Home Oxygen Use

Home Oxygen Use

Many individuals use home oxygen therapy outside the hospital and this remedy has allowed them to remain active and continue their fruitful lives. The typical patients who need oxygen therapy at home are those with lung cancer, asthma, congestive heart failure, emphysema, cystic fibrosis and some type of occupational lung disease. Not everyone can have home oxygen therapy and there are some guidelines established. The Centers for Medicare and Medicaid Services have a set of criteria for supplemental home oxygen therapy and maintain policy for most adult oxygen prescriptions, irrespective of the Health Insurance Carrier. In order for an individual to qualify for home based oxygen, the individual must have an arterial blood gas which has a documented PaO2 of up to 55 mmHg or a saturation of arterial blood oxygen of 88% on room air. The majority of Insurance Carriers will provide for life time home oxygen if the individual also has other co-morbid conditions like congenital heart disease, congestive heart failure or interstitial lung disease.

 A physician must approve a prescription for Home oxygen. The prescription should indicate the flow rate, the amount of oxygen/minute and whether the oxygen will be used continuously or intermittently. Some individuals require oxygen during the night, others need it continuously and yet others need while performing some type of activity. An arterial blood gas is a must before a physician can write a prescription for home oxygen. Home oxygen can be provided in three ways. The home oxygen can be delivered in a form of gas in various sized cylinders or a liquid in a vessel. The third way is to provide home oxygen by using a concentrator. Each has its pros and cons Compressed Gas: This common method uses oxygen which is stored in a cylinder under pressure. The oxygen is released at a set flow rate by adjusting the control on top of the cylinder. To avoid wastage of oxygen there is also a control device attached to the system. This device only releases oxygen when you inspire and shuts it off when you breathe out. The oxygen cylinders come in various sizes. For home use, one can have a large cylinder but there are also portable cylinders which one can walk around with. This is the cheapest method of home oxygen delivery. Liquid Oxygen –With this method of delivery, the oxygen is stored as a cold liquid like in a Flask/Thermos. When the device is opened, the oxygen liquid vaporizes and one can breathe in the air. This method of storage takes up much less space than a compressed cylinder and there are also a variety of portable such devices. The one negative of these devices is that they are more expensive than the compressed gas. They also do not come with on oxygen conserving device, but one can be built in. Oxygen Concentrator is an electrically powered miniature device that splits the oxygen, concentrates it, and stores it. This system has many advantages. The oxygen does not have to be supplied nor is it as expensive as the liquid oxygen. The system can be set up so that the individual can also remain mobile. Small versions of the oxygen concentrators are available which afford portability and mobility. All individuals who use this device must have a cylinder of oxygen as a backup in the event of a power failure. When power failure occurs, one must have an agreement with the electrical power company to restore services at the earliest convenience. Oxygen concentrators have the advantage of not being as dangerous as oxygen cylinders, which always have the potential for a leak and fire. Oxygen Delivery Devices Once the oxygen source has been sorted out, it must be delivered to the individual. This can be done in three ways. The most common is via a nasal cannula. The nasal cannula is a two pronged plastic tube which is inserted into the nostrils. The tube is then connected to the oxygen delivery system. The tubing generally rests on the ears, neck area or can be hooked on to the frame of eye glasses. Some people can not get enough oxygen via a nasal cannula and require higher flows. The higher flows can only be obtained with a mask. Some people alternate between a mask and a nasal cannula. The nasal cannula does get uncomfortable at times. There are other individuals who have had a tracheostomy and need oxygen. In most cases, the oxygen is provided by either a small plastic catheter or a mask which is placed directly over the tracheostomy site. All individuals who require oxygen via a tracheostomy must have the oxygen humidified prior to entering the lungs. Oxygen therapy is surrounded by myths which have been blown out of proportion. The most important part of oxygen therapy is patient education. There is a lot of evidence that long term oxygen therapy is beneficial and prolongs life. It is neither addictive, nor does it cause any harm.

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