Oxygen Therapy at Home
What is oxygen?
Oxygen is a gas that you can’t see, taste, or smell, but it is in the air all around us. Everyone needs oxygen in order to live. The amount of oxygen in the air is always 21 percent. This is enough for people whose heart and lungs work normally. A person with heart or lung problems may benefit from breathing air with more oxygen.
Why use oxygen therapy?
Oxygen therapy is used for any condition that may reduce the amount of oxygen available to the body, such as lung or heart disease. If your body is not getting enough oxygen from breathing the air around you, your doctor may put you on oxygen.
How do you know that you need oxygen?
Your doctor will order 1 of 2 tests to determine the amount of oxygen in your blood. In an arterial blood gas (ABG) test, blood is drawn from an artery, usually in your wrist. This test directly measures the amount of oxygen in your blood. The other test is pulse oximetry (ok-SIM-ehtree, sometimes called SpO2 or O2 Sat). A probe is attached to a machine called an oximeter that indirectly measures how much oxygen is in your blood. The painless probe may be attached to your fingertip, ear lobe, or forehead. It should be checked while you are resting, sleeping, and during activity.
Why Oxygen is Important
Oxygen is necessary for your body. It is used by all of your main organs and tissues. When your body does not get enough oxygen, you may have difficulty breathing, problems with your heart, fatigue, loss of memory, headaches, or confusion. Using oxygen decreases the work your heart has to do. Oxygen is one of your best medicines.
Oxygen is a medicine and it must be prescribed for you to get it. After your tests are completed, your doctor may prescribe oxygen on a temporary basis or for long-term therapy. Most insurance plans, including Medicare and Medicaid, will cover most of the cost as long as your test results show that you need the oxygen. The remaining cost is often covered by supplemental policies. Insurance coverage varies, so check with your insurance provider about your coverage. Your health care provider can help you choose a company to meet your oxygen needs.
When to Use Oxygen
Since oxygen is a medicine, your doctor will prescribe how much oxygen to use and when to use it according to your specific needs. Make sure you adjustand readjust the liter flow according to your prescription and activity.
_____________ liter(s) per minute during rest
_____________ liter(s) per minute during exercise/activity
_____________ liter(s) per minute during sleep
It is very important that you never increase or decrease your oxygen unless your doctor says you may.
Oxygen Supply Systems
Depending on your needs, oxygen may be delivered from a concentrator at home. A concentrator pulls air from the room and filters out the nitrogen to provide oxygen. A concentrator needs electricity and may increase the home electric bill. You should have a generator or backup cylinder in case the power goes out. Your home care equipment company should provide a backup cylinder. Tell your electric company if you have a concentator.
Portable oxygen concentrators, weighing just under 10 pounds, have become available. To learn more about these, you can go to: www.homeoxygen.org/airtrav.html.
Compressed Gas Oxygen Cylinders
Oxygen may be delivered as a gas under pressure in oxygen cylinders. These cylinders are made of steel or aluminum. The aluminum cylinders weigh less than the steel cylinders. Once empty, the cylinder can only be refilled by the home care equipment company.
Oxygen also may be delivered via a liquid oxygen system. Liquid oxygen turns into a gas when you use it. This means that large amounts of oxygen can be stored in a small container. When the portable liquid oxygen system is empty, you can fill it from a larger liquid stationary system. The home care company fills the stationary system every 1 to 2 weeks depending upon your oxygen prescription. This system gives you more flexibility and mobility.
Each type of oxygen delivery system is available in different sizes. They are:
- Stationary (large)
- Portable (medium)
- Ambulatory (small)
Stationary sources are any large tanks that can’t be easily moved. Examples are a concentrator, liquid reservoir, or large compressed cylinder (H or K cylinder).
Portable systems include equipment that is mobile and weighs more than 10 pounds. Examples are a mid-size liquid canister, mid-size compressed cylinder, and more recently a portable oxygen concentrator.
Ambulatory systems include equipment that can be carried and weighs less than 10 pounds. Examples are a small liquid canister or small high pressure gas cylinder.
Oxygen delivery devices
Ways of delivering oxygen include a tube that goes into the nose (nasal cannula), a mask, and a transtracheal catheter. Oxygen may be delivered continuously or intermittently through a pulsed system.
The oxygen tubing may irritate the skin behind your ears. The oxygen may irritate the inside of your nose. Some tips to help with this irritation include:
- Use normal saline spray or water-soluble jelly, such as brand name KY Jelly, to moisten the inside of your nose.
- Avoid petroleum-based products, such as brand name Vaseline. Petroleum products do not cause fires, but they will support burning if a fire occurs.
- If you have soreness around your ears, put cotton padding over the soreness. You can also call your doctor or home care equipment company.
Always store oxygen containers upright in an open and well-ventilated area. Make sure they will not tip over.
- Do not store paper, fabric, or plastic near oxygen units.
- Watch for kinks in your oxygen tubing.
- You will get a 50-foot supply of tubing for oxygen delivery at home. Be careful not to get caught or trip on this tubing.
- Be careful with metal fittings and pipes on liquid systems to avoid frost injury to your skin.
