Home oxygen treatment

Home oxygen treatment involves breathing high concentrations of oxygen from a cylinder or machine in your home.

If you've been prescribed oxygen therapy, it's because your blood oxygen level is low. Low oxygen levels can potentially damage your heart or brain.

The main purpose of home oxygen treatment is to raise your blood oxygen to a level that prevents such harm. It also helps relieve breathlessness and other symptoms of low blood oxygen, such as ankle swelling and blue lips.

However, using oxygen just for relieving symptoms of breathlessness is not helpful and can cause long term harm by making you less fit. This can also cause a delay in finding out why you are breathless.

The following information, for people who receive or are about to receive home oxygen therapy, explains:

• How home oxygen treatment can help
• Getting assessed for oxygen treatment
• Different types of home oxygen
• Portable (ambulatory) oxygen, for when you’re on the move
• What happens when you go on holiday 

How home oxygen treatment can help

If you have a medical condition that leads to a low oxygen level in your blood (hypoxia), you may feel breathless and tired, particularly after walking or coughing. You may also have a build-up of fluid around your ankles (oedema) and blue lips.

Breathing air with a higher concentration of oxygen can help increase the amount of oxygen in your blood. This makes it easier to do activities that might otherwise be more difficult. It also helps reduce the symptoms mentioned above.

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

• chronic obstructive pulmonary disease (COPD) - a long-term disease of the lungs
• severe long-term asthma
• cystic fibrosis - an inherited disease that causes the lungs to become clogged with thick, sticky mucus
• pulmonary hypertension - high pressure inside the arteries to the lungs, which causes damage to the right-hand side of the heart
• obstructive sleep apnoea - a condition that causes interrupted breathing during sleep
• diseases of the nerves and muscles or ribcage
• heart failure - when the heart struggles to pump enough blood around the body

People who have oxygen therapy have different requirements. Some people only need oxygen therapy for short periods during the day, when they're walking about (ambulatory oxygen). Others need it for longer periods and during the night.

Getting assessed for oxygen treatment

If you have a long-term medical condition and your doctor thinks oxygen treatment might be helpful, you will be asked to go for an assessment.

This usually involves measuring the amount of oxygen in your blood 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 breath into a device called a spirometer during a spirometry test.

If the amount of oxygen in your blood is low, regular oxygen therapy might be recommended.

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

You'll need to fill in a consent form to get home oxygen treatment. This is because, in order to provide you with the equipment and oxygen in your home, the oxygen clinic will need to share some information about your requirements with other organisations in the NHS. They will 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 have agreed this with the oxygen clinic, they will fill in a home oxygen order form for you. This is a bit like a prescription that goes to the company delivering your oxygen and equipment.

The equipment that provides your oxygen will be brought to you, installed and explained fully by one of the oxygen company’s engineers.

Different types of home oxygen

Oxygen can be obtained from:

• compressed oxygen cylinders
• liquid oxygen in cylinders
• an oxygen concentrator machine, which extracts oxygen from the air

Oxygen cylinders

If you just need oxygen for short periods to relieve attacks of breathlessness after an illness, you will probably be prescribed oxygen cylinders. However, this should be reviewed after a certain time so that the short-term relief does not hide more serious underlying heart or lung conditions. If your blood oxygen levels are normal for you during a review, that short-term oxygen should be withdrawn.

You breathe the oxygen through a mask or through soft tubes in your nose, called nasal cannulae. You can talk, eat and drink while using cannulae.

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

Oxygen concentrator machine

An oxygen concentrator machine is convenient if you would benefit from having oxygen for a large number of 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, about two-and-a-half feet (75cm) high, which plugs into your electrical socket. It filters oxygen from the air in the room and delivers it through plastic tubing to a mask or nasal cannulae.

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 with you 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 cylinder of oxygen is also provided in case the machine breaks down. Regular maintenance visits will be made to make sure the concentrator is always working properly.

Portable (ambulatory) oxygen

If you’d like to have a small portable cylinder to take oxygen outside your home, talk to your specialist. 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 is not recommended if you have heart failure or if you smoke.

Portable cylinders can provide oxygen at a rate of 2 litres or 4 litres a minute, or have an adjustable scale up to 4 litres a minute. The flow required is determined by your lung specialist or the oxygen service healthcare professional. When full, these cylinders weigh just over five pounds (2.3kg) and hold just under two hours of oxygen (at 2 litres a minute).

Going on holiday

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

Before you arrange your holiday, check with your doctor that you are well enough to travel.

The British Lung Foundation website has advice on travelling with a lung condition.

Safety

Oxygen is a fire hazard and, if you are supplied with home oxygen, it is important to take precautions.

For example:

• do not let anyone smoke while you are using oxygen
• keep away from flammable liquids while using oxygen - these include alcohol gel, cleaning fluid or aerosols
• keep oxygen at least six feet away from flames or heat sources
• keep oxygen cylinders upright to avoid them getting damaged

Your home oxygen supplier is also likely to let the local fire service know that there is oxygen in your home. They may request a risk assessment, even if you do not smoke.