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odllovesjdl Asked April 2014

Ideas on how to keep Mom on oxygen cannula?

She keeps taking it off and was at 74 O2 this morning. We are going home today...UGH!! She will take it off and fold it squeezing it...or she puts it in her mouth or on the floor. Taping will not work...she will pull it off. She pulled out three IV's while we have been in. Thank you!

GardenArtist Nov 2017
Just thought of something else, but it's more of a vague possibility as I don't recall when or where I read about it. It's an alert system that alarms when Sat Rates drop below a certain level.

Gretch, you might want to call your oxygen supplier and ask if there are any such alarms that trigger when Sat Rates hit a lower level.

I just can't remember when I read about this kind of alarm.

Any nurses here know anything about such an alarm, for home use?

GardenArtist Nov 2017
Gretch, I don't know why people remove their oxygen cannulas; I've seen it as well.

I think it might be a few issues though, in addition to the fact that it's not comfortable. As earlier mentioned, the gray foam circular patches that snuggle over the cannula help protect the ears. W/o them, the ears can become chafed, and even very irritated, and that can cause the wearer to resent the cannula.

If the oxygen concentrator has a water bottle, it should be filled daily, with distilled water, and changed periodically in accordance with the concentrator instructions.

It helps humidify the air that goes through the cannula. A dry nose isn't very pleasant, can itch, and become uncomfortable, so that might be another reason to pull out the cannula.

As I wrote earlier, a non petrolatum based lip balm can help keep the lips moist, even though they don't come in contact with the cannula. But I think the feeling of dry lips is uncomfortable enough that someone could erroneously conclude that the cannula is causing it.

I get mine through an herbal supplier; they're made with beeswax and are much softer than commercially made lip balms.

I bought a humidifier for the room air; it helps to keep moisture in the air, especially in an older person's home where the temperature is likely higher than what it would be in a caregiver's home.

With dementia, though, it just might be the whole "foreign object" on the face or in the nose issue. I don't have any suggestions for that; perhaps others here with more experience in dementia could help.

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Gretch54 Nov 2017
My mother is 87 and is starting to show signs of dementia/Alzheimer's. She has started recently pulling her oxygen out and tying it in knots and just pulling it apart. She also says she doesn't need it. I feel like it's too the point of being out of my control and in God's hands. Like one person said, it will all play like it will anyway. I love my Mama, but I feel like it's to that point. I have explained to her what can happen if her body doesn't get the proper oxygen, but it just doesn't sink in. I just feel like I'm fighting a lost cause. She is at home, bed ridden, and sleeps most of the time. I'm trying to make her comfortable and see to her needs. Her oxygen usually dips to 84 or 85 when she takes it out and it goes back up to 94 or 95 when she puts it back on.

GardenArtist Mar 2016
Kimmer, I'm glad you posted even if the thread is old and hasn't been addressed in almost a year. You are absolutely right about not using products with petrolatum, including Vaseline.

There are chapsticks that do not have petrolatum, and those are acceptable. I buy herbal ones which are far superior to the commercial ones, and the beeswax in them is more comforting to chapped lips.

Ingredients need to be checked to determine which do or do not have them. And recommendations for the dryness created in the nasal passages by oxygen are to use K-Y jelly. (no snide or humorous comments on that, please.)

Kimmer Mar 2016
Do not use Vaseline with oxygen! Our oxygen instructions were very clear that using any oil or petroleum based products with oxygen can be dangerous. They can be flammable and in the presence of oxygen cause severe burns! This includes Vaseline and chap stick.

SueMcA Apr 2015
I am on o2 at night (copd) and when I wake up the cannula is over my eyes, ears or under my chin. I'm clearly taking it out of my nose while I'm sleeping. I am also looking for a way to prevent myself from removing it. The mitten idea sounds good in theory, but as I am like the princess & the pea when trying to sleep I doubt I'd be able to tokerate my hands controlled.

SueMcA Apr 2015
Type your cotea for twomments and experiences here.

norestforweary Apr 2014
Mike the "about odllovesldl" states this person has dementia. I am assuming she was in the hospital by reading between the lines. I also see the 02 sat read 74%. I gather this person may be home already since it was originally posted 2 days ago.. It is possible the pulse ox reading was inaccurate if she was fidgeting with it. I would be surprised hospital would release a patient with a pulse ox that low. My guess there was a pneumonia or copd going on, just my guess. This patient was confused in hospital, hence pulling lines out and removing 02. Maybe more confused due to different environment also. She may go home on 02, probably not IVs but po antibiotics. So if needs 02 @ home for comfort measures the "mitts" seem reasonable. I am keeping in mind the 74 pulse ox reading is possibly inaccurate, but I see why you would worry about it.

