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    Nasal cannula

    Nasal cannula

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    For the general medical term , see Cannula.

    Nasal cannula

    Photograph of a patient wearing a nasal cannula

    ICD-10-PCS A4615 ICD-9 93.90 93.99 MeSH D012121 OPS-301 code 8-71 [edit on Wikidata]

    The nasal cannula (NC) is a device used to deliver supplemental oxygen or increased airflow to a patient or person in need of respiratory help. This device consists of a lightweight tube which on one end splits into two prongs which are placed in the nostrils and from which a mixture of air and oxygen flows. The other end of the tube is connected to an oxygen supply such as a portable oxygen generator, or a wall connection in a hospital via a flowmeter. The cannula is generally attached to the patient by way of the tube hooking around the patient's ears or by an elastic headband. The earliest, and most widely used form of adult nasal cannula carries 1–3 litres of oxygen per minute.

    Cannulae with smaller prongs intended for infant or neonatal use can carry less than one litre per minute. Flow rates of up to 60 litres of air/oxygen per minute can be delivered through wider bore humidified nasal cannula.

    The nasal cannula was invented by Wilfred Jones and patented in 1949 by his employer, BOC.[1]

    Contents

    1 Applications

    1.1 Supplemental oxygen

    1.2 Nasal high-flow therapy

    2 See also 3 References

    Applications[edit]

    Supplemental oxygen[edit]

    Nasal prongs

    A nasal cannula is generally used wherever small amounts of supplemental oxygen are required, without rigid control of respiration, such as in oxygen therapy. Most cannulae can only provide oxygen at low flow rates—up to 5 litres per minute (L/min)—delivering an oxygen concentration of 28–44%. Rates above 5 L/min can result in discomfort to the patient, drying of the nasal passages, and possibly nose bleeds (epistaxis). Also with flow rates above 6 L/min, the laminar flow becomes turbulent and the oxygen therapy being delivered is only as effective as delivering 5–6 L/min.

    The nasal cannula is often used in elderly patients or patients who can benefit from oxygen therapy but do not require it to self respirate. These patients do not need oxygen to the degree of wearing a non-rebreather mask. It is especially useful in those patients where vasoconstriction could negatively impact their condition, such as those suffering from strokes.

    A nasal cannula may also be used by pilots and passengers in small, unpressurized aircraft that do not exceed certain altitudes. The cannula provides extra oxygen to compensate for the lower oxygen content available for breathing at the low ambient air pressures of high altitude, preventing hypoxia. Special aviation cannula systems are manufactured for this purpose.

    Since the early 2000s, with the introduction of nasal cannula which uses heated humidification for respiratory gas humidification, flows above 6 LPM have become possible without the associated discomfort,[2] and with the added benefit of improving mucociliary clearance.[3]

    Nasal high-flow therapy[edit]

    See also: High-flow therapy

    High flows of an air/oxygen blend can be administered via a nasal cannula to accurately deliver high volume of oxygen therapy.[4] Respiratory gas humidification allows the high flows to be delivered comfortably via the cannula.[5] Nasal high-flow therapy can be used as an effective alternative to face mask oxygen[6] and allows the patient to continue to talk, eat and drink while receiving the therapy.[7] Definition: Non-invasive delivery of oxygen air mixture delivered via a nasal cannula at flows that exceed the patient's inspiratory flow demands with gas that has been optimally conditioned by warming and humidifying the gas to close to 100% relative humidity at body temperature.

    See also[edit]

    Oxygen tank – Storage vessel for oxygen

    Oxygen therapy – Use of oxygen as a medical treatment

    Oxygen mask – Interface between the oxygen delivery system and the human user

    Hyperbaric medicine, also known as Hyperbaric oxygen therapy – Medical treatment at raised ambient pressure

    Space suit – Garment worn to keep a human alive in the harsh environment of outer space

    Oxygen tent – A canopy placed over a patient to provide oxygen at a higher level than normal

    Oxygen bar – Establishment that sells oxygen for on-site recreational use

    References[edit]

    ^ "Improvements in or relating to nasal inhalation apparatus". (Primary Source). . The European Patent Organisation. Retrieved November 26, 2018.^ Roca O, Riera J, Torres F, Masclans JR (April 2010). "High-flow oxygen therapy in acute respiratory failure". . 55 (4): 408–13. PMID 20406507.^ Hasani A, Chapman TH, McCool D, Smith RE, Dilworth JP, Agnew JE (2008). "Domiciliary humidification improves lung mucociliary clearance in patients with bronchiectasis". . 5 (2): 81–6. doi:10.1177/1479972307087190. PMID 18539721. S2CID 206736621.^ Sim MA, Dean P, Kinsella J, Black R, Carter R, Hughes M (September 2008). "Performance of oxygen delivery devices when the breathing pattern of respiratory failure is simulated". . 63 (9): 938–40. doi:10.1111/j.1365-2044.2008.05536.x. PMID 18540928.

