all right so we'll start with a first low flow oxygen device which is nasal cannula a standard a is like a no can deliver 1 to 6 liters of oxygen and we'll talk about that certainly what that kind of converts to in the amount of oxygen they're actually inspiring or their fraction aspiring oxygen or fio2 so standard cannula nothing really special about this first of all it will plug in the flow meter and that's very fairly simple you have to have a Christmas tree as we showed before plug them right here I always start the oxygen flow turn the knob counterclockwise let's go with three liters here the ball was that right ml of three liters now I'll show you how to apply it the patient's face all right so now I'm going to apply this to the patient's face you're going to notice that there is a little bit of a curvature to these cannula prongs as you can see it what you want to think about are these going in and following the path of the nasal cavity nasal cavity it's not go up it goes back and around so these things always curve back like this if you put them on backwards like this it's going to oxygenate the epithelial cells on the inside their nose but not get down into their oral pharynx down to lungs where you really need so curving back I always put in the nose first a little bit of pressure of course I'm going to put it on this a year and then I'm going to show you for this side how it goes over the ear and under the chin and then this piece right here kind of goes tight you don't want to go too tight with it just enough to secure it and then sometimes I do a little bit of adjustment to what feels best for the patient one real key don't do it too tight a lot of the tubing's net is now made so that's soft because this can cause some a lot of breakdown hospital-acquired pressure ulcers especially on the tops of the ears and then if it's real tight across the skin right here this course of skin is very thin and then right on the nose if this is pulled really tight and it's not frequently moved so this salad is like annulus run of course it's going to go back into the nasal cavity and it's going to act almost like a reservoir so when they take their breath in they'll pull that fraction of inspired oxygen our lungs and then exhaling take the next breath in so this is standard a has a cannula review one to six liters if the patient is on greater than 3 years we recommend cubed a humidifier or what we call it bubbler and what that does it just helps to humidify the air so doesn't dry out their hands let me cosa