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I agree, get a clarification on the order. Also, get a humidifier for the O2 (the little "bubbler" of sterile water that gets screwed on to the O2 source) to help prevent the nose bleeds be keeping the nasal passages soft and "hydrated" (so so speak).
As for "blow the brain..." Where did you hear this? Do you mean mechanically blow the brain? Or such a high level of supplemental O2 can lead to O2 toxicity and (in COPD pts) increased CO2 retention? I've seen patients who are on 15 L NC (high flow) for long periods...and their brain did not "blow."
Agree with above suggestions to clarify orders and humidify O2.
Using peroxide on Q-tips is sooo not a good idea. Peroxide can damage the delicate mucous membranes and leave her more vulnerable to nose bleeds. I'm sure you know this, but she might need to have it explained.
If she's on 6L of O2, she should be using a simple mask or a NRB mask. If, however, she doesn't like the mask, maybe she can use a face tent or some other delivery system.
Is Respiratory Therapy involved in her care? They would be the ones to investigate this further.
If you have a non-intubated patient who requires continuous end-tidal CO2 monitoring, some systems will allow you to monitor that via a nasal cannula setup while delivering high-flow oygen through a separate NRB mask. That's the only situation where I've seen a cannula and an NRB on the same patient.
I'm not 100% clear on your patient's situation, but if there is actually flow going through both devices, that just doesn't sound right.
And...I don't know what the patient's diagnosis is, BUT--If the patient is "air hungry" due to COPD....well that is another whole can of worms and is really not in the patient's best interest, to say the least. And I would not put my license on the line continuing this way without specific orders on route of delivery, flow, humidified O2 or not, and what to do with the nose sores. What is the O2 sat. goal? I agree with vaseline in the nose, peroxide will erode the inside of the nose, and watch mouth care as well....if one gulps up enough O2 on the non-rebreather 24/7 the inside of patient's mouth will be a mess as well....If you are a nurse, I would be ultra sure that you get a clarification.
rusure
7 Posts
Saw a patient on a nasal cannula @ 6L o2 and a non re breathing mask. Her nose has been bleeding none stop. She is using peroxide n q tips to clear her nose once the blood drys. The nurses know that this is going on. I'm not sure what to do. I once read that on such a high level nasal cannula o2 u basically blow the brain and after 4L on a nasal cannula don't do any good anyway. What can/should I do or not do?