Nasal Cannula: What is it? Applications, Benefits, How to Use and Maintenance

It is a device that is used to supply supplemental oxygen or increase air flow to a patient or person who needs respiratory assistance.

This device consists of a lightweight tube that at one end is divided into two tips that are placed in the nostrils and from where a mixture of air and oxygen flows.

The other end of the tube is connected to an oxygen supply such as a portable oxygen generator or a wall connection in a hospital through a flow meter.

The cannula is usually attached to the patient by means of the tube that is hooked around the patient’s ears or by an elastic headband. The oldest and most widely used form of adult nasal cannula carries 1 to 5 liters of oxygen per minute.

Smaller tipped cannulas for infant or neonatal use can carry less than one liter per minute. Flow rates of up to 60 liters of air / oxygen per minute can be delivered through a larger diameter humidified nasal cannula.

The nasal cannula was invented by Wilfred Jones and patented in 1949 by his employer, BOC (a multinational industrial gas company based in Great Britain).

How is the nasal cannula used?

One end of the oxygen cannula, which contains the tips, is placed inside the nostrils, while the other end is usually attached to an oxygen tank or oxygen tubing by an oxygen tubing connector that allows a ‘ Longest belt »on the oxygen cylinder tank or oxygen compressor.

While oxygen therapy can be delivered to a patient through a nasal cannula, in a hospital or clinic; It can also be used at home or while on the go.

However, in hospitals, the oxygen tank or oxygen compressor is often placed next to the patient’s bed and remains stable.

In contrast, the use of nasal cannulas for breathing on the go requires the proper transport of the oxygen tank or oxygen compressor together with the patient.

Care must also be taken to ensure that the oxygen tank has enough oxygen for the patient to breathe easily.

Doctors determine the required oxygen level by taking a blood sample to assess the amount of oxygen present in the blood.

Applications

Supplemental oxygen

A nasal cannula is generally used where small amounts of supplemental oxygen are required, without rigid control of breathing, such as in oxygen therapy.

Most cannulas can only deliver oxygen at low flow rates, up to 5 liters per minute (L / min), resulting in an oxygen concentration of 28 to 44%.

Rates above 5 L / min can cause patient discomfort, dry nasal passages, and possibly nosebleeds (epistaxis).

Also with flow rates greater than 6 L / min, laminar flow becomes turbulent and the oxygen therapy that is administered is as effective as the administration of 5-6 L / min.

The nasal cannula is often used in elderly patients or patients who may benefit from oxygen therapy, but do not need it to breathe. These patients do not need oxygen to the point of wearing a non-rebreather mask.

It is especially useful in those patients where vasoconstriction could negatively affect their condition, such as those who suffer from strokes.

A nasal cannula can also be used by pilots and passengers on small pressure-less airplanes that do not exceed certain altitudes.

The cannula provides additional oxygen to compensate for the lower oxygen content available for breathing at the low pressures of high altitude ambient air, preventing hypoxia. Special aviation cannula systems are manufactured for this purpose.

Since the early 2000s, with the introduction of a nasal cannula that uses heated humidification for humidification of respiratory gases, flows above 6 LPM have been made possible without the associated discomfort, and with the added benefit of improving mucociliary clearance.

High flow nasal therapy

High flows of an air and oxygen mixture can be delivered through a nasal cannula to accurately deliver a high volume of oxygen therapy.

Humidification of respiratory gases allows high flows to be delivered comfortably through the cannula.

High-flow nasal therapy can be used as an effective alternative to mask oxygen and allows the patient to continue talking, eating, and drinking while receiving therapy.

Definition : The non-invasive delivery of the oxygen-air mixture is administered through a nasal cannula at flows that exceed the inspiratory flow demands of the patient with a gas that has been optimally conditioned by heating and humidifying the gas to a 100% relative humidity at body temperature.

High flow nasal cannula in neonates

The High Flow Nasal Cannula (HFNC) is commonly used to support newborns with respiratory distress syndrome (RDS), but reports suggest that there is great variation in the management of clinical practice with this therapy.

When should a nasal cannula be used to deliver oxygen?

Nasal cannulas are used to deliver oxygen when low flow, low or medium concentration is required and the patient is in a stable state.

They deliver oxygen in a variable way; This means that the amount of oxygen inspired depends on the patient’s breathing rate and pattern. For this reason, they are not suitable for use in the acute phase of the disease with patients requiring controlled oxygen therapy.

This includes patients with acute exacerbations of chronic obstructive pulmonary disease (COPD); these patients retain carbon dioxide and require a Venturi oxygen mask.

In other acute situations, patients may require a higher concentration of oxygen and often a non-firming mask or a simple oxygen mask is used.

