Home oxygen treatment 

Introduction 

Home oxygen treatment, also known as home oxygen therapy, involves breathing in air that contains more oxygen than normal from a cylinder or machine in your home.

Oxygen treatment may be prescribed for people with a heart or lung condition that causes low oxygen levels in their blood. Low oxygen levels can damage the heart or brain.

Therefore, the main aim of oxygen treatment is to increase the amount of oxygen in your lungs and bloodstream to a level that prevents such harm.

It can also help relieve breathlessness and other symptoms of low oxygen, such as ankle swelling and blue lips. However, oxygen treatment shouldn't be used for the sole purpose of relieving breathlessness because it can have harmful long-term effects such as making you less fit. It can also cause a delay in finding out what's making you breathless.

How oxygen treatment is given

Oxygen treatment can be given in a number of ways including through a:

• tube positioned under the nose (nasal cannula)
• face mask placed over the nose and mouth
• tube placed into the mouth and down the windpipe (trachea) of a person who's unable to breathe on their own; the tube is attached to a ventilator machine that helps the person breathe

How home oxygen treatment can help

If you have a health condition that causes low levels of oxygen in your blood (hypoxia), you may feel breathless and tired, particularly after walking or coughing. Fluid may also build up around your ankles (oedema) and you may have blue lips.

Breathing air with a higher concentration of oxygen than normal can increase the amount of oxygen in your blood. This makes it easier to carry out activities that might otherwise be more difficult, and it helps reduce the symptoms mentioned above.

Oxygen treatment can help people with a range of health conditions that affect breathing or blood circulation, including:

• chronic obstructive pulmonary disease (COPD) – a long-term lung condition
• severe long-term asthma
• cystic fibrosis – an inherited condition that causes the lungs to become clogged with thick, sticky mucus
• pulmonary hypertension – high pressure inside the arteries to the lungs, which damages the right-hand side of the heart
• conditions that affect the nerves and muscles or ribcage
• heart failure – when the heart fails to pump enough blood around the body at the right pressure

People who have oxygen treatment have different requirements. For example, you may only need oxygen treatment for short periods during the day when you're walking about (ambulatory oxygen), or you may need it for longer periods during the day and night.

Oxygen treatment assessment

If you have a long-term medical condition and your doctor thinks oxygen treatment might be helpful, you'll be asked to visit your nearest oxygen clinic for an assessment.

During the assessment it's likely that the amount of oxygen in your blood will be measured by taking a blood sample from your earlobe or wrist, or attaching a sensor to your finger (a pulse oximetry test). You may also be asked to breathe into a device called a spirometer during a spirometry test.

Regular oxygen treatment may be recommended if the amount of oxygen in your blood is low. It's important that home oxygen treatment is only given if test results indicate that it's needed. This is because studies have shown that if oxygen is given just for breathlessness it can cause unnecessary harm.

If you decide to have oxygen treatment at home, a healthcare professional at the oxygen clinic will help you work out how much oxygen you’ll need and how long you’ll need it for. They'll also discuss the different ways you can get oxygen at home (see below).

You'll be asked to fill in a consent form to get home oxygen treatment. This is because, in order to provide you with the equipment and oxygen, the oxygen clinic will need to share some information about your requirements with other NHS organisations. They'll also need permission to send an engineer to your home to install the equipment and explain how to use it, deliver new supplies of oxygen and check your equipment every so often.

Once you've agreed this with the oxygen clinic, they'll complete a home oxygen order form for you. This is similar to a prescription and it's sent to the company delivering your oxygen and equipment.

The oxygen equipment will be delivered to your home and installed by one of the oxygen company’s engineers. They'll also explain how it works.

Oxygen cylinders

If you only need oxygen for short periods to relieve attacks of breathlessness after an illness, you'll probably be prescribed oxygen cylinders. However, this should be regularly reviewed so that the short-term relief doesn't hide more serious underlying heart or lung conditions. If your review shows that your blood oxygen levels are normal, short-term oxygen should be withdrawn.

You breathe the oxygen through a face mask or through a soft tube inserted into your nose (nasal cannula). You can talk, eat and drink while using a nasal cannula.

Cylinders containing oxygen compressed into liquid form can contain more oxygen than standard cylinders. This type of oxygen supply will last longer and the tank may also be lighter.

Oxygen concentrator machine

An oxygen concentrator machine is suitable if you would benefit from having oxygen for many hours a day, including while you're asleep. It ensures you have a source of oxygen that never runs out.

An oxygen concentrator is a machine that's about 75cm (two-and-a-half feet) high and plugs into your electrical socket. It filters oxygen from the air in the room and delivers it through plastic tubes to a mask or nasal cannula.

Long tubing can be fixed around the floor or skirting board of your house, with two points where you can "plug in" to the oxygen supply.

When the machine is installed, the engineer or nurse will discuss the length of tubing you’ll need. The machine is very quiet and compact, and the engineer will explain how to use it and will answer any questions you have.

A back-up oxygen cylinder will also be provided in case the machine breaks down, and regular maintenance checks will be carried out to ensure that the concentrator is always working properly.

Portable (ambulatory) oxygen

Talk to your specialist if you’d like a small, portable cylinder so you can take oxygen outside your home. You’ll need to be fully assessed to see whether portable oxygen (also known as ambulatory oxygen therapy) is likely to be helpful.

Portable oxygen isn't recommended if you have heart failure or if you smoke.

Portable cylinders can provide oxygen at a rate of two litres a minute – some cylinders allow you to increase the amount of oxygen being delivered to up to four litres a minute. The flow required will be determined by your lung specialist or the oxygen service healthcare professional. When full, these cylinders weigh just over 2.3kg (five pounds) and hold just under two hours of oxygen (at a rate of two litres a minute).

Going on holiday

If you're going on holiday in England or Wales, talk to your supplier to see whether you can make arrangements to have home oxygen supplied to you at your destination. Try to give them as much notice as possible.

Check with your doctor before arranging your holiday to check you're well enough to travel.

The British Lung Foundation website has advice about going on holiday with a lung condition.

Safety

Oxygen is a fire hazard and, if you're supplied with home oxygen, it's important to take precautions. For example:

• never let anyone smoke while you're using oxygen
• keep oxygen at least six feet away from flames or heat sources, such as gas cookers and gas heaters
• don't use flammable liquids, such as cleaning fluid, paint thinner or aerosols while you're using oxygen
• keep a fire extinguisher within easy reach at home
• install fire alarms and smoke detectors in your home and make sure they're working
• inform your local fire brigade that you have oxygen at home
• keep oxygen cylinders upright to prevent them being damaged

The supplier of your home oxygen may inform the local fire service on your behalf to make them aware that there's oxygen in your home. They may also request a risk assessment, even if you don't smoke.