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Oxygen Therapy

Home Oxygen Delivery System

Oxygen concentrator and nasal cannula

Oxygen Tanks   

     Home oxygen therapy usually consists of one or two compressed oxygen tanks to have for travel or, in case the electricity goes out, an oxygen concentrator, tubing, and the delivery system chosen.  An oxygen concentrator is a machine that removes nitrogen from room air, increasing the oxygen concentration of the room air to more than 90%. It’s less expensive, refilling is not required, and safer to use than an oxygen tank. Clean the air filter at least twice a week, and wipe down the unit with a damp cloth daily to keep it clean. However, it is loud, and it needs to have ventilation to keep it from over-heating.

Use Caution with Pressurized Tank

   Take precautions with the back-up oxygen tanks.  They are pressurized gas.  If one developed a leak, the tank could act as a missile and cause lots of damage. Containers should be stored in a secure stand and should never be stored in your car’s trunk or under your bed (unless there is good air circulation there).

   Note: The oxygen in the compressed air tanks can become combustible if allowed to come too close to a fire, and the tank is leaking — post warning signs related to combustion and possible burning.

Reference: 

https://www.lung.org/lung-health-diseases/lung-procedures-and-tests/oxygen-therapy/oxygen-delivery-devices

https://www.webmd.com/lung/lung-home-oxygen-therapy

https://copd.net/living/dos-donts-supplemental-oxygen/

Oxygen Safety

     Follow these safety tips if you use oxygen in your home.

  • You should post “NO SMOKING” signs on all entrances.
  • When wearing oxygen, stay at least five feet away from any open flame (i.e., candles, gas stove, fireplace, campfire, sparklers, etc.)
  • Don’t use flammable products like aerosol sprays, paint thinners, rubbing alcohol, etc.,
  • Oxygen may make your lips, mouth, or nose dry. Use Aloe Vera or a water-based lubricant such as K-Y Jelly. Do Not use oil-based products like petroleum jelly (Vaseline).
  • If your ears get sore from the tubing, ask your oxygen equipment provider if they have foam cushions to protect your ears from the tubing.
  • Please do NOT change your oxygen’s L/minute (flow rate) without discussing it with your doctor first.
  • Take good care of your teeth and gums. The drying effect of the oxygen may make you prone to dental irritation.
  • If you plan to travel on public transportation, talk to the transportation company about your use of oxygen and the accommodations needed in advance. Contact airlines in advance when flying if you need oxygen on a trip.  Many have special rules in effect about oxygen.

Reference: https://medlineplus.gov/ency/patientinstructions/000048.htm

Oxygen therapy

Mom holding young child who is having difficulty breathing.
Oxygen is a Medication

     Because giving too much or too little oxygen can cause significant harm to a person, the Food and Drug Administration classifies oxygen as a medication. It requires a doctor’s order to have it covered by insurance. For Medicare to cover home oxygen therapy, a patient’s PaO2 level (partial pressure of arterial oxygen) must be at a severe level (55 mm Hg), or their arterial oxygen saturation reading must be around at 88% on room air while at rest (pulse ox reading). Hopefully, your supplement to Medicare will pay for your oxygen needs. 

 
Why Supplement Oxygen is Needed

     The need for supplemental oxygen can occur due to poorly functioning lungs or organs in other parts of the body that aren’t working correctly.

  • The problem could be that air sacs are closed off and shut down for business (atelectasis-complete or partial collapse of part of the lung), causing oxygen not to get through that area).
  • Maybe the problem is an over-abundance of secretions clogging up the air passages requiring suctioning, postural drainage, or drugs to decrease secretion formation.
  • Could it be that the chest muscles are weak and can’t pull the diaphragm back and forth enough to give the lungs sufficient room to breathe in and out, and therefore, gases can’t be exchanged?
  • Maybe the heart is not pumping well-causing fluid to back up into the lungs (congestive heart failure). The air from outside the body cannot get through the extra fluid in the lungs to give oxygen to the body.
  • The kidneys may also be in trouble and not functioning as they should.  If they stop eliminating water, the extra fluid fills up the lungs making breathing difficult. See above
  • Maybe the heart is fragile and can’t pump blood around, so very little oxygen is getting to the lungs.

     In each of these situations, supplemental oxygen must be added to room air levels to meet the individual’s minimum requirements for acceptable oxygen levels.  The amount of oxygen and method of delivery depends again on why the person cannot get oxygen in the first place.

Reference: 

https://www.healthline.com/health/oxygen-therapy

Boy wearing face mask delivering oxygen therapy.

Two Types of Home Oxygen Therapy

Nasal Cannula 

    Oxygen is delivered through plastic cannulas (prongs) that sit in the nose.  

Advantage: safe and simple to use; comfortable, allows movement, eating, talking, and can be adjusted to any shape or size face.

Disadvantage: Can’t deliver oxygen concentrations above 40%, may cause headaches, dries out mucous membranes if the flow rate is above 6 L/min, comes out of the nose easily.

How to Use: Hook the cannula tubing behind the ears and under the chin.  Slide the adjuster upward under the chin to secure the tubing. If using an elastic strap, position it over the ears and around the back of the head. Don’t apply it too tightly. Provide humidification at a flow rate higher than 4 L/minute. They can be washed with liquid soap and rinsed with water once or twice a week to keep them clean. Replace nasal cannulas every 2-4 weeks. If you get a cold, replace them once your symptoms are over.

Simple Mask

Oxygen flows through an entry port at the bottom of the mask and exits through large holes on the mask’s side.

Advantage: Can deliver concentrations of 35%-50%

Disadvantages: Hot and confining, may irritate the skin, tight seal required, may cause discomfort, interferes with talking, eating.

How to Use: Place the mask over the nose, mouth, and chin and mold the flexible metal edge to the nose’s bridge, adjust elastic band around the head to hold the mask firmly but comfortable over the cheeks, chin, and bridge of the nose. If you can’t get an air-type seal, try taping gauze over the check area to help make a seal. The mask’s flow rate must be at least 5 L/min to flush expired CO2 from the mask to prevent rebreathing it. Replace the mask every 2-4 weeks.  If you get a cold or flu, change the mask when your symptoms are gone. Keep the mask clean by washing it with soap and water and rinsing it thoroughly.

Reference: https://medlineplus.gov/ency/patientinstructions/000048.htm