MikeB26 Apr 2014
For the RNs out there: It seems my perspective is dramatically different from yours. I'm a homecare RN. For us, a pulse ox of 74% is time to start calling anybody you can think of and documenting it.

It seems to me that the first thing to do is get a MD to assess this situation and take responsibility for it. Is the patient ready to go home? I don't think so. That 74% seems to have happened when a family member was observing and was there to intervene. Who knows how low the pulse ox will go during a long night without observation?

There could be all kinds of factors, including apnea, obesity, alveolar damage and skeletal muscle dysfunction. As far as I'm concerned, assessing for these problems are well beyond the purview of a nurse, no less a family member.

Or maybe I'm just being a panicky ninny.

I'd be very interested in the opinions of others.

moondance Apr 2014
Lord, she is just a few years older then me.
I am an R.N. can tell you that the O2 dries out the nasal passages & just a small dollop of Vaseline can stop the dryness.
As far as the I.V's go . Will she need then at home?? There are always soft wrist restraints that give some range of motion , but can be adjusted to keep her hands away from her cannula. They are not painful but sometime needed for the client's safety.
Good luck. It all will manifest the way it should anyway...

kmonksmsn Apr 2014
There are a lot better and safer ways to solve the problem than a tracheostomy. There are many potential complications with a trach.

The mitten idea is good.
It depends upon where your mother is.
The caregiver needs to monitor the cannula frequently.

Instead of the prongs, there are single, small cannulas that can be inserted in one nostril and taped. Sometimes those are easier to keep in.

MikeB26 Apr 2014
I'm sorry. I didn't read your post carefully enough. Are you saying that your mother's oxygen saturation was 74%?

Is your mother in the hospital?

Contact your doctor immediately.

Your mother could be at risk for stroke and heart attack.

I'm sorry. I'm never alarmist on these forums like this. But, if I'm interpreting your post correctly, this is a dangerous situation.

Normal O2 sat is between 95-99%. In people with diseases like COPD it can run lower-- down to 88%. 70% poses a risk of organ damage.

Your mom is OK now. Maybe I'm misinterpreting your question and you weren't referring to Pulse Ox at all. Or maybe she wears nail polish that interferes with the reading. And perhaps your doctor will be more reassuring than I am. I'm a nurse, not a doctor. He might not be concerned about this. And he'll know more than I do.

But, in my mind, 74% O2 Sat is no joke. Make sure that your doctor has given specific orders for the nurses to follow at specific percentages.

And, if your mother is at home, you must have a serious discussion with your doctor today.

norestforweary Apr 2014
Good idea dcoach.....I am surprised the hospital has not thought of that. I have forgotten about those!

dcoach Apr 2014
A large soft glove (no fingers) could be placed over each hand and perhaps taped at the wrist. These allow for movement inside but prevent grasping items (think boxing glove). If this is truly a health and welfare (life and death) situation, it may prevent removing the cannula and IV lines.

norestforweary Apr 2014
Can the hospital assign someone to sit with her to keep "watch" on her? Are IV's and oxygen necessary? if so, the only solution I can see is to have them use soft restraints for arms only. It must be so hard when she can not understand the purpose of these things.

MikeB26 Apr 2014
You may want to talk to your doctor about a tracheostomy that delivers oxygen directly though a hole in her throat. It might not solve the problem, but your mother will be less aware that it's there.

LindaS Apr 2014
I'm afraid you will continue to have problems with this. As an FYI, there are little cushions you can put on the piece that goes around the ear which makes it a little more comfortable on the ear and doesn't irritate the ear so much. I know my mother was on one for awhile in the hospital and a couple of different skilled nursing homes and no one told us about them or offered them until she went under hospice care a couple of years after she started using oxygen. It isn't a magic cure but it did help some in that my mother would leave it in a lot longer before taking it off. Hopefully someone else has a better answer for you but at least you can give this a try. The cannula do irritate the ears and they will become red and sore. Ask the oxygen company who supplies the oxygen for them. I think some offer them but some don't.

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