An Overview of Nasal Cannulas

Female patient with nasal cannula
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Nasal cannulas are medical devices used when people are unable to get sufficient oxygen to keep their body functioning optimally, whether that's due to a condition like chronic obstructive pulmonary disease (COPD) or other respiratory disorders, or an environmental change like high altitude. Nasal cannulas are lightweight, easy to use, and affordable. They may be used in a variety of hospital settings, at home, or on-the-go.

How It Works

A nasal cannula consists of a small, flexible tube that contains two open prongs that sit just inside your nostrils. The tubing attaches to an oxygen source and delivers a steady stream of medical-grade oxygen to your nose. The oxygen concentration used in nasal cannulas is relatively low, though high-flow cannulas do exist—these are similar to the output of continuous positive airway pressure systems (CPAP). Your physician will calibrate your oxygen supply to the proper level for your needs.

Nasal cannulas are less invasive than other oxygen delivery systems, most of which involve a face mask. In contrast, nasal cannulas generally don't prohibit regular eating and talking, and are pretty portable: they can often be toted along when walking or traveling.

When It's Used

Using a nasal cannula means you'll have increased oxygen levels, and hopefully increased energy and reduced fatigue, as you'll be able to breathe easier during the day and sleep better at night. Your doctor may recommend you use a nasal cannula if you have any of the following conditions:

  • Asthma
  • COPD
  • Sleep Apnea
  • Cystic Fibrosis
  • Pneumonia
  • Bronchopulmonary Dysplasia (underdeveloped lungs in newborns)

They also may be utilized in acute cases, such as heart failure or trauma, or in situations at high altitude, when oxygen levels are naturally lower.

Risks and Considerations

One side effect of using a nasal cannula is ensuing nasal dryness, which is fairly common as cold, dry oxygen is streamed into your nostrils. However, some oxygen units now come equipped with warming humidifiers, or these may be available as a separate attachment. Employing warm, moist air combats the effects of dryness.

While generally regarded as safe, there are several risks to consider before using any form of supplemental oxygen. Namely, long-term use has been linked to lung damage, eye damage (resulting from pressure buildup) or a condition called pulmonary oxygen toxicity, in which too much oxygen exists in the body and may result in damage to airways.

Oxygen is also highly flammable, and care should be taken to avoid situations where you may encounter cigarettes, candles, or stoves, etc.

Cost and Insurance

The cost of a nasal cannula ranges from around $20 to $50, depending on the length and number of disposable tubes involved.

With sufficient proof, most insurance companies and Medicare will cover nasal cannulation. Generally the following criteria is assessed:

  • Your doctor can prove that your health would improve with oxygen therapy
  • You have severe lung disease and oxygen may help
  • You have arterial blood gases within a certain range
  • Alternative measures have failed

In these cases, insurance will likely cover the cost of the oxygen-supplying system, the oxygen containers, and any necessary tubing/attachments required to deliver the oxygen. Medicare may require you to rent the oxygen equipment/systems for 36 months, and then will continue to supply them to you for up to 5 years. The cost covers routine maintenance. Check with your insurance company to discuss your personal benefits and inclusions.

Cleaning and Maintenance

Because of where the prongs of the nasal cannula sit (in the nares), they get soiled quite regularly.

While there is little clinical evidence supporting the claim that a soiled nasal cannula can lead to lung infections like pneumonia, the American Lung Association recommends changing your nasal cannula fairly often, especially when the prongs become soiled or uncomfortable.

Most manufacturers advise that patients change their nasal cannulas once a week for regular daily use or up to a month for sporadic use.

Cleaning Your Nasal Cannula

You can prolong the life of your cannula by taking proper care of it and washing it regularly. The biggest danger in not changing or washing your cannula on a regular basis is the buildup of bacteria, which may lead to infection.

After each use, you'll need to clean the cannula with an alcohol wipe or swab to prevent bacteria buildup. If you use oxygen continuously, take a break to disinfect the cannula at least once or twice a day—more if you are congested. Getting sick can be very dangerous for people with respiratory conditions like COPD, so you need to be vigilant about using alcohol to kill any bacteria.

For a deeper clean, soak the tubing in warm water with a small amount of dish soap and white vinegar, which is a good bacteria killer that won’t eat away at the cannula.

Once you have thoroughly washed the cannula, rinse it well in cold water to be sure all the soap and bacteria have been removed. Hang the cannula to dry before using it again.

Changing the Cannula

While most manufacturers recommend changing your cannula anywhere between once a week and once a month, the most important factor in deciding when to change your cannula is your immune system. It's very important that you change your cannula any time you have been sick or feel like you may be coming down with something to keep bacteria in check.

Be sure to keep extra supplies on hand so you can change the cannula whenever necessary. Make sure you take stock of your supplies and order more long before you run out.

As always, follow your doctor’s instructions for how often you should change your nasal cannula and the proper care and maintenance of your equipment.

A Word From Verywell

Nasal cannulation is a relatively noninvasive way of providing oxygen that may greatly improve your quality of life. Having sufficient air to breathe can make a world of difference in performing your daily activities, giving you more energy, and helping reduce fatigue. Talk to your doctor about whether nasal cannula-delivered oxygen is right for you and your condition.

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