on, which can make patients resistant to wearing them. [3]
However, in some cases, using a face 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 face 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]
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Typically, your doctor will be the one to choose whether you use an 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.
|
Delivery Device |
Approx. oxygen delivery |
Flow Rate |
Comments |
|
Nasal Cannula[3] |
24-40% |
1-6 LPM |
May be drying to nares above 4L/min. |
|
High Flow Nasal Cannula[5] |
21-100% |
up to 60 LPM |
Can deliver warmed and up to 100% humidified oxygen |
|
Simple face mask (low-flow system) [3] |
40-60% |
6-10 LPM |
|
|
Non re-breather mask[3] |
60-80% |
10-15 LPM |
Efficiency depends on how well mask fits and the patient’s respiratory demands |
|
Venturi Mask[6] |
24-60% |
up to 15 LPM |
Can deliver a more precise level of oxygen but mask must be properly fitting |
Your health care providers will 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. Selection should be based on preventing and treating hypoxemia and preventing complications of hyper-oxygenation. Factors such as how much oxygen is required, the presence of underlying respiratory disease, age, the environment (at home or in the hospital), the presence of an artificial airway, the need for humidity, a tolerance or a compliance problem, or a need for consistent and accurate oxygen must be considered to select the correct oxygen delivery device.[3] 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 healthcare providers will make any decisions and adjustments to your oxygen delivery device based on information about your overall respiratory health.
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 face mask, there will be times you experience frustration as you get used to wearing them comfortably throughout the day and navigating around the tubing. Optimizing outcomes often depends on selecting the correct oxygen administration device. [2]
If you have questions about your oxygen delivery device, or are interested in exploring a different kind of face 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.
Portable oxygen concentrators (POCs) are devices developed in response to demand for a lightweight, portable source of supplemental oxygen.[1] Pulse dose delivery allows concentrators to deliver medical grade oxygen all day, every day while remaining convenient to carry.
If you think you have a health condition that would benefit from oxygen therapy and you are interested in getting oxygen at home, talk to your doctor about whether you meet the criteria for oxygen therapy. Ask about options for supplemental oxygen for home use, about home O2 requirements and anything else you need to know about getting oxygen at home. If you are wondering, “Do you need a prescription for oxygen?” the answer is yes. There are several factors for both you and your doctor to consider before you can obtain a prescription for supplemental oxygen. Medicare, Medicaid and commercial insurance companies may pay for home oxygen. Medicare and other insurance providers have specific requirements for oxygen coverage and payment. Payment for your oxygen supplies is based on each company’s unique criteria for oxygen therapy, which may include diagnosis, laboratory results and other information as summarized below.
For most oxygen therapy patients, learning how to use a nasal cannula as comfortably as possible is an important step in easily incorporating oxygen therapy into their lives. But for many people, figuring out how to wear the oxygen nose piece properly and learning what to do with all the tubing can be confusing. If you are unsure where to put the excess tubing and whether your nasal cannula prongs go up or down, let us walk you through how to wear your nasal cannula comfortably and find the right fit. Read on to learn how to choose the appropriate type of nasal cannula, how to put on a nasal cannula and how to ensure the oxygen nose piece fits properly. After that, you can read some of our tips to help ensure you have the most comfortable nasal cannula possible.
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