By Sandy Morris
There are many diseases and disabilities that can decrease lung function and ultimately require use of supplemental oxygen (O2). The U.S. National Library of Medicine lists COPD, pneumonia, asthma, late-stage heart failure, cystic fibrosis and sleep apnea as common conditions requiring oxygen therapy.
If your loved one is having any of these issues and has recently been prescribed oxygen, it is likely you will see an improvement in their activity level, alertness and outlook once treatment begins. However, it’s important to be sure you are using the right equipment and observing all necessary safety precautions.
How to get and pay for supplemental oxygen
Only a doctor can prescribe durable medical equipment (DME) including oxygen concentrators and tanks. Such prescribed equipment is rented and covered by Medicare Part B for a certain amount of time, but make sure that your doctor has documented the need for oxygen in your loved one’s medical record, or your claim may be denied.
In addition to meeting Medicare’s criteria for medical need, oxygen must be required on an ongoing basis and it must be used in the home. Medicare may also pay for a humidifier for patients who require one in conjunction with their therapy. The degree of coverage can vary with private insurance plans, so remember to check the details of your loved one’s policy. Keep in mind that you are on your own paying for any electricity needed to operate the equipment, though.
Home and portable oxygen options
Oxygen therapy may be administered from a tank of compressed gas, cold liquid or concentrated gas taken from the air around you. Each of these options varies in size, weight and capacity, so one of these is sure to fit into your loved one’s routine.
Most people associate oxygen usage with compressed tanks. These come in a variety of sizes, are relatively heavy and must remain upright. They can be used to fill portable tanks and are good to have on hand in case of a power failure when using an electric-powered concentrator in the home. Some compressed O2 containers are small enough to carry in a backpack or wheel on a cart.
Another option is liquid O2. Since the liquid form takes up only 1/10th the space of compressed gas, these tanks hold more, but weigh less. Like compressed tanks, they can be used to fill portable tanks, but note that liquid oxygen is more expensive and has a shorter shelf life as well.
A concentrator takes air from the environment, filters out other gases, and compresses and stores O2. Concentrators are powered by plugging in to an electrical outlet or using rechargeable batteries. A standard flow concentrator can deliver up to 5 liters per minute (L/min), while high flow concentrators can deliver up to 10 L/min. Concentrated oxygen is one of the most economical options, but, as stated above, you’ll have to pay for the electricity used to run the machine.
Pulse dose or constant flow
Oxygen is released to the user through either pulse doses or continuous flow. Pulse dose technology delivers oxygen based on breathing and inhalation rates, whereas continuous flow is delivered at a constant rate, whether it is inhaled by the user or not. Pulse dose allows for more efficient use of the supply, but requires sufficient lung function to initiate each pulse.
Methods of administration
Oxygen is delivered for use by either a nasal cannula or face mask. Less frequently a tracheostomy mask is used. Face masks are typically utilized for shorter periods of therapy. Nasal cannulas are most popular, but can cause irritation and dry skin inside and around the nose. Never use petroleum-based lotions, creams or balms to treat these areas, as they can cause the oxygen to combust. Vegetable glycerin is a good choice for protecting and healing dry, chapped skin and nasal passages. Nasal cannulas can also cause skin irritation where the tubing rubs the ears. In that case, you might want to try soft foam ear protectors that can be purchased to cover the tubes.
A tracheostomy mask fits over a patient’s tracheostomy and administers oxygen directly into the trachea. When we breathe, our mouth and nose filter, warm and moisten the air that we inhale. Individuals with artificial airways require additional equipment such as a nebulizer to make up for these mechanisms and keep their respiratory system healthy.
Monitoring oxygen saturation levels
Pulse oximeters are available over the counter without a prescription and can be useful in monitoring the blood oxygen levels of people with more severe respiratory issues. This tool measures both O2 concentration and heart rate and can be useful for those who experience bouts of extreme shortness of breath. This simple, painless tool uses light to take these vital measurements.
Oxygen is a highly flammable element. Store tanks away from heat sources and keep them upright at all times. Never smoke while using oxygen or when near someone using it, and keep equipment away from all open fire. Do not use electrical devices such as heating pads while undergoing therapy. Packs designed to be both heated in a microwave or cooled in a freezer can be substituted for a heating pad, just be sure to not overheat them.
Traveling with oxygen
If you plan to travel with someone who is dependent on supplemental oxygen, make sure to bring a written prescription from their doctor. You can usually have a prescription called in, but a handwritten one will ensure your loved one can get the treatment they need in emergency situations or when your doctor may not be immediately available.