Flow rates of 1 to 4 liters per minute are used with nasal cannulas, which equates to a concentration of approximately 24 to 40% oxygen. Flow rates of up to 6 liters can be administered, but this will often cause nasal dryness and can be uncomfortable for patients.

Benefits of the nasal cannula

These oxygen cannulas are used to treat patients with a history of respiratory disorders and illnesses.

Nasal cannulas could also be used to deliver oxygen to trauma patients in hospitals.

Severely ill patients, suffering from chronic illnesses or acute medical conditions such as heart failure, also receive the required amount of oxygen through a nasal cannula.

Since most patients with serious conditions cannot breathe properly, oxygen is vital to the effective functioning of our bodily functions.

Nasal cannulas are like little lifesavers that provide a breath of fresh air to the patient, ensuring consistent breathing and better sleep as well.

The lives of certain patients with chronic obstructive pulmonary disease can also be saved by the constant and effective delivery of oxygen through nasal cannulas.

The advantages of nasal cannulas for patients with stable chronic respiratory problems is that it is possible to eat, drink and talk while using them; they also reduce the risk of carbon dioxide being breathed in again.

Dry nasal passages can be a problem initially, but with continued use this usually resolves on its own.

The main advantages of the nasal cannula include its usefulness in patients with fear of the face mask or nasal hood and in claustrophobic patients.

These people are unable to tolerate the face mask or nasal hood comfortably, while the nasal cannula is invariably satisfactory for them.

A second advantage of the cannula is during the treatment of the upper anterior teeth.

With a traditional nasal hood resting on the patient’s upper lip and against their upper anterior teeth, treatment involving the soft tissues of the lips or the teeth themselves can be difficult because the nasal hood compresses the upper lip against the soft tissues and hard in this region.

One way to minimize this possible difficulty is to place cotton rolls under the patient’s upper lip before putting on the nasal hood. The cannula, however, does not interfere with dental treatment in this area.

How to clean a nasal cannula

Patients with chronic obstructive pulmonary disease, or chronic obstructive pulmonary disease, often need supplemental oxygen therapy that is usually delivered through a tube with two split ends that sit under the nose, known as a nasal cannula.

Due to the nature of where the tips of the nasal cannula are located (in the nostrils), they get dirty quite often.

While there is little clinical evidence to support the claim that a dirty nasal cannula can lead to lung infections like pneumonia, the American Lung Association recommends changing your nasal cannula fairly frequently, especially when the tips become dirty or uncomfortable.

However, the term “quite often” is quite subjective, and what one person thinks is “quite often” can be very different from another.

That said, most manufacturers advise that patients change their nasal cannulas once a week for regular daily use or up to a month for sporadic use.

You can prolong the life of your cannula by taking proper care of it and washing it regularly. The greatest danger of not changing or washing the cannula on a regular basis is the build-up of bacteria, which can lead to infection.

Daily maintenance of the cannula

If you have chronic obstructive pulmonary disease and are receiving daily supplemental oxygen therapy, you should follow the instructions provided by your healthcare team for cleaning and maintaining your nasal cannula. There are some basic guidelines that you should know.

To avoid bacteria build-up, you should clean the cannula with an alcohol swab or wipe after each use. If you use oxygen continuously, take a break to disinfect the cannula at least once or twice a day, more if it is congested.

Getting sick can be very dangerous for people with chronic obstructive pulmonary disease, so you need to be vigilant about using alcohol to kill any bacteria.

Cleaning your nasal cannula

Many patients with chronic obstructive pulmonary disease choose to clean the nasal cannula to prolong its use.

To do this, soak the tube in warm water with a small amount of dish soap and white vinegar, which is a good bacteria killer that does not eat the cannula.

After you have washed the cannula well, rinse it well with cold water to make sure all soap and bacteria have been removed. Hang the cannula to dry before using it again.

Changing the cannula

While manufacturers recommend changing your cannula between once a week and once a month, the most important factor in deciding when to change your cannula is your health.

You should change the cannula anytime you have been ill or are going down something, to control bacteria.

Make sure you have extra supplies on hand, so you can change the cannula whenever needed. Make sure to inventory your supplies and order longer before it runs out.

As always, follow your doctor’s instructions on how often to change your nasal cannula and the proper care and maintenance of your equipment.

Oxygen cannulas are recognized as a primary option for delivering oxygen to patients.

The reason for this preference is because they have a less intrusive application method and also leave the patient free to talk and eat without worry.

Oxygen is less functional when the nasal cannula is used as a headband

A recent study shows that the administration of oxygen is significantly less effective for patients who use their nasal cannulas as a headband.

