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How to Care for Your Nasal Cannula

 

nasal cannulaPhysicians and other medical experts agree that people with chronic (ongoing) lung diseases like COPD should remain as active as possible, despite their need for oxygen therapy.[1] Thanks to advances in medical technology that have made it possible to create oxygen delivery sources with mobility and portability in mind, it’s never been easier to stay connected to an oxygen source like your Inogen One G4, wherever you may be.

Why Choose a Nasal Cannula?

Choosing a nasal cannula as your primary oxygen delivery solution assures you’ll get the right amount of oxygen while maintaining an active, healthy lifestyle. Nasal cannulas are the right choice for you if your condition is stable and your health care provider determines you need low-flow oxygen therapy at low to medium concentrations. Some of the benefits of using a nasal cannula include:[2]

  • Supports comfort.
  • Lowers the risk of carbon dioxide rebreathing.
  • Less intrusive than oxygen masks.
  • Grants you the freedom to eat, drink and speak without restraint.
  • Can be used in a wide number of settings, including hospitals, doctor’s offices, at home and on the go.

Types of Nasal Cannulas

To date, the nasal cannula is the most commonly used medical device providing supplemental oxygen to large numbers of patients in a wide variety of settings. Over the years, it has been adapted to meet the needs of numerous age groups, including infants, adolescents and adults.  To follow is a list of the various types of nasal cannulas on the market:[3]

  • Standard nasal cannula low flow devices that deliver oxygen concentrations of 24-40% at flow rates of 1 to 6 liters per minute (LPM).
  • High flow nasal cannula – high flow oxygen delivery at concentrations of 60-90% and flow rates of 10-40 LPM.[4]
  • Soft cannula (Soft Touch)made with softer, more pliable plastic that minimizes the irritation and discomfort often associated with standard nasal cannulas.
  • Reservoir cannula (Oxymizer and Oximizer Pendant) – stores oxygen in a reservoir during exhalation delivering 100% oxygen with the next breath. Saves 2 to 4 times the amount of oxygen used with continuous flow oxygen.[5]
  • CO2/O2 nasal cannula provides supplemental oxygen to both nostrils while simultaneously obtaining samples of carbon dioxide during regular breathing.

What Is the Maximum Flow Rate for a Nasal Cannula?

That depends on the type of nasal cannula you use. A standard nasal cannula’s maximum flow rate is 6 liters per minute, while a high flow nasal cannula can deliver up to 40 liters per minute. Your doctor will help you choose the flow rate that is ideal for your oxygen needs.

Talk to your doctor, respiratory therapist or oxygen supply company about which nasal cannula suits you best.

Care and Cleaning of the Nasal Cannula

Depending upon your insurance benefits, your oxygen supply company may or may not provide you with a free supply of nasal cannulas when they set up your oxygen concentrator or deliver your monthly supply of oxygen. Nasal cannulas are usually available for purchase at your local pharmacy. Although most are disposable, nasal cannulas should still be kept clean in between replacements. The following guidelines are recommended for care and maintenance:3

  • Clean Your Nasal Cannula Daily – in general, you should clean your nasal cannula daily, in between replacements, with a sanitizing solution to keep it free from bacteria that may cause infection. Another option is to wash in warm, soapy water, rinse in a vinegar solution and allow to air dry. When in doubt, check with your oxygen supply company or the manufacturer to obtain their advice.

Ideally, you should have at least two nasal cannulas available at all times so that you have one to use while washing the other, or have a spare in case your cannula is somehow misplaced. Those using oxygen all day may want to consider keeping more that two on hand.

  • How Often Should You Change Your Oxygen Tubing?
    How often you change your nasal cannula and extension tubing depends upon the manufacturer, as well as how frequently you use your oxygen nasal cannula. Some recommend changing your nasal cannula every 2 weeks, while others say changing it every month works just as well. If you are only using your nasal cannula for a few hours a day, you should be able to use it for the longer period, but with frequent or constant use, replacing your nasal cannula every two weeks is ideal. Extension tubing should also be replaced regularly – usually every 3 months – or according to the manufacturer’s recommendation.

    Do keep in mind that if you have been sick, you should replace both your nasal cannula and your extension tubing right away. Bacteria and viruses can live within the tubing, reinfecting you and causing your illness to last longer. While you are sick, and during the few weeks of recovery following your illness, changing your nasal cannula at least once a week is recommended by experts.

