nasal cannula debate

[tamaith]

Hello,

Does anyone remember a time when the MAX amount was 8 lpm?

sorry for a nasal cannula

[rock_shoes]

Hello,

Does anyone remember a time when the MAX amount was 8 lpm?

sorry for a nasal cannula

I don't recall it ever being that high. I've never run a nasal cannula at a rate greater than 5 lpm. The normal range I've used is 1-5 lpm. Wouldn't a flow rate that high dry out a patients nasal passage excessively? That would be my take on why it isn't advisable.

[WolfmanHarris]

Put a nasal on 8 lpm and see how it feels up your nose. I have trouble believing that one personally.

[itku2er]

Most I have seen on a Nasal Cannula is 6. Two is the standard protcol we use with standing orders to titrate prn.

[FireMedic65]

Nasal Cannula is supposed to be used any where from 1-6LPM. If you exceed this, it can cause discomfort to the patient, dry out the membranes and even cause nose bleeds. Oxygen is very dry.

This is what is recommended on the national standard. You are best to check your local protocols though to see what they say. They may say different as to not exceed 4 or even 5lpm.

[tamaith]

thank you everyone. i had heard through the grapevine that back in the early 90's some states had the max allowed set at 8 lpm

[VentMedic]

Standard cannula starts at 0.25L for infants and goes up to 6L for adults. In home care you may find patient running their portable tanks at 8L, especially the demand flow models.

In the hospitals, some nursing homes, SNFs and hospice facilites you may find high flow cannulas that go up to 40 Liters per minute. The prongs will look like a regular cannula but will be hooked through a heated water system to provide the humidity that closely matches that in the body.

However, if you had said a nasal catheter, those could run at a slightly higher flow and were popular in the 80s and early 90s.

Edited October 7, 2009 by VentMedic

[Dustdevil]

thank you everyone. i had heard through the grapevine that back in the early 90's some states had the max allowed set at 8 lpm

That's what I was going to ask; the max according to whom? I wouldn't doubt that there is a wide variation in local protocols. And I've certainly seen more than a few EMTs and medics slamming 8lpm or more through a cannula over the years. But having first attended EMT school in 1973, I don't think I recall ever being taught more than 6lpm in a formal course. I can't swear it wasn't 8 at one time, but I don't think so. I don't have my original EMT orange books anymore, but I know a few here do, and hopefully someone can look back through them for us to see what the original AAOS said.

[tamaith]

i knew i could count on you dust. i believe the states the person was talking about where ( and i could be mistaken) but i think maybe conn or new york.

[Dustdevil]

If I am recalling correctly off the top of my head, the original AAOS was not revised until 1978 or maybe 77, when they replaced the AAOS seal on the cover with a Star Of Life. I'm pretty sure that when I re-took EMT in 1978, after coming off active duty, that 6lpm was the standard being taught. So the original AAOS book should be the only one we need to recheck. I can almost guarantee you that, if it was 6lpm in 1980, it was not at any time raised to 8lpm after that. By '80 I was in respiratory therapy, so I would remember if anything that absurd was in the EMT curriculum. Although, there still was a lot of absurd stuff in there, lol.

Obviously, a lot of state and local medical directors march to a different drummer though, so it is probable that someone somewhere was doing that.

Edited October 7, 2009 by Dustdevil