Canberra Hospital and Health Services Clinical



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Section 19 - Low Flow Nasal Cannula-Oxygen Therapy



Purpose

Section 18 describes the process of providing supplemental oxygen to infants with an ongoing oxygen requirement who do not require ventilation or CPAP


Equipment


Neonatal Alert

For humidification use the sterile water pack. Once the flow has become micro low flow < 40 L/min there is no need to use humidification

Change humidity weekly


  • Obtain medical order for the commencement of oxygen therapy.

  • Explain the procedure and principle of low flow oxygen therapy to the parents

  • Ensure the neonate is monitored using a pulse oximeter, with the alarm limits set at 88-95% (2) unless otherwise directed by the medical staff

  • Attach low flow meter to an oxygen outlet

  • Attach nasal cannula to the low flow meter

  • Prepare the neonates skin with no sting barrier and duoderm.

  • Tape the appropriate size nasal cannula, ensuring there is no pressure on the nares

  • Set oxygen flow rate to maintain SaO2 levels between 88-95%

  • Observe and record oxygen saturations 1/24 – 4 hourly with cares

  • Notify neonatal registrar/neonatologist of significant changes in oxygen administration

  • Document procedure in neonate’s records

  • For long term oxygen therapy, provide education to the parents and allow them ample opportunity to practice changing the nasal cannula and observing changes in infants condition prior to discharge


Alert

Micro low flow & Low flow meters should be attached to the wall oxygen outlet only, do not attach to the blender.


Blended Gas Delivery

  • Apply nasal cannula as above.

  • Adjust flow as per Table 1. Please note this table is a guide only.







Consider other modes of respiratory support eg CPAP
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