The nasal cannula delivers supplemental oxygen through a thin tube resting over the ears and secured under the chin. While effective for respiratory support, the constant pressure and friction from the tubing can cause significant discomfort, irritation, or pressure sores on the delicate skin behind and on top of the ears. This skin breakdown, often called a medical device-related pressure injury, is a common complication for individuals requiring long-term oxygen therapy. Understanding preventative measures and physical solutions is necessary for maintaining comfort and skin integrity while using this equipment.
Protective Cushioning Devices
Physical barriers offer a direct way to reduce the abrasive contact between the hard plastic tubing and the skin surface. Specialized foam ear cushions are commercially available, designed to slide over the tubing where it rests over the ear, providing a soft buffer. These products, sometimes called cannula wraps or ear guards, are typically made of soft foam or fleece material that snugly fits around the oxygen line. The cushioning redistributes the pressure, decreasing the constant force concentrated on a small area of skin.
Some manufactured options use moisture-wicking materials or closed-cell foam, which helps prevent skin maceration by repelling moisture. For a simple, immediate solution, a small piece of soft gauze or a cotton ball can be placed behind the earlobe before the tubing is put in place. Secure these makeshift barriers carefully, ensuring they remain in position without causing new pressure points. Hydrocolloid dressings, which are specialized medical pads, can also be applied directly to the skin behind the ear to serve as a protective layer.
Adjusting Tubing Placement and Tension
Manipulating the tubing’s route and reducing its tightness can significantly relieve direct pressure on the ears. This involves assessing the tension created by the slide adjuster, which should be loose enough to avoid pulling the tubing taut against the head and neck. A common alternative is to run the tubing over the top of the head instead of looping it behind the ears.
This over-the-head routing can be achieved by securing the tubing to a soft elastic headband or a lightweight cap with surgical tape or small clips. The change in position moves the pressure point from the sensitive skin of the outer ear to the scalp. For individuals who wear corrective lenses, specialized devices are available that integrate the oxygen delivery into the frame of the eyeglasses. This innovation completely bypasses the earlobe and the skin behind the ear, eliminating friction and pressure.
Proactive Skin Care and Monitoring
Maintaining the skin’s health and integrity is a proactive step in preventing device-related injuries. A daily, thorough inspection of the skin behind and around the ears is necessary to identify early signs of irritation, such as redness, indention marks, or skin breakdown. Early identification allows for adjustments to be made before a superficial red mark progresses into a painful sore.
The skin in contact with the tubing must be kept clean and dry to reduce the risk of irritation and infection. When applying moisturizers or gels to reduce friction, use only water-based products. Oil-based substances, such as petroleum jelly, must be avoided because they can react with concentrated oxygen and pose a fire hazard. Applying a thin layer of a water-based skin protectant or barrier cream to the area can help reduce friction and keep the skin supple.