FOOTHILL COLLEGE

Oxygen Administration via Nasa Cannula

Candidate Name: _________________________________________ Date: ______________________

Examiner Name and Signature: _________________________________________________________

Time Started: __________ Time Ended: __________ Points: _____/8 PASS/FAIL (Circle One)

Points Possible Points Awarded
Choose the appropriate size nasal cannula 1
Attach the NC tubing to the regulator 1
Set oxygen to appropriate liter flow (2-6 Liters/minute) 1
Check for the flow of oxygen through the NC

** Listen for leaks where the tubing attaches to the cylinder

1
Place the nasal cannula prongs into the nostrils (nares) correctly 1
Secure the NC by:

**Hold loop of tubing anterior to face and neck

**Slip tubing around the patient’s ears and under the chin

1
Adjust the tubing under the chin until the NC is secure 1
Evaluate the patient’s comfort 1


Points Possible: 8                      Total Points Awarded_______________

Critical Criteria


☐ Failure to adjust the oxygen flow rate to the nasal cannula to between 1-6 lpm

☐ Failure to evaluate the patient’s comfort

Notes:

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