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Cannula ?


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#1 Tim

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Posted 03 February 2010 - 09:55 AM

Cannula's are designed with a curve in the prongs:

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Should the prongs be placed in the nostril facing up or down?

This came up at P/R yesterday and it was apparent that we all had different opinions
about how they should be worn.

Thanks

Tim

#2 Jane M. Martin

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Posted 03 February 2010 - 10:00 AM

Good morning,

A lot of people wonder about this, Tim. I'm glad you brought it up. I always tell my patients to point them downward. When Sandy gets here, we'll see what she says.

Jane. :P

#3 peg

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Posted 03 February 2010 - 10:26 AM

Good Morning,

Interesting question, Tim. I'm not a therapist, but if I turn the prongs up accidently, it is very uncomfortable and even hurts sometimes.

Every once in awhile I get a cannula that "whistles", or sounds like it is leaking. I wondered if anyone else ever got that...since we are talking about cannulas, anyway.

Jane, and Sandy, isn't it a matter of comfort as long as the oxygen is flowing and improves our stats as it is supposed to do?

Makes me wonder what brought it up at P/R, Tim?


#4 Jane M. Martin

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Posted 03 February 2010 - 10:54 AM

Yes, Peg. When it comes right down to it, as long as the sats stay up, as I tell my patients, "You're doing something right!" It would seem to me that the prongs pointed up would do more to dry out the inside of your nose (not what we want) than send the oxygen to the back of your upper airway, which is what we want it to do.

Jane.
:P

#5 Guest_Eileen/MA_*

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Posted 03 February 2010 - 11:19 AM

The prongs always feel uncomfortable in my nose unless the curve is downward. I never thought about whether it was right or wrong - just if it felt right.

My only problem with the nasal cannula is that my skin breaks out frequently around my nose. Annoying but not a major problem. I clean around my nose often, but it must be the latex. I wonder if instead of throwing them away after a week or two, I washed them. Maybe the tubing wouldn't be so irritating.

#6 Tim

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Posted 03 February 2010 - 12:08 PM

Peg, when I went on oxygen back in 2004, I was in the Hospital for testing.
I'm not sure who it was(staff) but they told me to ware the cannula with the prongs
up. Yesterday at P/R, I was switching cannula's and the R/T noticed how I wore
mine and she told me that I was wearing it wrong. I told her that's how I always
wore it(6 years). There were three other people there and one wore their cannula with
the prongs up and the others wore it with the prongs down. Everybody disagreed
on how it was suppose to be worn.

I change my cannula every couple of weeks. The prongs get hard and sharp from the
constant air flow and start sticking me. They've caused nose bleeds before. I get them
by the case free from the VA so it's not a big deal money wise but could be a problem
if you had to pay for them yourself.

I do have problems with my nose drying out, especially during the winter. A couple
of years ago, my Pulmo told me to use Saline spray three times a day and that helps
but I'm trying to wear the cannula with the prongs down today and so far, I think I
like it better. I was just wondering if there was a right or wrong way to ware it or if
it's just one of those "what works best for you" type of things?

Thanks for the input...

Tim

#7 peg

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Posted 03 February 2010 - 12:16 PM

Tim, In my uneducated opinion, it's whatever works best for you. I, too, use the saline spray to clean out and re-moisten my nasal passages.

Let's just be honest here - those of us who have earned the coveted right to walk around for the rest of our lives (how great is that??) with something stuck up our noses better find a comfortable way of doing it!! :P

Smiles, B)
Peg


#8 Dee

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Posted 03 February 2010 - 01:44 PM

I figured I might as well join in. Here is what I found.


Do the prongs of a nasal cannula face up or down in the nostrils?

