bcpap & nare/septum damage

[nicu4me]

Hi, I have looked through other posts on bcpap and how some units rarely use vents for very long. We have the old fashioned fancy safety pins and hat combo and cannulaide. We are trying to use it as much as we can but to be honest those 24 wkrs do not do well on it. When we do use it and they do pretty well gas wise, they are on it for months....so we are now seeing septum/nare damage more frequently. The prongs are sized appropriately, they are not wrapped any longer, just cannulaide. Skin is checked for breakdown, but we are seeing some serious damage. I personally change the cannulaide at least once my shift and re do the hat and put in dry prongs, get all the h20 out of the tubing, etc. but I wondered in some of the previous posts how your unit does it because we do keep babes on HFOV/vents for weeks also. And a new practice is no cannula for under 30 weeks..... so these kids that can do just great on BCPAP sit at 21% all the time and do great when totally off for weights/changes, etc. I was wondering if there were problems in your NICU and what you did to prevent them. I find it interesting all the nasal intubation information that has been posted here....would never happen on our unit. We only use high tape (the pink stuff) and a neo bar. No fancy aids for fastening cannulas or NG tubes either. Thanks!