Author Archives: Jackie Aim

Oxygen safety

oxygen_hazard_symbols

Flammable Materials:
Do not let oxygen equipment come into contact with oils or grease, paraffin based products and NEVER use any form of lubricant (ignition is a greater risk in an oxygen enriched environment).

Do not use or store oxygen near any flammable/ oily materials.
Do not cover or wipe the equipment with any fibrous material.
Protect the equipment by carrying, storing and using in approved carry cases only (where provided).
Wash and dry hands thoroughly before handling any oxygen equipment.
Do not use or store the oxygen equipment within three metres of:
- naked flames.
- sources of intense heat (e.g. cooker hobs, ovens, heaters etc).

Prevention:
Avoid oxygen enrichment by:

Turning off the equipment when not in use.
Not permitting oxygen to accumulate on absorbent materials such as clothing, bedding, furniture.
Keeping the user environment well ventilated.

Fire Risks:
Consequences of oxygen enrichment:

Materials which are not flammable in air may ignite and /or burn in higher concentrations of oxygen.
Materials which will burn in air will burn/ ignite at lower temperatures if the oxygen concentration is higher.
Do not smoke or let others smoke near anyone while using oxygen. This not only presents a fire risk but is seriously detrimental to health.

You should be advised that the Scottish Fire and Rescue Service will be provided with your details to:

Place on record the fact you have Oxygen equipment.
Conduct a risk assessment / fit smoke alarms where appropriate.

Anyone can arrange a free fire safety check and free smoke alarm fitting anywhere in Scotland at a time to suit you by calling 0800 0731 999 or go to the Scottish fire and rescue website.

Free Home Fire Safety Visit and Free Smoke Alarm leaflet – Fire Scotland [pdf]

How to use oxygen – do’s and don’ts

Home oxygen is usually prescribed for a minimum of 15 hours a day.
This sounds like a lot but if used overnight it may give you some oxygen free time during the day.

Do	Don’t
Do keep nose and mouth healthy. Drink at least 6 to 8 cups of water or juice to keep hydrated. Your mouth and nose may feel dry when on oxygen. Do stay active with oxygen. Portable oxygen cylinders are available. Most people with oxygen can maintain an active lifestyle. If you need oxygen to get out and about, this will be considered as part of your assessment.	Don’t get sore ears. You may have to adjust the position of the tubing behind your ears. Padding and an aqueous cream may help. Don’t use open fires. Your home will be checked for safety reasons. Any open fire or flame is a potential explosion or fire risk. Don’t smoke or use E-cigarettes. It is recommended that people who are still smokers are not prescribed oxygen as there is a risk of combustion and severe facial burn. If smoking, you will be given smoking cessation advice. If you manage to stop, then oxygen will be considered if needed. It is also essential that others do not smoke in the same room when you have your oxygen on.

Don’t

Do keep nose and mouth healthy. Drink at least 6 to 8 cups of water or juice to keep hydrated. Your mouth and nose may feel dry when on oxygen.
Do stay active with oxygen. Portable oxygen cylinders are available. Most people with oxygen can maintain an active lifestyle. If you need oxygen to get out and about, this will be considered as part of your assessment.

Don’t get sore ears. You may have to adjust the position of the tubing behind your ears. Padding and an aqueous cream may help.
Don’t use open fires. Your home will be checked for safety reasons. Any open fire or flame is a potential explosion or fire risk.
Don’t smoke or use E-cigarettes. It is recommended that people who are still smokers are not prescribed oxygen as there is a risk of combustion and severe facial burn. If smoking, you will be given smoking cessation advice. If you manage to stop, then oxygen will be considered if needed. It is also essential that others do not smoke in the same room when you have your oxygen on.

Equipment

The following pictures show some examples of the kind of home oxygen equipment you may be supplied with. You will not be given all of these. Your own need for home oxygen will influence the equipment which will be the most suitable for you. This will be discussed at your assessment.

Homefill cylinders

Oxygen concentrator

Oxygen cylinder

Oxygen conserver

Oxygen mask and cannula

What can I expect from my health care team?