Nasal cannulas are traditionally placed inside the nostrils, possibly causing mild discomfort, but allowing the necessary oxygen to flow freely directly into the body through the nose.

However, patients have found clever new ways to use their nasal cannulas – as headbands, necklaces, or even single-sided earrings.

Given the increasing demand from patients to use nasal cannulas in the most creative and ineffective way possible, nurses Erin Rose and Kerry Ryan decided to conduct their own study to determine the best way for patients to use nasal cannulas.

The study included 10 patients who required oxygen administration to stay alive and each patient required a nasal cannula to receive oxygen.

The study found that in all 10 patients, the most effective way to use the nasal cannula is in the nostrils.

The bandages caused a decrease in oxygen saturation to 80% and less, while other methods caused similar results.

Not all nasal oxygen cannulas are the same

For your patients with chronic obstructive pulmonary disease, where long-term oxygen therapy is required, a nasal cannula is used to deliver the flow of oxygen.

These devices are easy to use and install, but they are not all created equal. The following are some helpful tips for selecting the best nasal cannula for each individual patient in order to achieve the best results.

Know the basics

No matter what type of cannula you choose, the most important thing is that it works. Make sure oxygen flow is not interrupted by selecting a tube without kinks.

Some are reinforced with multiple internal channels (3-channel, 5-channel or 6-channel tubes) to make the whole tube stronger.

Others are known as a “smooth hole,” which means that the interior is smooth.

In some cases, smooth diameter tubes are sufficient if the tube is narrow and the walls are thicker; however, when the tubes are wider, as with a high-flow cannula, multiple channels are recommended for additional support.

The second important factor is the comfort of the patient. To achieve a comfortable fit, the tube must feel soft against the skin and must have no memory. To test this, request samples from your manufacturer and place them on a flat surface.

If the tube lies flat instead of rolling, it is memory free, which will increase patient comfort by fitting securely against their face and reducing friction against the skin.

Buying from a reputable dealer

With Medicare’s cuts in oxygen reimbursement, it can be tempting to buy your cannulas based on price.

However, if your patients are not satisfied with the equipment you provide, you will incur the additional cost of sending them a new cannula or sending a technician to check them.

Even if you do successfully replace faulty equipment, your reputation for providing quality products may suffer, so it is worth the effort of doing some additional initial investigation.

A qualified distributor will have a rigid set of quality control tests that their products must pass before they can be sold to you, so you can be sure that you will receive a reliable product the first time, every time.

Ask your current manufacturer what quality control measures they have in place and if you are not satisfied with the results, look elsewhere.

Make sure it fits

Most cannulas come in three basic sizes: adult, pediatric, or infant, which can work for most patients.

The shape of the nasal tip can also vary from curved to straight and conical to flared. This is based on the patient’s preference and the shape of the nose.

Most patients prefer a curved shape as it matches the natural curvature of the nasal canal.

When placing a cannula with a curved nasal tip in a patient, the curve should be oriented downward. The tips can also be trimmed slightly for comfort.

Check flow as prescribed by the patient’s physician

A standard cannula can effectively deliver between 1 and 6 liters / minute of oxygen.

Where higher rates are required (6–15 liters / minute), a high-flow cannula is a good way to provide adequate saturation without wearing a mask.

High flow cannulas have a larger orifice (wider tube opening compared to standard tubing) to allow effective delivery of oxygen flows up to 15 LPM.

Check the oxygen device

For most oxygen devices, a standard tube is used, sometimes called a “single light.” With regard to the oxygen tube, the description of a single lumen means that there is a tube that carries the oxygen from the concentrator to the patient.

For dual port oxygen conserving devices that only deliver oxygen when the patient inhales, a demand cannula must be used.

A demand cannula has a double lumen split tube with two airways, one that delivers oxygen and one that detects the patient’s breathing pattern to tell the device when to expel air.

Another factor to verify in the device is the maximum length of the tube that the concentrator allows.

Typically, the length of the oxygen tubing is determined by use and patient preference; however, some concentrators have limits on how long the tube can last before the pressure level is affected.

This information can usually be found in the device’s instruction guide.

The last thing to consider when checking the device is the connection port. Most major manufacturers, including SeQual, respironics, Invacare, and covidien nellcor puritan Bennett, use standard connectors.

For non-standard or specialty connections, some manufacturers offer Fits-All connectors that are wider and can be adjusted to fit or separate adapters that allow a standard tube with a special connection to be used.

Replace the cannula regularly to avoid infection

There is a lot of debate about how often a nasal cannula is changed. We recommend that home care companies change their patients’ cannulas once a week to avoid infection and other complications.

Also, the cannula should be changed after the patient has become ill to avoid contact with bacteria and mucus.