A nasal cannula is a simple, flexible device designed to deliver supplemental oxygen into the nostrils, often necessary for individuals with respiratory conditions like COPD. Proper placement is important to ensure the oxygen therapy is effective and comfortable. Correct positioning allows the prescribed flow of oxygen to reach the respiratory system efficiently without causing irritation. This successful delivery helps maintain appropriate blood oxygen levels and supports the overall therapeutic goal.
Pre-Installation Setup and Safety Checks
Before placing the cannula, preparatory steps and safety checks ensure a smooth and safe process. First, gather all necessary supplies: the nasal cannula, the oxygen source (like a concentrator or tank), and the flow meter. Select the correct size cannula (adult, pediatric, or infant), as an incorrect fit reduces efficacy or causes discomfort.
Perform hand hygiene to prevent the introduction of germs near the nasal passages. Securely attach the cannula’s connector to the oxygen source’s regulator or flow meter to ensure an airtight seal. Gently untangle the tubing and check for any kinks or blockages that could impede oxygen flow.
Verify the flow meter setting against the prescribed rate from a healthcare provider, as this controls the amount of oxygen delivered. Turn on the oxygen source and perform a quick check by placing the prongs against the hand or listening for a gentle hiss to confirm gas flow. This readiness check ensures the system is operational before the cannula is inserted.
Step-by-Step Insertion Technique
Physical placement begins with identifying the correct orientation of the prongs. Most modern cannulas feature slightly curved prongs, which should face downward to align with the natural shape of the nasal passages. This orientation directs the oxygen toward the back of the throat and ensures effective delivery.
Gently insert the prongs into the nostrils, ensuring they sit comfortably and snugly without causing pain or fully obstructing the opening. A small tab on some models should rest on the upper lip, guiding proper placement. Avoid forcing the prongs too deeply, as this causes discomfort and is unnecessary for effective oxygen delivery.
Once seated, guide the tubing over the ears, similar to wearing eyeglasses. The tubing should rest gently behind the ears, bringing the two lines down the cheeks and under the chin. This method anchors the cannula and prevents it from being easily dislodged.
Move the slide adjuster, often called a bolo, up the tubing until it is snug beneath the chin. The tubing must be secure enough to hold the prongs in place but loose enough to allow two fingers to fit comfortably underneath. This adjustment ensures a stable fit that resists movement without causing excessive pressure.
Confirming Proper Fit and Oxygen Flow
After placement, immediately verify the cannula’s fit and function to ensure correct therapy delivery. Visually check the prongs inside the nostrils, ensuring they are seated correctly and not pulling at the nasal tissue. The tubing must be free of kinks and should not obstruct the patient’s movement, especially when turning the head.
Oxygen flow can be confirmed by placing a finger or the back of the hand near the prongs to feel the gentle flow of air. If the flow is difficult to sense, briefly place the prongs into a small cup of water; a steady stream of bubbles confirms gas delivery. This check verifies that oxygen is actively moving through the system.
Assess the patient’s comfort level by checking for pressure points, particularly around the ears and under the chin. A fit that is too tight can restrict circulation or cause skin irritation. Loosen the adjustable slide slightly if any blanching or discomfort is noted around the ears or under the chin.
Ongoing Care and Troubleshooting Common Issues
Maintaining the nasal cannula is important for hygiene and continued effectiveness. The cannula should be replaced regularly, generally every two to four weeks, or immediately if it becomes soiled, stiff, or discolored. Daily cleaning of the prongs and the section of tubing resting on the face is advised, using a damp cloth with mild soap and water to wipe away residue.
Skin irritation or dryness is a common issue, often caused by the constant pressure of the tubing or the drying effect of the oxygen. Use water-based lubricants or saline nasal sprays to moisturize the nostrils and prevent cracking or bleeding. Avoid oil-based products, as they can be harmful if inhaled into the lungs.
For irritation behind the ears or under the chin, cushioning materials like soft pads or gauze can be placed beneath the tubing to relieve pressure points. If troubleshooting unexpected changes in oxygen delivery, check for kinks in the tubing or ensure secure connections to the oxygen source. If issues persist after checking the equipment, contact a healthcare provider to verify the flow setting or equipment function.