Using Oxygen At Home

GENERAL INFORMATION:

What is supplemental oxygen?

• Oxygen is an invisible gas that your body needs to live. Your lungs take the oxygen out of the air you breathe and put it into your blood. Your blood takes the oxygen to your brain and all of the cells in your body. Your cells use oxygen and nutrition from the foods you eat to make the energy they need to function.
  
  
• You may need supplemental (extra) oxygen if you have problems with your lungs, heart, or blood. Your body may also need extra oxygen after some injuries, such as burns. You may need extra oxygen when traveling to high altitudes or traveling by plane. You may need oxygen if you were exposed to a toxic substance, such as cyanide or carbon monoxide.
  
  
• Supplemental oxygen is thought of as a drug. You must have a prescription (pree-SKRIP-shun) from a doctor for oxygen therapy in order to get it. The prescription will include how much oxygen you should have, and how often. Getting too much oxygen may be dangerous. Always use your oxygen as directed by your caregiver.
  
  
• Oxygen therapy may help you feel better. You may sleep better, be more alert, and be in a better mood. You may be able to carry out your daily activities without feeling as tired or as short of breath. You may only need supplemental oxygen during certain activities, such as sleeping or exercising. You may need to have oxygen on all of the time. You may need oxygen therapy for a short time, or for the rest of your life.

What kinds of oxygen systems are there? The oxygen system that is right for you depends on the amount of oxygen you use and how active you are. Oxygen can be supplied in liquid form, in compressed gas form, or from an oxygen concentrator.

• Liquid oxygen: Liquid oxygen is kept very cold in an insulated container. Liquid oxygen warms and turns into a breathable gas when it is released from the container. Liquid oxygen takes up less space than compressed oxygen, so it is more portable. You can refill small, lightweight liquid oxygen tanks from a big tank kept in your home. Liquid oxygen may cost more than other oxygen systems. Your liquid oxygen supply may not last as long as compressed oxygen because it can evaporate. Liquid oxygen is very cold and may burn your skin if it spills. Keep your liquid oxygen container in an upright position. Secure the container when you travel so that it does not tip.
  
  
• Compressed oxygen: Oxygen is often supplied in a metal cylinder under pressure. This compressed oxygen does not need electrical power to operate like an oxygen concentrator does. Compressed oxygen cylinders are heavier than liquid oxygen containers. Small cylinders and wheeled carts are available so that you can move around while using compressed oxygen. The stem of a compressed oxygen cylinder must be protected from damage. Cylinders should always be stored in an upright position and secured so that they do not fall over.
  
  
• Oxygen concentrator: An oxygen concentrator is an electric machine that takes oxygen out of the air and stores it. You must have a backup cylinder of oxygen with you at all times in case there is a power failure. Let your electric company know that you have electrically-powered medical equipment. They will put you on a priority list so that you get your power back quickly if it goes out.

What kinds of oxygen delivery devices are available? Your oxygen can be given to you through a variety of ways. The most common ways to deliver oxygen to people at home include:

• Nasal cannula: A nasal cannula is made of lightweight, flexible plastic tubing. One end attaches to the oxygen source. The other end has two curved prongs that fit just inside your nostrils. Place one prong in each nostril. Position the prongs so that their curve directs the oxygen toward your airway (curve downward towards your mouth). The tubing can be held in place by looping it around your ears, or attaching it to your eye glasses. Wash your nasal prongs with soap and water twice a week. Replace your nasal cannula and tubing once a month, or more often if needed.
  
  
• Oxygen mask: An oxygen mask is attached to the oxygen supply by plastic tubing. The oxygen comes through the tube and fills the mask. A mask covers your nose and mouth, which allows you to breathe through either one and still get oxygen. It is usually held in place by an elastic strap that rests above your ears. You may need to use an oxygen mask if you are on a high flow rate of oxygen. You may need to use a mask for a short time if your nose gets too dry. You may need to use a mask if you have a stuffy nose, or while you sleep. Clean the mask with soap and warm water. Replace the mask once every two to four weeks.
  
  
• Transtracheal oxygen: Transtracheal (trans-TRAY-kee-al) oxygen is given through a small flexible plastic catheter. It is put directly into the trachea (windpipe) through an opening in the neck. A necklace holds the catheter in place. Your caregiver will teach you how to care for your transtracheal oxygen catheter.

What do I need to know about using and maintaining oxygen equipment? It is important that you learn how to use your oxygen system safely and effectively. Ask your oxygen supply company for more information about caring for your equipment. Here are some basic things you need to know about oxygen therapy and equipment.

• Contents indicator or pressure gauge: This tells you how much oxygen is left in the container. It is important to keep track of how much oxygen you have left so that you do not run out. Order your new supply of oxygen two to three days before you will need it, or when the gauge reads one-quarter full.
  
