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A GUIDE TO USING DOMICILIARY

OXYGEN

WELCOME

Nau mai haere mai

ki te hohipera o Mawhera

CNS - Respiratory

INFORMATION NAME: ADDRESS:

HOSPITAL PHONE NUMBER:

GENERAL PRACTITIONER:

RESPIRATORY NURSE:

DISTRICT NURSE:

OXYGEN ENGINEERS:

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1. OXYGEN THERAPY IN THE HOME

You have been supplied with oxygen at home. This booklet is intended to give you further information about its use.

1) When is oxygen necessary?

Oxygen is supplied to deal with circumstances where you are short of oxygen because of abnormal function of the heart and lungs. Often this is perceived as breathlessness. But there are many other causes of breathlessness for example narrowing of the bronchial tubes. Oxygen therefore, will not necessarily help if you are not short of oxygen. We establish your oxygen requirements by obtaining a blood sample (from an artery), or using a machine known as a pulse oximeter. The blood sample is the more accurate technique.

2) How much oxygen should be used?

Once it has been established that you require oxygen, careful assessment to establish how much you oxygen you need will be required. This is usually completed in hospital. Different oxygen flow rates via nasal prongs or mask will be tried until your blood oxygen levels rise to an acceptable level. Oxygen will then be prescribed at the determined FLOW RATE (usually between 0.5 and 2 litres per minute). It is important that you use oxygen at the prescribed flow rate. Do not be tempted to increase the flow rate above what has been prescribed, even if you are increasingly short of breath - IT IS DANGEROUS. If you administer too much oxygen, there is a risk of becoming drowsy and stopping breathing. You should report any headaches, confusion or drowsiness to your doctor.

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3) How is oxygen administered?

Oxygen is delivered either by a concentrator machine which operates using the domestic electricity supply, or it may come in cylinders.

Oxygen Concentrator Oxygen Cylinder

4) How long do I use the oxygen each day?

If you have been prescribed oxygen for 16 hours a day, it is important that you use if for at least this each day. Studies have demonstrated that the beneficial effects are reduces if treatment is not maintained. This usually applies to patients who have chronic bronchitis and/or emphysema.

- If you have a chest infection you may require O2 for longer periods at this time.

- If you feel you need to use the O2 for longer periods that prescribed please contact the Respiratory Nurse Specialist as you may need to be reassessed.

5) Reassessment Policy

Home oxygen may not be required permanently. For example, you may have been admitted to hospital with pneumonia or a flare up of your bronchitis and for three four weeks after such an event, oxygen may be required. In many instances, recovery of lung function means that oxygen is not required long term and it is then possible to withdraw oxygen therapy. Conversely, there may be a need for more oxygen.

For these reasons further assessment of your oxygen requirements will be undertaken six eight weeks after it has been supplied.

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2. SAFETY PRECAUTIONS

Oxygen is a serious fire hazard. Smoke detectors are recommended.

Failure to adhere to these rules could result in damage to equipment or injury to persons.

Under no circumstances should the patient or visitors be permitted to smoke while oxygen is being used.

Ensure NO SMOKING sign is displayed.

No naked flame, open fire or electrical radiator should be within two metres of cylinder or concentrator.

Oxygen should not be placed on, or close by, an electrical appliance.

Flammable compounds such as grease, oils, lotions or alcohol must not be used in the presence of oxygen. Wash and dry hands prior to handling equipment and ensure they are not greasy.

Use of oil or grease on oxygen equipment should be avoided.

Do not tamper with valves or flow meters. Supervise young children when they are around oxygen equipment.

If you are carrying a cylinder in your car, you should have it well secured so it cannot be projected forward if you stop suddenly.

Cylinders should be stored in an upright position. In the event of a house fire, if it is possible, remove all oxygen cylinders from the house. Inform the fire brigade.

The 16-meter oxygen tubing can be a hazard around the house.

Care is needed to prevent unnecessary falls.

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3. OXYGEN EQUIPMENT Oxygen may be supplied to you in either cylinders or by oxygen concentrator machine depending on how long you need to use oxygen during the day.

When oxygen equipment is delivered to your home you will be

shown how to set up the equipment and advised on the use of it.

While oxygen equipment is in your care you are required to

take reasonable measures to protect and maintain it. If you have a concentrator machine you should arrange with

your insurance company for it to be covere4d as part of your House Contents Policy.

A.

B. C. D.

Protective Plastic Cylinder Valve Regulator Wheel (to tighten regulator)

E. F. G.

Gauge Oxygen Outlet Flow Meter

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4. HOW TO ASSEMBLE YOUR OXYGEN EQUIPMENT

1) Remove the protective plastic sleeve from the pin index outlet of the oxygen cylinder (Fig A.)

2) Ensure that the connective port of the oxygen regulator is

clean and entirely free from oil and grease. 3) Check that the rubber seal is in place on the connecting face

of the regulator. The rubber seal prevents oxygen leakage. 4) Fit the regulatory/flow meter (Fig C.) to the cylinder outlet by

placing the yoke over the cylinder valve (Fig A.) align the pins on the regulator to the pin holes on the cylinder and hand tighten the wheel (Fig D.)

5) Attach the tubing and cannula or mask to the outlet of the

regulator (Fig F.). Ensure the tubing is not kinked or obstructed.

5. HOW TO USE THE OXYGEN 1) Turn the regulator to your prescribed flow rate (Fig G.)

2) Open the cylinder valve (Fig B.) at the top of the cylinder slowly by turning it anticlockwise with the key. The gauge on your regulator will show pressure (Fig E.).

3) When not using your oxygen cylinder, turn it off (clockwise) as oxygen can slowly leak out of the cylinder.

