A nasal cannula is a medical device that delivers supplemental oxygen through two small prongs resting just inside the nostrils. Although effective, the tubing’s flexibility often leads to dislodgement, interrupting therapy. Maintaining consistent oxygen flow requires reliable methods to keep the cannula securely in place throughout the day and during sleep. This article explores techniques for ensuring proper fit, reliable securing, and managing associated skin discomfort.
Ensuring Correct Fit and Placement
Keeping the cannula in place starts with selecting the correct equipment size, as inappropriate sizing is a leading cause of frequent repositioning. Prongs that are too large may press uncomfortably against the nasal septum, causing irritation or pressure sores. Conversely, prongs that are too small may slip out easily or fail to deliver oxygen efficiently. Patients should confirm the prongs sit comfortably and loosely within the lower nasal opening without extending beyond the nostril entrance.
Proper initial placement ensures the tubing is routed correctly before external securing aids are applied. The tubing should be draped over the ears and cinched gently under the chin using the sliding adjuster ring. This positioning uses the head’s contours to absorb tension, preventing the prongs from being pulled out by the weight of the main oxygen line. Routinely checking the tubing for kinks or stiffness ensures the line remains pliable and does not exert unnecessary pulling force on the face.
Practical Methods for Securing the Cannula
Once the fit is confirmed, physical securing methods provide reliable fixation, especially during sleep or activity. Specialized medical tape, such as hypoallergenic paper or silk tape, is effective for securing the tubing to the face without causing excessive skin traction. A common technique involves placing a section of tubing high on the cheekbone and securing it with a strip of tape, angling it slightly away from the eye area. This placement utilizes a flatter, less mobile area of the face to anchor the cannula prongs and minimizes movement.
Alternatively, securing the tubing behind the neck or near the temples can prevent the backward pull that often causes dislodgement when turning the head. When using tape, first clean the skin with a mild, non-oil-based cleanser or a skin barrier wipe to improve adhesion. Always inspect the skin for redness or irritation before reapplying tape to the same spot to prevent localized skin breakdown or blistering.
Beyond tape, several commercial products are designed specifically for cannula retention, offering convenience and skin protection. Adhesive patches, often made of hydrocolloid or soft foam, are placed on the cheek or neck and feature a tab or loop for the tubing to thread through and lock into place. These patches distribute tension over a larger surface area, minimizing localized pressure and providing a stable anchor point. Many users find these devices helpful for pediatric patients or individuals with sensitive skin.
Managing the excess length of the main oxygen supply line prevents accidental pulling on the nasal prongs, which is a major cause of failure. Tubing clips, similar to ID badge clips, can be used to attach the slack line to clothing, such as a shirt collar or pajama top, preventing the tube from dragging or getting tangled. This simple step ensures that if the main line is tugged, the force is redirected to the clothing clip rather than to the nasal prongs. For nighttime use, coiling the excess tubing loosely under a pillow or securing it to the bed linens with a safety pin can also prevent rolling over and pulling it out.
Managing Skin Irritation and Discomfort
Long-term oxygen use can lead to nasal dryness and irritation, often prompting users to remove the cannula for temporary relief. Utilizing a humidifier bottle attached to the oxygen source is recommended, as it adds moisture to the flow and prevents the drying of nasal mucosal tissues. For localized irritation, only water-based lubricants or gels should be applied sparingly to the inside of the nostrils to soothe the skin. Petroleum-based products must be strictly avoided near concentrated oxygen due to the risk of combustion.
Pressure points behind the ears are a common source of discomfort that leads to tube removal. The constant friction and pressure from the tubing can cause chafing and localized skin breakdown. Foam tubing wraps or soft gauze padding can be slipped over the cannula where it rests behind the ear to cushion the pressure and distribute the force.
For persistent ear irritation, switching to specialized headset-style cannulas is an option. These feature a wider, softer band that loops over the head instead of individual tubes over the ears. These designs distribute the weight and tension across the top of the head, eliminating the pressure point behind the ears. Finding the right balance of security and comfort improves patient compliance and keeps the cannula in place for longer periods.