Nasal trauma from bubble cpap

[Julie Basilio]

How do you manage nasal trauma form bubble cpap? Thanks alot!

[karnicurnc, MSN, APRN, CNS]

Since prevention is key, we apply a barrier to the nose from the bridge to the upper lip. It is skin-friendly and made specifically for this purpose. We love it!

[Humbled_Nurse]

We use a lot of Bubble CPAP in our unit. It's rare that we have a ventilated baby. Prevention is key. We just try to be diligent on keeping the prongs off of the septum and making sure they fit appropriately. Our RT's are awesome with our Bubble CPAP babies in are always looking out for breadown and changing out the prongs often. We sometimes use a barrier on the nose with the real little ones.

[SteveNNP, MSN, NP]

1. VIGILANT nursing care to make sure there is no pressure on the septum EVER.

2. Correct prong size. NEVER cut prongs to fit.

3. We do not use barriers between the septum and the prong bridge. We find that this exerts more pressure + the skin breaks down easier due to the tendency of the barrier to absorb water and stay wet.

4. Proper securement. We use 4 safety pins and 4 small elastics to secure the insp/exp tubes attached to a SNUG hat to prevent twisting and movement of the prongs.

5. Frequent assessment.