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Q. How do I prevent nasal septal injury?
• Use the correct nasal prong and mask size. Prongs
that are too large may cause excessive pressure
against the nares and septum. Prongs that are too
small may increase movement and friction.
• Avoid overtightening the xation side straps.
• Properly align the support cradle and generator
assembly to the nasal area.
• Frequently inspect the nasal area for skin irritations,
and remove any moisture.
• Keep the generator assembly positioned to minimally
contact the nasal interface to the infant’s skin.
• Alternate between the nasal prongs and
mask interface.
• Use positioning aids to help keep the infant in
position if the bed is tilted. Otherwise, the infant may
migrate down, causing the circuit to pull against the
nasal septum.
• Do not use creams, gels, lubricants or hydrocolloid
products, as they may lead to excessive moisture and
undermine the skin integrity.
• Refer to the Routine Inspection section, nasal care,
for a more detailed description.
Q. What causes nasal blanching?
A. Two main causes are the prongs are too large or
incorrectly positioned. Recheck the measurement.
If the selected prong is the best size, try dilating the
nares before inserting the prongs. Insert only one
prong into the nare, and allow it to dilate. Remove
the prong and repeat the insertion with the other
nare. Then, try inserting both prongs.
Q. Can I prevent the “pig nose” appearance, often
associated with nCPAP?
A. The “pig nose” is caused by the nasal interface and
generator pushing up against the nasal septum for
an extended period of time. This occurs when the
generator assembly is not properly aligned with the
infant’s nose. If the generator assembly sits too far
back in the support cradle, it applies pressure against
the nose. If the headgear or bonnet are too high
on the forehead and not at the browline, it causes
the generator assembly to pull back and the nasal
interfaces to push up against the septal area.
Q. How do we clean the circuits, prongs, masks,
headgear and bonnets between patients?
A. All of these devices are for single patient use only
and should not be reused.
Infant Flow LP generator assembly and interface (continued)
nCPAP therapy
Q. The infant has thickened oral and nasal sections. Do I
need to carry out routine suctioning?
A. When receiving nCPAP therapy, routinely suctioning the
infant’s oropharynx and nasopharynx is not required.
Suctioning should only be carried out with clinical need.
Over vigorous suctioning can cause further secretion
production in response to the procedure. If the infant
exhibits signs of increased WOB or distress, suctioning
may be indicated.
Q. Can you nebulize medication through the Infant Flow
LP generator?
A. No. The system is not designed for the nebulization
of medications. If the nebulizer was placed in line
prior to the impinging jets, the majority of the
medication would be pushed out the exhalation tube.
The additional flow used for the nebulizer would
impact the pressure delivery.
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