A nasal cannula is a flexible device that delivers supplemental oxygen through two small prongs inserted into the nostrils. While effective and less restrictive than a mask, the continuous airflow and constant contact of the plastic tubing frequently lead to common complaints like dry nasal passages and skin irritation. Addressing these sources of discomfort with specific strategies can significantly improve the experience of oxygen therapy.
Alleviating Nasal Passage Dryness and Irritation
The oxygen delivered through a nasal cannula is typically a dry gas, which bypasses the nose’s natural humidification function and can quickly dry out the mucous membranes. This dryness often results in irritation, soreness, and minor nosebleeds. A primary strategy for counteracting this effect is to use a humidifier bottle, which connects directly to the oxygen source to infuse the gas with moisture.
For direct relief of the nasal lining, a saline nasal spray can be employed several times a day to rehydrate the tissues. Saline solution closely matches the body’s natural fluid composition, making it gentle for long-term use. This helps to soothe dry membranes and encourages the clearance of secretions.
Applying a water-based lubricant directly to the inside of the nostrils can also reduce friction and keep the skin supple. Select only water-soluble gels or balms, as petroleum-based products must be avoided. Oil-based substances can react with oxygen, creating a potential fire hazard, and may also clog the cannula prongs.
Preventing Skin Irritation from Tubing
The constant pressure and movement of the plastic tubing against the skin, especially behind the ears and on the cheeks, can cause chafing and pressure sores. Specialized foam ear cushions or wraps are an effective solution, as they slide over the tubing to create a barrier between the plastic and the skin. These cushions distribute the pressure more evenly, reducing the friction that leads to skin breakdown.
For the tubing that rests against the cheeks, consider using fabric sleeves or medical-grade silicone pads designed to widen the contact area. These accessories prevent the tubing from digging into the face, which can cause indentations and discomfort, particularly overnight. Regular inspection of the skin in high-pressure areas helps identify irritation before it develops into a serious issue.
Securing the tubing can also minimize movement and friction. Fabric medical tape can be used to gently secure the tubes to the skin behind the ears, preventing the cannula from shifting. Additionally, using a clip to attach the main oxygen line to clothing or bedding manages the tubing’s slack, reducing strain on the face and ears.
Ensuring Proper Cannula Fit and Positioning
Selecting a cannula with the correct size prongs is essential for comfort and effective oxygen delivery. The prongs should fit snugly into the nostrils without fully blocking them, allowing space for air to pass around the prongs. If the prongs rub against the inside of the nostrils, they are likely too large, while a pinching sensation suggests they are the incorrect shape or size.
The fit of the cannula is controlled by the plastic slide, or bolo, which adjusts the tension of the tubing under the chin. This slide should be positioned to keep the prongs securely in place without causing excessive tightness. A common guideline is to adjust the slider so that the tubing is snug, but still allows two fingers to fit comfortably underneath the tubing at the chin.
Ensuring the tubing is positioned correctly over the ears, like a pair of glasses, helps maintain alignment. If the standard over-the-ear method causes discomfort, some cannulas can be rotated so the tubing rests behind the head, with the slide adjusting the fit at the back of the neck. Consulting with a healthcare provider about trying different cannula materials, such as softer silicone or PVC, can also refine the fit and reduce irritation.