    Source : en.wikipedia.org

    Elsevier – Clinical Skills │Oxygen Therapy: Nasal Cannula or Oxygen Mask

    Elsevier’s Clinical Skills are a quick and easy way to find evidence-based skills and procedures. Ensure your knowledge on Oxygen Therapy: Nasal Cannula or Oxygen Mask follows the latest clinical guidelines and is reflective of best practices.

    THISISCLINICALSKILLSCONTENT

    SEP.30.2021

    OXYGEN THERAPY: NASAL CANNULA OR OXYGEN MASK - CE

    ALERT

    Oxygen is considered a medication and requires a practitioner’s order; administer it cautiously and observe the patient closely for adverse reactions. Assess the patient’s need for oxygen and recognize the signs and symptoms of hypoxemia.

    Use caution in the presence of oxygen. Oxygen is a fire hazard because it lowers the temperature at which materials catch fire in the presence of an ignition source, such as a spark or heat from a light source.

    Respiratory depression can develop in a very small percentage of patients who are chronically hypercapnic when breathing moderate to high oxygen concentrations.undefined#ref1">1

    OVERVIEW

    The goal of oxygen therapy is to maintain adequate levels of oxygen to manage suspected or confirmed hypoxemia. Selection of the type of oxygen therapy is based on the patient’s need, the severity of hypoxemia, and the disease process. Signs and symptoms of mild hypoxemia include restlessness, anxiety, disorientation, confusion, listlessness, and headaches (Box 1).

    The two types of oxygen delivery devices are high flow and low flow. High-flow devices discourage entraining of room air, which dilutes the fraction of inspired oxygen (FIO2).

    The target peripheral oxygen saturation (SpO2) for most acutely ill patients is 94% to 98%.2 Patients with chronic obstructive pulmonary disease should have a target of 88% to 92%.2

    OXYGEN THERAPY

    Devices that deliver oxygen therapy include a nasal cannula, various types of face masks, and oxygen tents and hoods (Table 1).

    A nasal cannula is a simple, effective, comfortable device for delivering low-flow oxygen (Figure 1).1 It consists of two prongs protruding from the center of a disposable tube and inserted into the nostrils. The nasal cannula allows breathing through the mouth or nose, is available for all age groups, and is adequate for short- or long-term use. Compared with other oxygen delivery systems, a nasal cannula decreases a patient’s feeling of claustrophobia, but it may not be suitable for mouth breathers. Cannulas are inexpensive, disposable, and easily accepted by most patients. When cannulas are used at higher flow rates, the airway mucosa may dry. A humidifier should be used to help prevent drying of the nasal and oral mucous membranes if the flow rate is greater than 4 L/min.1 Approximate FIO2 is estimated by the flow rate. The delivered oxygen percentage varies, depending on the rate and depth of the patient’s breathing.1

    A simple face mask is for short-term, low-flow oxygen therapy (Figure 2).1 A clear plastic mask is placed on the patient’s face with an elastic strap to secure it. The body of the mask stores oxygen between the patient’s breaths. Side port openings located on either side of the mask allow room air to mix with delivered oxygen and allow exhaled air to escape. The percentage of delivered oxygen varies, depending on the rate and depth of the patient’s breathing.1 Some patients find the face mask uncomfortable, and it must be removed for eating.

    A partial rebreathing mask is a face mask with a reservoir bag that delivers moderate to higher concentrations of oxygen (Figure 3A).1 Frequent inspection of the reservoir bag is required to ensure that it remains inflated; if it is deflated, exhaled air collects in it, which results in the patient rebreathing large amounts of exhaled carbon dioxide. Side port openings on either side of the mask vent exhaled air on expiration and allow room air to enter the mask on inspiration. The delivered oxygen percentage varies, depending on the rate and depth of the patient’s breathing.1

    A nonrebreathing mask is a face mask with a reservoir bag that delivers high concentrations of oxygen (Figure 3B).1 A one-way inspiratory valve sits on top of the reservoir bag, and a one-way expiratory valve covers one of the side ports on the mask. During inhalation the expiratory valve over the side port closes, preventing air from entering the mask while the inspiratory valve on top of the reservoir bag opens, providing oxygen to the patient. During exhalation, the expiratory valve opens allowing exhaled air to vent out of the mask while the inspiratory valve closes preventing exhaled air from entering the reservoir bag. The open exhalation port is a safety feature designed to allow air to enter the mask if the oxygen source fails. However, this feature can result in dilution of the inspired oxygen. The delivered oxygen percentage varies, depending on the rate and depth of the patient’s breathing.1

    A Venturi mask is a cone-shaped device with entrainment ports of various sizes at its base (Figure 4).1 The entrainment ports adjust to deliver various oxygen concentrations. This mask is useful because it delivers a more precise concentration of oxygen to the patient.

    A face tent is a shield-like device that fits under the patient’s chin and encircles the face (Figure 5). It is used primarily for humidification and for oxygen only when the patient cannot or will not tolerate a tight-fitting mask. Because it is so close to the patient’s face, there is no way to estimate how much oxygen is delivered to the patient.

    Source : elsevier.health

    Nasal Cannula: What It Is and When To Use One

    A nasal cannula is a medical device used to provide supplemental oxygen. Learn about what to expect from one.

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    Source : www.webmd.com

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