The continuous use of a nasal cannula, which delivers oxygen through prongs resting in the nostrils, is a common practice in respiratory care. The plastic tubing that loops behind the ears and under the chin can cause significant physical discomfort for many users. Constant friction and pressure at these contact points can irritate the delicate skin, potentially leading to redness, pain, and pressure injuries. Addressing this discomfort is important because pain and irritation can severely reduce a person’s willingness to use the oxygen as prescribed. Ensuring physical comfort is a necessary step toward maintaining long-term compliance with medical treatment.
Using Specialized Protective Sleeves and Padding
Many manufacturers offer specialized cushions or sleeves designed specifically for oxygen tubing, often made from soft, medical-grade foam, silicone, or fleece material. These products wrap around the portion of the cannula tubing that rests over the ears. They work by distributing the mechanical force over a wider surface area, which reduces the point-specific pressure that can restrict blood flow. The soft material also mitigates the shear forces that occur when the tubing moves against the skin.
Proper placement involves positioning the sleeve so it covers the two most vulnerable areas: the superior part of the ear (the helix) and the post-auricular area immediately behind the ear. The skin over the helix is thin and lacks significant underlying padding, making it highly susceptible to shear forces. Ensuring the cushion fully encapsulates the tubing at these bends prevents direct plastic-to-skin contact, which is the primary source of irritation.
Users can also create effective barriers using readily available materials. Small pieces of soft foam or medical-grade cotton padding secured with hypoallergenic paper tape can serve as temporary cushions. Hydrocolloid dressings are particularly beneficial because they provide a thick, self-adherent, gel-like barrier that molds to the skin’s contours. This type of dressing offers robust protection against both friction and moisture accumulation.
When using medical tape to secure a DIY barrier, apply the padding directly to the skin, not the tubing, to act as a true protective layer. This barrier should be checked daily for moisture or displacement to ensure it remains effective. The goal is to provide a soft, non-abrasive surface that prevents the hard plastic tubing from digging into sensitive areas. Utilizing soft silicone cannulas, when available, can also lower the incidence of pressure injuries compared to traditional devices.
Strategies for Tubing Management and Routing
Preventing excessive tension on the cannula tubing is a primary strategy for protecting the ears from pressure injury. When the tubing is cinched too tightly under the chin, it pulls the entire loop down and inward across the sensitive ear tissues. Users should adjust the slider mechanism so the tubing rests loosely and comfortably beneath the jawline, allowing for slack. A loose fit minimizes the downward shearing force exerted on the delicate ear tissue and prevents the tubing from cinching into the skin.
One effective method to eliminate ear pressure is to reroute the tubing over the head using specialized accessories. Soft headbands or tubing retainers are available that secure the cannula to the top of the head using a small clip or Velcro. This technique shifts the weight and tension of the tubing away from the fragile skin of the ears and onto the scalp, which is much more resilient and less prone to pressure injury. This change in routing completely bypasses the ear area, providing immediate relief from chronic pressure.
For users who cannot utilize an over-the-head system, anchoring the tubing to clothing can prevent accidental tugging and shifting. Using a simple clothing clip or a dedicated tubing clip, the line can be secured to the collar of a shirt or pajama top. This anchor point absorbs any sudden tension or movement, such as turning over in bed, stopping the force from pulling directly on the nasal cannula prongs and the ear loops.
Securing the tubing path is particularly important during periods of reduced awareness, such as sleep. A small piece of medical tape can be used to lightly affix the tubing to the cheek or temple, ensuring it maintains its proper routing and intended slack. This prevents the tubing from shifting and creating new pressure points while the user is lying down.
Proactive Skin Care and Inspection
Maintaining skin integrity requires a consistent daily hygiene routine for all areas in contact with the oxygen tubing. The skin behind and around the ears should be gently cleaned with a mild, pH-neutral soap and warm water, then thoroughly patted dry to prevent moisture buildup, which can weaken the skin barrier. Applying a non-petroleum-based moisturizer or a specialized skin barrier cream can increase the skin’s resilience against both friction and dryness. Petroleum-based products must be avoided near oxygen sources as they can pose a fire hazard and may also degrade the plastic tubing material.
Regular skin inspection is the most effective preventative measure against pressure injury progression. Users or caregivers should visually check the skin at least once daily for any signs of redness, tenderness, or warmth, especially in hard-to-see areas behind the ear. A concerning sign is non-blanching erythema, where a red area does not turn white when gently pressed, indicating that underlying tissue damage has begun due to sustained pressure.
If redness persists for more than 30 minutes after removing the tubing, or if the skin shows signs of blistering, cracking, or open sores, a healthcare provider must be contacted immediately. These skin changes indicate that the current protective measures are insufficient and require adjustment by a medical professional. Early intervention is necessary to prevent a minor irritation from developing into a deeper pressure ulcer.