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6. AFTER USE AND WHEN CYLINDER IS EMPTY 1. Turn the key spanner clockwise (closed).

2. Wait until oxygen stops flowing.

3. Turn the flow control knob fully clockwise (closed).

7. SETTING THE PRESCRIBED FLOW Your oxygen prescription states how much oxygen you need a minute (the flow rate). The flow rate is controlled by the flow meter attached to the pressure regulator. Your oxygen flow rate should be set at ______ . Set the flow rate. Do not adjust the flow rate unless advised to by your Physician.

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8. HOW LONG WILL MY CYLINDER LAST? The pressure gauge on the regulator indicates the contents of the cylinder. When the needle reaches the red zone, your cylinder is nearly empty and it is time for you to arrange further oxygen to be supplied. How long your cylinder lasts will depend upon how often you use the oxygen and the flow-rate at which it is used. MAKE A POINT OF CHECKING THE PRESSURE GAUGE REGULARLY.

9. CHANGING THE OXYGEN REGULATOR TO YOUR NEW CYLINDER

1. Turn the key spanner clockwise and wait until the oxygen

stops flowing. 2. Turn the flow control knob fully clockwise (closed). 3. Undo the connective wheel. 4. Lift oxygen regulator off empty cylinder. 5. Follow instructions HOW TO ASSEMBLE YOUR OXYGEN

EQUIPMENT (Section 4, page 7).

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10. LEAKS Should a leakage of oxygen occur, a hissing noise will usually be heard. Possible Cause Action

1.

Poor alignment of the pin-index with the connecting face of the oxygen regulator.

Realign the oxygen regulator.

2.

Loss of rubber seal from connecting port of the oxygen regulator.

Contact oxygen engineers.

3.

Leakage around the cylinder valve spindle.

Contact engineers.

11. OXYGEN CONCENTRATORS

The concentrator is powered by electricity. These machines concentrate oxygen from the surrounding air by compressing and releasing the air over a catalytic sieve bed. Because the air is drawn into the machine through a filter, the concentrator must stand in a well ventilated area.

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12. USING OXYGEN CONCENTRATORS Concentrators must be at least 2 metres away from radiators, heaters or open fires. Plug into power supply. Connect the oxygen tubing to the outlet port. Turn the on/off switch to the ON position. The alarm should sound for a maximum of 60 seconds and then stop. The flow meter is located on the front of the concentrator and is used to control the rate of oxygen supplied to the user. Set the flow meter to your prescribed oxygen flow rate. The indicator ball must be centred on the index line. Do not change the flow rate without discussing with your Doctor.

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13. GENERAL

Oxygen concentrators are to be used in a well-ventilated room.

The maximum length of tubing must be 16 metres (50ft). Anything over 16 metres will significantly reduce the flow from the machine.

The concentrator is on castors so it can be moved from room to room. It is not necessary for the concentrator to be in the same room as the person using oxygen.

When moving or shifting the concentrator, it is essential to keep it in an upright position to avoid damaging the machine.

The machine must be unplugged from the power point before cleaning.

14. CARE OF CONCENTRATORS

Before cleaning, concentrator must be unplugged Wash foam filter in warm soapy water and air dry more

frequently, if required, weekly When moving or lifting the concentrator, keep in an upright

position Concentrators are checked three-monthly by Respiratory

Nurse Specialist.

If your concentrator will not operate, please check: -

Is it plugged in properly and switched on at the wall? - Try plugging into another power point in the house.

Is it plugged in firmly at the back of the concentrator? Is the tubing free of twists? Is the filter dust free? If all these fail, turn the flow meter knob to O, stop the machine.

Contact __________________________ if your concentrator will still not operate.

DO NOT PANIC.

Treat the time as your time off oxygen. 12

15. CLEANING AND CHANGING FILTERS Cleaning the air inlet filter is the most important maintenance activity that you will perform and should be done at least once a week. STEP A: Press down on Whisper Cap tabs (2 places), if present, to access air inlet filter.

STEP B: 1) Remove the filter from the cabinet

2) Visually inspect the filter for damage, such as holes or tears

3) If damaged, replace with a new filter. Contact your health care provider for a new filter if necessary

4) Rinse and wash the filter in warm water. A mild detergent may be used if rinsed thoroughly

5) Squeeze out the excess water and allow the filter to air dry. The filter should be completely dry before using again

6) Visually inspect the filter after cleaning. Make sure it is not damaged or clogged

7) Reinsert the filter on the cabinet

8) Reinstall the Whisper Cap

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16. RUNNING COSTS It is estimated that the oxygen concentrator usage (electricity) is up to $3.00 per day. If you are having difficulty meeting this cost, you may be eligible to apply for a Disability Allowance. Discuss this with the Respiratory Nurse Specialist.

17. NASAL PRONGS

This device fits easily into the nostrils and is the most convenient way of providing oxygen over a long period

The correct way of wearing nasal prongs is over the ears and under the chin, as per the instructions in the packet

Wash the tips of the nasal prongs in warm soapy water 2 3 times weekly or as required. Rinse and dry by shaking well, then run oxygen through the prongs for a minute or two to dry the inside. You dont need to wash the tubing

Keep the prongs in a plastic bag when not in use

Nasal prongs should be replaced every 3 months to maintain comfort and hygiene

Old nasal prongs can be disposed of in the rubbish

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18. POTENTIAL PROBLEMS

Occasionally the following problems may occur: -

Problem

Possible Solution

Dry, crusty nose

Apply glycerine via cotton buds four times daily (Obtainable from your local pharmacy)

Blood spotting from nose

As above. (if it doesnt settle contact your doctor)