Nasal CPAP
Nasal CPAP via mask and prongs is a frequently used form of respiratory support for newborns in the Neonatal Intensive Care and High Care unit. A side effect is that many newborns receiving nasal CPAP develop skin and/or nasal damage. This ranges from redness and swelling to bleeding. In some cases, even necrosis of the septum and/or surrounding areas occurs. Newborns experience discomfort from this. There is also a higher risk of infection. Within the strategy to reduce skin and nasal damage, there are several important aspects that we can strive for regarding the system of masks and prongs. In this blog, we highlight the importance of proper positioning.
Positioning
Alignment of the mask or prongs with the patient’s nose is important. When the system is not properly aligned, it causes skewed positioning of the mask or prongs and carries a higher risk of skin and nasal damage. More pressure will then be placed on one part of the mask or prongs, or a part will ‘pull’ on the nose. This increases the chance of skin and/or nasal damage.
Due to the child’s own movement, the system sometimes shifts, and the system can also shift due to actions during care. Regularly checking whether the system is still ‘straight’ is important. For example, if the fixation straps are tightened too much or attached just too high or too low, this can also lead to irritation. A lot of local pressure can then be exerted on the mask or prongs, increasing the risk of skin and nasal damage.
The EasyFlow applicator
An important component of the EasyFlow CPAP system is the EasyFlow applicator. The mask or prongs are attached to the applicator. This helps to maintain the alignment of masks and prongs. With this setup, the pressure is distributed over the applicator and not directly on the nose or skin of the child. The mask or prongs only need to be attached with the fixation straps without much pressure or tight tightening. Proper positioning with the EasyFlow system helps to reduce skin and nasal damage.
The positioning of the applicator on the forehead or the cap also plays an important role. The correct size of cap or headband helps with this. More on this in a subsequent blog in which we will discuss sizing and material type.