- Fasten your oxygen tanks upright in your car. Do not put oxygen tanks in
- Do not leave home with less than half a tank.
- Tell your local fire department that oxygen is in the home. A sign should be posted that you have oxygen in your home.
- Make sure smoke detectors are working. Make sure fire extinguishers are easy to reach and not outdated.
- Do not use appliances that could create a spark in the room with the oxygen unit, such as hair dryers or electric razors.
- Ask your doctor for other options if you have a gas stove.
- Be careful when unplugging any appliance.
- Keep oxygen units and tubing at least five feet away from any source of heat, such as open flames, stoves, space heaters, or candles.
- Do not use flammable products around oxygen, such as aerosols and cleaning
- Do not smoke or allow anyone to smoke around you.
- Post a no-smoking sign in clear view.
- In a restaurant, ask to sit in the no-smoking section.
- Tell your electric company that you have a concentrator.
- Test the alarm system on your concentrator regularly.
Traveling with Oxygen
You can still travel even if you need oxygen. Many people with heart and lung diseases travel freely. All it takes is a little planning. Talk to your doctor and home care equipment company before you travel. At different altitudes, your oxygen needs may change.
You’ll need to answer these questions before your trip so you can plan how much oxygen you’ll need:
- How long will you be gone?
- How will you get there (car, plane, bus, train)?
- How long will it take you to get there?
If you are driving, make sure all oxygen containers are secure at all times.
- Tanks — Keep upright and make sure tank is secure. If you have to lay the tank on its side, make sure that it can’t roll.
- Liquid oxygen canister — Must be kept upright at all times. You may want to loop the strap attached to the canister over the headrest of the seat next to you.
- Have a handicapped parking sticker in clear view. Ask your doctor about applying for a handicapped parking sticker.
If you are flying, make your arrangements as far in advance as possible. Tell the airline that you use oxygen when you make your reservation. You must have a statement from your doctor saying that you need oxygen in order to fly on a commercial airline. Ask about the airline’s guidelines for passengers needing oxygen. You may not be allowed to bring your own oxygen on board. Some airlines may require you to use the oxygen supplied by the airline. The airlines charge for oxygen, but the charges vary. Some airlines may require you to use a portable oxygen concentrator. These units are available for rent if needed.
You may want someone to be responsible for taking your oxygen tank or canister back home once you board the plane. You may take your liquid or compressed gas cylinder system on board only if it is empty. Be sure to ask about oxygen needs during a layover or if there is a delay. Contact your home care equipment company to be there when you arrive at your destination.
Confirm your arrangements 48 hours before your trip and arrive at least 3 hours early the day of your trip.
Most cruise lines accept people with oxygen. A doctor’s letter and advance notice of 4 to 6 weeks is required. You must arrange and provide your own oxygen and equipment.
Oxygen equipment can be brought on board, but you must tell your train service provider in advance. Amtrak requires notification at least 12 hours in advance that you will be bringing oxygen on board.
Be sure of the total traveling time so that you take enough oxygen. Take at least 20 percent more than you need in case of delays. If you can’t take enough oxygen, make arrangements with an oxygen supply company to re-supply you at stations along the way. Confirm with the reservation agent that the train will be stopped at the station long enough for you to receive oxygen delivery.
Check with your train service provider for detailed oxygen travel arrangements as soon as possible before your trip.
Bus or Taxi Travel for a Long Distance
Long distance bus or taxi carriers generally require advance notice. Contact your bus or taxi company for details and help to meet your needs while traveling with oxygen.
A travel trailer allows you to bring an entire liquid or concentrator system
with you. You must take a few extra safety measures:
- Make sure the system is secure and cannot be knocked over or roll.
- Make sure that no other items can bump or damage it.
- Keep all oxygen tanks, canisters, and equipment secure.
- Drive safely to avoid accidents and unnecessary jarring and bumping that may cause the oxygen system or other items to become loose.
Resources for Traveling with Oxygen
National supply chains and many local dealers belong to a network of oxygen providers and can help you make arrangements.
- A website called “Breathin’ Easy” has listings of oxygen suppliers located throughout North America. Visit http://www.breathineasy.com or call 1-888-699-4360.
- A resource for air travel is www.homeoxygen.org/airtrav.html.
- Many travel agents specialize in planning for travelers with special needs and can help with oxygen.
Several companies can arrange oxygen in destinations around the world. They do charge a fee for this service, but will take care of all the details.
Always ask your oxygen provider for help before you travel with oxygen.
Questions to ask your supplier
- How do I estimate how long my system will last?
- How do I estimate what is left in my system?
- What routine care and maintenance is needed for my equipment?
It is very important to know your system. Work with your supplier and keep their telephone number handy.
For further information on oxygen, go to www.portableoxygen.org.
Feelings About Wearing Oxygen
It is common to feel uncomfortable about wearing oxygen in public. Some people choose to isolate themselves and stay home. Others may choose to go out without oxygen. This makes them short of breath, tired, and uncomfortable. Using your oxygen takes the work off your heart so you can be more active and enjoy life more.