Dealing with Complications

Oxygen therapy, prescribed by a doctor and used according to that doctor’s instructions, is generally a safe and effective gas to administer in the home setting. Although minor complications may occur, most can be managed at home. Check out the following to get a better idea on how to cope with complications, should they arise:3

  • Nosebleeds – occur as the result of the drying effect of oxygen and can usually be managed with saline nasal spray and/or asking your oxygen supply company to set you up with humidified oxygen.
  • Skin irritation – untreated skin irritation may lead to skin breakdown, which is often unsightly and painful. If you begin to notice skin changes while wearing your nasal cannula, it may be that your device isn’t fitted properly. Speak to your oxygen supply company to see if they can send a respiratory therapist to your home to be fitted with another type of nasal cannula. There are also a number of protective accessories that you can purchase to help safeguard the more vulnerable spots on your face and ears.
  • Dry nose and nasal passages – a common complication caused by the drying effect of oxygen. Can be managed with saline nasal spray and/or humidified oxygen.

What Is the Proper Way to Wear a Nasal Cannula?

In order to ensure that you are getting the maximum benefit from your nasal cannula and to reduce potential complications, it is important to make sure you wear it properly. First, ensure that you have the right size nasal cannula for you. If it is the right size for you and you have inserted it properly, your nasal cannula should rest comfortably, but snuggly, inside your nostrils without chafing or discomfort. It should not pinch or fall out, both of which are signs of the incorrect size, nor should it go too far back into the nostril.

Once you have found the correct size for your nasal cannula, place it in your nostrils as far as it will go. The prongs should sit comfortably inside your nostrils. Then, lift the tubes and place them over your ears, just as you would a pair of glasses. Make sure the tubes of your nasal cannula fit snugly over your ears and against your jaw and chin, using the sliding adjuster to modify the fit. It should be snug enough to fit two fingers between the tubes and your chin, but no tighter. If it is not bothering you after a few uses with your oxygen concentrator, you are wearing it correctly.

If the feel of your nasal cannula is still bothering you or you are experiencing friction, here are a few tips to help make wearing it more comfortable:

  • Use fabric medical tape to help with any friction between the tubes and your skin.
  • Use fabric medical tape to tape the tubes in place behind your ears.
  • Try using softer or thinner tubing to relieve the pressure or irritation on your face or ears.
  • Try adjusting the slider so the tubes are tighter and higher on your cheeks, reducing friction from moving around.
  • If you are unable to solve discomfort with the tubes looped over your ears, try turning your nasal cannula so the tubes go from your nostrils down toward the back of your neck with the sliding adjusting resting behind your head at the base of your neck.

Do be aware, however, that you may need to adjust the fit of your nasal cannula from time to time with changes in weather and in your skin. Once you have learned what it feels like to wear the cannula comfortably, you should be able to make adjustments quickly and easily.

A Nasal Cannula Can Help You Get the Oxygen You Need

With a nasal cannula and an oxygen delivery source like The Inogen One, you can regain your independence, enjoy more freedom and continue to enjoy an active, healthy lifestyle. Receive the oxygen therapy you need in a variety of settings, without the intrusiveness of wearing an oxygen mask.

For more information about nasal cannulas and oxygen therapy, contact your primary health care provider and find out whether a nasal cannula is right for your oxygen needs.

 

[1]Cleveland Clinic. COPD: Exercise & Activity Guidelines. Last Reviewed June 8, 2017.

[2] American Thoracic Society. “Oxygen Delivery Methods”. Updated 2015.

[3] David Heitz. “Nasal Cannulas and Face Masks”. Healthline. Medically Reviewed by George Krucik, MD, MBA on January 21, 2014

[4] Jeffrey J Ward, MEd RRT FAARC. “High-Flow Oxygen Administration by Nasal Cannula for Adult and Perinatal Patients.” Respiratory Care. January 1, 2013 vol. 58 no. 1 98-122.

[5] Cheryl Plate Dumont, RN, MSN, CCRN and Brian L. Tiep, MD. “Using a Reservoir Nasal Cannula in Acute Care.” Crit Care Nurse. August 2002 vol. 22 no. 4 41-46.

 

 
 

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