High and Low Flow Nasal Cannulas (1)

what is a low-flow nasal cannula used for?

to give a relatively low oxygen concentration when only minimal o₂ support is needed

what are low-flow nasal cannulas also called?

nasal prongs

what oxygen device is this?

low-flow nasal cannula

when do we use low-flow nasal cannulas?

only when a minimal amount of oxygen support is required

usual flow range for low-flow nasal cannula

1-6 L/min

list advantages of low-flow nasal cannula

• safe, simple, easily tolerated

• effective for low concentrations

• does not impede eating

• inexpensive

list common disadvantages or risks of low-flow nasal cannula

• dries nasal mucosa

• can dislodge easily

• may irritate skin behind the ears

why might someone with an nasal cannula want humidification?

oxygen is a drying agent (can cause nosebleeds)

do all low-flow cannula patients need humidification?

no, they can choose

• add humidification if appropriate per order (at least 4 L/min)

• a “christmas tree” adapter connects the humidifier

when do people usually start using a humidifier for a low-flow nasal cannula?

when taking at least 4 L/min

what connects the nasal cannula to a humidifier?

christmas tree adaptor

what unit is used on the flow meter?

liters per minute (L/min)

before placing the cannula, what must you confirm?

confirm oxygen is flowing out of the prongs

what patient coaching improves delivery with low-flow cannula?

encourage breathing through the nose with the mouth closed

what oxygenation device is this?

high-flow nasal cannula

what is high-flow nasal cannula?

nasal cannula that delivers oxygen through a wide-bore cannula at 30–60 l/min

• up to 100% humidified, heated oxygen

rate of oxygen deliver for high-flow nasal cannula

30-60L/min

• can give up to 100% humidified O2

a high-flow nasal cannula can give up to ____ humidified O2

100%

why might we use a high-flow nasal cannula?

mild to moderate respiratory failure

who uses high-flow nasal cannulas?

patients with CPOD, people who have high oxygen needs

do all high-flow cannula patients need heat and humidification?

yes, it is built into the setup

advantages of high-flow nasal cannulas

• reduces patient discomfort and upper-airway dryness

• reduces risk of intubation

• improves SpO₂

• re-expands collapsed alveoli

what should be considered before intubation?

high-flow nasal cannula

downside of high-flow nasal cannulas

you need an extra machine to set it up

steps to using nasal cannulas

1. connect it to the oxygen

2. set up with humidification if needed

3. adjust to flow rate ordered by doctor

4. check that the oxygen is flowing out of prong before putting it in patient’s face

how should the prongs and tubing of nasal cannulas sit?

• prongs follow the angle of the nose

• tubing over/behind ears

• use gauze to prevent pressure injuries

what ongoing checks apply to any cannula?

• reassess respiratory rate, effort, lung sounds

• watch for signs of hypoxia: tachypnea, nasal flaring, accessory muscle use, dyspnea

signs of hypoxia

• tachypnea

• nasal flaring

• accessory muscle use

• dyspnea

how often should you do skin and cannula care?

at least every 8 hours (or per agency)

• check nares for any irritation or bleeding

what do we check for during assessments of patients with nasal cannulas?

respiratory rate, effort, and lung sounds

• no bleeding or irritation of nostrils

what should a patient do before putting in a nasal cannula?

blow their nose

what core oxygen safety rules always apply?

• no smoking

• keep electrical devices in good condition

• avoid static-producing synthetics

• avoid oils/flammables around oxygen equipment