Wear a cannula so that it causes a minimum of discomfort. The nasal cannula is a small piece of plastic tubing that is attached to a larger tube which, in turn, connects to the oxygen container. The cannula has two small prongs that are inserted into the nostrils. If the prongs are curved, they should point downward inside the nostrils.

http://wiki.answers.com/Q/Do_the_prongs_of...in_the_nostrils
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#9 Sandy W

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Posted 03 February 2010 - 02:03 PM

Well sorry everyone that I am so late in joining in...Yes as I have always known it and taught it...the prongs do face downward...but as I am reading I guess if the sats are up and the comfort is there with them facing/curving up then go for it. As far as the dryness from the oxygen. Everyone is different and it depends on the liter flow that you are using. Higher liter flow obviously will dry more because the air is going in with that much more force and the humidied air that you are taking along isn't enough the keep you moist. Some folks have more trouble in the winter months when the furnace is on and some are not bothered at all. If this seems to be the case, dryness inside your nose, some bloody secretions coming from your nose when you blow this may mean you need some humidification. Ask your home care representative about this and they can set you up with water that you can use as needed.
Ther is some maintenance involved with this also so if you don't need it you may want to just use your cannula without. You will need distilled water and you will need to make sure that you clean/steralize your bottle at;east once a week.....a vinegar and water solution will do it but it is still time spent and should be done regularly.
I hope tis answers the question about the "curve" and which way is right......If there are any other questions fire away!!!!
Sandy W RRT

#10 Sandy W

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Posted 03 February 2010 - 02:11 PM

View PostEileen/MA, on Feb 3 2010, 11:19 AM, said:

The prongs always feel uncomfortable in my nose unless the curve is downward. I never thought about whether it was right or wrong - just if it felt right.

My only problem with the nasal cannula is that my skin breaks out frequently around my nose. Annoying but not a major problem. I clean around my nose often, but it must be the latex. I wonder if instead of throwing them away after a week or two, I washed them. Maybe the tubing wouldn't be so irritating.

Sandy W RRT

#11 Sandy W

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Posted 03 February 2010 - 02:23 PM

And to address Eileen's concern...are you using any type of petroleum based moisturizer around your nose when it dries out? This can cause a chemical burn with the oxygen and the petroleum coming in contact with each other. Make sure to look at your lables and use water soluble solutions only...i.e. KY is water soluble...bee's wax like Burt's Bees products but just keep in mind if there is any peroleum ingrediant in the solution it can cause irritation....

Sandy
Sandy W RRT

#12 Darrell

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Posted 03 February 2010 - 04:04 PM

I have tried it with the prongs up but it is much more comfortable for me with the prongs down. Maybe it depends on the shape and size of the nose? Actually, Tim, your nose it kinda cute. :P

I have had "whistlers" before and it is usually that the prongs are pressing against the inside of my nostril. I try twisting or rotating the cannula a couple of times and that usually takes care of it. Once they gave me a batch of "small" cannulas, presumably for children, and they made so much noise at 2 lpm that they were unuseable. I should change mine more often but I'm not very vigilent about that. Now that you mention it, I'm just getting over an infection so it's the perfect time to change the cannula.

Darrell

#13 Guest_Eileen/MA_*

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Posted 03 February 2010 - 05:38 PM

I never use anything petroleum based around the cannula. I am a big fan of the saline nasal spray - it works wonders to keep the inside of the nose from caking all up with gunk by keeping it moist.

#14 craigrrt

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Posted 03 February 2010 - 07:08 PM

Wow,

Never would have thought to see so much input on cannula placement. This is a good topic though. About half the patients that are transfered for the ER have the cannulas upside down. My facility also uses plenty of "muleskin" over the ears and close to the nostrils. This keeps the plastic off the skin and helps plenty with irrritation. There is also a foam product that can be used over the tubing to get the plastic off the skin. A humidity bottle with higher flows does seem to help with dryness as well. Like Sandy said, a good room humidifier can help a bunch.

I have also seen plenty of patients place the "slipnot" behind the head instead of over the ears and secured under the chin. They often worder why the back of their head is bothering them.

#15 Darrell

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Posted 03 February 2010 - 10:07 PM

"Muleskin"????





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