Oxygen treatment at home

Written by: 
Steve Chaplin, medical writer

Who needs to use oxygen?

Oxygen is a medicine. Inhaled in a high concentration (up to 60 per cent), it is used for short periods to speed recovery from brief episodes of breathing difficulty, such as can occur in people with pneumoniaInflammation of one or both lungs., a severe asthma attack or severe trauma. It is used for longer periods (at least 15 hours a day) at low concentrations (initially up to 28 per cent, then adjusted according to how much oxygen is being carried in the bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid.) for the treatment of long-term conditions that make breathing difficult. The amount you need is prescribed by a doctor or nurse as the flow rate (the speed at which the gas leaves the cylinder, measured in litres per minute) and the length of time you need to use it.

The commonest example of a long-term condition for which oxygen is used is chronic obstructive pulmonary diseaseEmphysema and bronchitis; often associated with smoking and air pollution. Abbreviated to COPD. (COPDChronic obstructive pulmonary disease. Emphysema and bronchitis; often associated with smoking and air pollution.), but others include cystic fibrosisA hereditary disease associated with the obstruction of various glands and organs, including the intestinal glands, the pancreas and the airways (bronchi)., severe chronicA disease of long duration generally involving slow changes. asthma, heart failureFailure of the heart to pump adequately. and interstitial lung disease.

Oxygen cylinders and concentrators

Oxygen cylinders contain oxygen under pressure and they need no additional power source to work. They may be large, for use in the home or a hospital, or small enough to be carried (weighing 2-3kg). A small cylinder fitted with a conserver (see below) and carried in a holster or backpack lasts for about three hours and allows the user to leave the house for day-to-day tasks. People who need long-term oxygen therapy and who are away from their home on a regular basis can also use these (this is called ambulatory therapy).

An oxygen concentrator separates oxygen from other gases in the air and, for people who need oxygen for more than eight hours per day, it is cheaper in the long term than using cylinders. Concentrators run on electricity.

People who use oxygen at home can have tubes permanently installed in several rooms so that oxygen from a single large cylinder or concentrator can be piped to anywhere in the house.

Reducing wasted oxygen

The flow of oxygen from a cylinder or concentrator is continuous. This means that oxygen is supplied even when you are breathing out and this part of the supply is therefore wasted. This waste can be reduced by a conserver, a device that allows oxygen to flow only when you breathe in. Conservers are battery-operated and make a cylinder last three to five times longer.

Another way to reduce waste is to fit a special mask with a reservoir that stores oxygen as you breathe out and releases it when you breathe in.

Prongs and masks

Oxygen is inhaled through the nose and mouth. It may be easier to do this by having a pair of small, soft plastic tubes, known as nasal prongs, taped into place in your nostrils. These, in turn, are attached to the oxygen supply by lengths of tubing so that you can move about. Oxygen delivered by nasal prongs may cause dryness of the nasal membranes and consequent discomfort. This can be reduced by applying a water-based lubricant to the nasal lining, or by humidifying the oxygen by bubbling it through water before inhalation.

One alternative to prongs is a mask covering the nose and mouth. This is suitable for short periods but it's impossible to eat or drink while wearing a mask.

If prongs can't deliver enough oxygen, it is possible to deliver oxygen directly into the windpipe by surgically inserting a small pipe into the throat. This can be cleaned and changed at home.

Travel

Oxygen cylinders and concentrators are portable and you can take them with you when you travel, although it may not be permissible to take cylinders on an aircraft without prior approval from the airline. Concentrators must be kept upright, so you need to put yours on a car seat and fasten it in with a safety belt, or secure it upright in the boot. If you're travelling by bus, train or ship, it is important to ask the carrier what arrangements they have for transporting your equipment before you book your ticket.

Flying

If you are travelling by air you will need to check with each airline you're using what equipment you will be allowed. Some equipment is approved by aviation authorities, but don't assume that all airlines have the same rules. It's important to be sure when you book your ticket - and well in advance of travelling - that adequate arrangements can be made for you to use oxygen until you reach your destination. If you depend on a companion when you travel, you will need to ask the airline to ensure that you are seated together.

  • Some airlines provide in-flight oxygen (for a charge)
  • Portable oxygen concentrators approved by the Federal Aviation Authority may be allowed on some flights
  • Any equipment you want to take on a flight has to undergo a security check, so you will need to allow enough time for this at the airport
  • It is also important to ensure that you will have access to oxygen at any stopover airports and that you will have assistance moving your equipment between flights; before boarding, check whether any delays could affect your plans
  • You will also need to make sure that there is a supplier at your destination who can provide what you need; if a supplier is meeting you at the airport, check that they can be there if the flight lands outside normal working hours.

Safety

Oxygen  promotes burning and makes fires more intense. It is therefore vital that you do not smoke whilst using oxygen. In addition, oxygen must not be used near a gas cooker, a lighted fire or any other sources of heat or flame. However, oxygen cylinders are safe to transport and store as long as you follow the supplier's instructions.

More information

Patient support groups

  • American Lung Association (Link)
  • Australian Lung Foundation (Link)
  • British Lung Foundation (Link)
  • European Lung Foundation (Link) (includes links to other sites in European states)

Travel

Contact the airline, carrier or travel company in your own country for travel information. Regulations about flying and oxygen therapy are international; details are available from your national regulator and from these sites:

  • US Transport Security Administration. Link.
  • Federal Aviation Administration. Link.
  • UK Civil Aviation Authority Aviation Health Unit. Link.

Equipment suppliers

Some suppliers provide information about their equipment on their websites. For example, BOC in the UK (Link), Afrox in South Africa (Link) and BOC in Australia and New Zealand (Link).