  
• Flow meter: This controls the rate (how fast) the oxygen comes out of the container. The flow rate of oxygen is usually measured in liters per minute (LPM). Set the flow meter so that you receive the amount of oxygen per minute that your caregiver has prescribed for you. Some flow meters use a needle or numbered dial. Some flow meters use a ball that rises as you increase the oxygen flow. Look at the center of the ball when measuring your oxygen flow rate. Never change the flow rate on your oxygen without your caregiver's OK. Too much oxygen may be dangerous for people with certain medical conditions.
  
  
• If you think that oxygen is not coming through the tubing:
  
  
  • Check for oxygen flow by holding your mask or cannula up to your ear and listening for air flow. If you have a nasal cannula, you can dip the prongs in a glass of water. If the water bubbles, there is oxygen coming through the tubing.
    
    
  • Check your pressure gauge or contents indicator to make sure there is still oxygen in the container.
    
    
  • If you use an oxygen concentrator, make sure it is turned on and plugged in.
    
    
  • If you use a cylinder, make sure the valve is open. The pressure gauge may have a reading even if the valve is shut off.
    
    
  • Look for kinks, blockages, or water in the tubing. Make sure the tubing is still connected to the oxygen source.
  
  
• Using a humidifier with your oxygen system:
  
  
  • A humidifier (hu-MID-i-feye-er) bottle holds clean water. The water is mixed with the oxygen before you breathe it. This helps to prevent your nose, mouth, and throat from becoming too dry. You may need a humidifier if you receive oxygen at a flow rate over one or two LPM. Your caregiver may want you to be on humidified oxygen depending on your illness.
    
    
  • Empty and refill the humidifier bottle with fresh water at least once a day. Wash the bottle with soap and warm water, making sure all the soap is rinsed out. Then refill the bottle with sterile or distilled water. A pre-filled bottle can also be used. Do not use tap water. There are minerals and other things in tap water that could damage your equipment. Hook the humidifier to your oxygen tank. Attach the tubing of your nasal cannula or mask to the humidifier.
  
  
• Using an oxygen cylinder:
  
  
  • Open the oxygen cylinder by turning the valve counter-clockwise (to the left). Turn the valve until the pressure gauge or contents indicator shows how much oxygen is in the container. Always turn the valve slowly when opening or closing an oxygen cylinder.
    
    
  • When you are done using the cylinder, turn the valve clockwise (to the right) to seal it. After closing the valve, "bleed off" the remaining oxygen in the regulator by turning on the flow meter until the pressure gauge goes to zero. This helps prevent wear on your equipment and lets you know that the cylinder is really turned off. It also prevents you mistakenly thinking the tank is turned on and giving you oxygen when it is not.
    
    
  • An easy way to remember which direction to turn the valve is to remember this phrase: "Left makes it loose, right makes it tight."
  
  
• Using an oxygen concentrator:
  
  
  • Check the air filter on the concentrator every week to make sure it is in place and clean. Wash it in soap and water if it is dirty. Then rinse it, pat it dry, and put it back on the machine. Follow the instructions that came with the concentrator, or the instructions given to you by your oxygen company.
    
    
  • If your oxygen concentrator has an alert buzzer, check it weekly. Turn the unit off, unplug it, and then push the power switch to "on". The alarm buzzer should sound, which tells you there is no power supply. If the buzzer does not sound, use a different oxygen source and call the oxygen company.
    
    
  • Push the power switch to turn on the unit. The power light should come on. With some concentrators, the alert buzzer should sound for 60 seconds.
    
    
  • Turn off your oxygen concentrator and call the oxygen supply company if you have any of the following problems. Use a backup oxygen supply until your concentrator is fixed or replaced.
    
    
    • The alert buzzer does not come on when it should.
      
      
    • The power light goes out and the alert buzzer sounds while you are using the oxygen concentrator. Check your electrical outlet and your fuse box before you call your oxygen supply company.
      
      
    • The alert buzzer sounds even though the power supply and oxygen flow has not stopped.
  
  
• General tips:
  
  
  • Keep the phone number of your oxygen supply company in a place where you can find it. Call them if you have any problems.
    
    
  • Plan ahead. If a holiday or bad weather is expected, order extra oxygen in advance.
    
    
  • Have a back-up oxygen supply to use in an emergency.

How can I use my oxygen safely?

• General safety tips:
  
  
  • You need to be informed about how to use your equipment safely and correctly. Do not accept delivery of unfamiliar equipment until your oxygen supply company has taught you how to use it.
    
    
  • Check the label on every oxygen container before you use it. Liquid oxygen should have "Oxygen Refrigerated Liquid U.S.P." on the label. Compressed oxygen cylinders should have "Oxygen Compressed U.S.P." on the label. If the label of a container reads differently, do not use the container. Call your oxygen supply company immediately.
    