Respiratory nurse administering oxygen to a female patient

Once you start home oxygen, you will be seen once a year by the team to review how you’re getting on with it. This may include: a discussion about your symptoms, an examination and a discussion focused on how you are feeling.
A medication review including inhaler technique (for more information see our section on: A practical guide to inhalers).
Pulse oximetry to check your oxygen levels.
A blood test to check your oxygen levels.
A review of the oxygen flow rate prescribed.
A check of the oxygen equipment you are using.
A check of the hours of oxygen you are using each day.
A Spirometry test.
A discussion about smoking status including passive smoking (if appropriate).
A check to see if your vaccinations are up to date.
A discussion about anticipatory care planning (about your future health care wishes and choices if your condition worsens). This can include resuscitation. A record of the discussion will be made, for more information please see our section on anticipatory care plans and end of life care.

My results show that I’m suitable for home oxygen. What happens now?

The home oxygen service in Scotland is provided by Dolby Vivisol.

Will I get Oxygen to take home with me?
No. It will be delivered by a company called Dolby who manage the oxygen service for Scotland. They will contact you within a few days to arrange delivery of equipment.

How will I know how to use the equipment?
The installer will guide you and provide you with a written and visual information sheet. You will be given a contact number to use if you have any questions.

How will I know if I’m using it correctly?
The respiratory team will arrange a review for you after a few weeks. This is to check how well the oxygen is working and to answer any questions you might have.

My health care team have told me I might benefit from home oxygen.

Pulse oximeter icon
What happens then?
Your GP will refer you to the respiratory team who will arrange for you to have an oxygen assessment . This is normally done over a few hours in hospital as a day patient.

Part of it will be to measure your arterial blood gas, (ABG). This is a blood test which is normally taken from the wrist.

In some hospitals you may have a sensor attached to your finger or earlobe. It measures accurately how much oxygen is circulating in your blood. It usually needs to be done twice at around 3 weeks apart to make sure it is accurate. You need to be free from infection when you have your oxygen assessment.

When will I know the results?
Normally, you should be told your results and if you will need home oxygen at the same appointment.

For more information please read: CHSS Oxygen Therapy

How do I know if I need home oxygen?

Only people with chronically low levels of oxygen in the blood need home oxygen.

A blood test is usually done to check your level accurately but a full oxygen assessment is required to decide if you may need home oxygen.

Oxygen is like any medicine, it has to be prescribed for you.

Common signs that you may have low oxygen are:

Swollen ankles

Worsening breathlessness

Irritability

Tiredness

Poor concentration

Who needs oxygen therapy?

Oxygen is vital to everyone, not just people with respiratory problems. Only certain people with COPD will need home oxygen therapy.

*This situation affects some patients with severe COPD – measuring oxygen saturations when you are stable is a good screening test; a specific oxygen assessment is indicated if stable oxygen saturations are below normal.

View text alternative

Person 1: A person without COPD has enough oxygen.
Person 2: COPD means you have to work harder to get oxygen in to your lungs and this makes you feel breathless but levels of oxygen in the blood are not too low.
Person 3: This person with COPD lacks oxygen in their body so oxygen therapy may help. This situation affects some patients with severe COPD – measuring oxygen saturations when you are stable is a good screening test; a specific oxygen assessment is indicated if stable oxygen saturations are below normal,

If you still feel breathless there may be other causes of breathlessness

For more information on breathlessness please see the section on: What makes you breathless.

Check before you leave

What happens next?
Do you need any follow up appointments?
How will you get results of tests?
Who do you ask if you don’t understand what test results mean?
Make sure you are clear about any instructions you have been given, especially if you have a change of medicine.
If you don’t understand, ask the specialist to explain again. If necessary ask them to write down instructions or name of new medicines for you.
Check your list of questions to make sure you have not forgotten to ask anything which is important to you.
If you have been struggling with daily tasks, ask what help is available and how you can get extra help. The specialist or your GP may be able to make referrals for you.

Tests

A female patient undergoing a chest x-ray

You should expect to have a chest X Ray, if this has not been done in the past few months and breathing tests. Blood tests play only a minor part – often to rule out other health problems.

With all this information your specialist will decide if your problem is COPD alone, some other condition, or a combination of more than one condition. This will help them decide on the best long term treatment – this is based on evidence from research. There should always be a discussion about stopping smoking if you can or at least reducing the amount you smoke if you have not already realised that this is very important not only for your lungs but also for your general health. You can get lots of help for this, for more information see our section on Help to stop smoking.