    
  • Keep all cords and tubing neat. Do not leave cords or tubing running across an area where you or someone else may trip on it.
    
    
  • Keep oxygen containers from becoming too hot. Store containers in an area with good air flow. Never leave an oxygen container in a car trunk or a hot vehicle.
    
    
  • Keep oxygen containers secured in an upright position.
    
    
  • Oxygen containers should always be secured in a stand, holder, or to a fixed object. Containers can be damaged if they fall over.
    
    
  • Oxygen in cylinders is stored under pressure. If the cylinder is damaged, it can become a missile and shoot off at a high rate of speed. This may cause serious injury. Aim the cylinder valve away from you and other people when opening or closing the valve. Always open or close the valve slowly.
    
    
  • If an oxygen container is dropped or damaged in some way, do not use it. If you hear loud hissing from an oxygen cylinder after it is damaged, get away from it immediately. Let your oxygen supply company know about any cylinders that may be damaged.
  
  
• Fire prevention tips: Oxygen allows a fire to start very easily. Sparks or materials that normally would not burn can start a fire because of the oxygen you use. It is very important to protect you, your house, and those around you when using oxygen.
  
  
  • Never smoke or allow others to smoke near the oxygen.
    
    
  • Put signs on all the doors of your house to let visitors and emergency personnel know that oxygen is in use. "No smoking" signs should be posted as well.
    
    
  • Do not use oil, lubricants, or anything greasy on or around your oxygen equipment.
    
    
  • Do not use anything flammable while you are wearing your oxygen. This includes cleaning fluid, gasoline, paint thinner, aerosols, or alcohol-containing sprays.
    
    
  • Do not use electric razors, hair dryers, or any electrical appliance that has a motor while you are wearing your oxygen. Avoid using appliances with control boxes, such as heating pads, while wearing your oxygen. The control box may cause a spark.
    
    
  • Keep a working fire extinguisher within easy reach. Make sure everyone living in your house knows how to use it.
    
    
  • If a fire starts, turn off the oxygen right away and leave the house.
    
    
  • Keep the oxygen container away from open flames, such as candles, fireplaces, gas stoves, or hot water heaters. Do not go within eight feet of an open flame while you are wearing your oxygen.
    
    
  • Turn your oxygen container or concentrator off when you are not using your oxygen.
    
    
  • Watch for signs of oxygen leaking from the container. If you hear a loud hissing from your tank or if it empties too fast, stay away from the container. Open windows to help clear out any extra oxygen in the room. Call the company that brought the oxygen system to your home right away.
  
  
• Electrical safety tips:
  
  
  • When using an oxygen concentrator, plug the power cord into a grounded electrical outlet. A grounded outlet has three holes, and can take a three-pronged plug. Never alter a plug or use an adapter that allows you to plug a three-pronged plug into a two-hole outlet. This can ruin your electrical equipment, cause an electrical shock, and even cause a fire.
    
    
  • Do not plug in your oxygen concentrator if the cord looks damaged. Call your oxygen supply company.
    
    
  • Do not use an extension cord to plug in your oxygen concentrator.
    
    
  • Do not plug the concentrator into an outlet that has other appliances plugged into it. Overloading an electrical outlet can cause a fire.
    
    
  • Unplug the concentrator before cleaning the unit or the filter. Make sure your hands are dry before you plug the concentrator back in.
    
    
  • Make sure your oxygen supply company services and inspects your oxygen concentrator regularly. It should be serviced every 9,000 hours of use.

How do I prevent skin problems while using oxygen?

• Place gauze pads or cotton wrap between the tubing and your skin. You may need this protection over the cheek area and behind your ears. Padding helps keep your skin from getting sore where the cannula tube or mask strap rests against your skin. Call your caregiver if you see blood or feel sores behind your ears.
  
  
• Check around your nose and ears for areas of redness or irritation. If you see redness, rub the area gently. Change the position of the tubing or add extra padding to prevent further irritation.
  
  
• Oxygen can make your nose and mouth dry. If dryness is a problem, use a water-based lubricating jelly (such as K-Y Jelly®) on your lips and nose. Do not get the lubricating jelly in the tubing or prongs of the cannula. Do not use oil-based products, such as petroleum jelly.
  
  
• Take off the cannula or mask two or three times a day and wipe it clean with a wet cloth.

When to call your caregiver: You may not be getting enough oxygen if you have any of these symptoms.

• Becoming unusually short of breath.
  
  
• Being confused or having trouble thinking clearly.
  
  
• Breathing that is too fast, or if you become exhausted (very tired) from working to breathe.
  
  
• New onset of blue or dusky fingernail beds or lips.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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