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Oxygen Therapy At Home Guide

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Using Oxygen at Home

Why would you need to use oxygen at home?

If you have chronic lung disease, your health care provider may prescribe oxygen. Examples of chronic lung diseases are asthma, emphysema, chronic bronchitis, lung cancer, cystic fibrosis, and heart failure.

Oxygen therapy can help you:

  • Breathe better.
  • Sleep better.
  • Feel better.
  • Be more alert.
  • Have more stamina.
  • Lead a more normal life.

Oxygen at very high levels over a long time can be dangerous, which is why you need a prescription from your health care provider. The prescription will spell out how much oxygen you need per minute (flow rate) and when you need to use oxygen. Some people need oxygen therapy only when they exercise or while they sleep. Others need to use oxygen around the clock. Your health care provider will measure the level of oxygen in your blood to see how much oxygen you need.

How can you get oxygen?

There are 3 ways to get oxygen at home:

*Tanks of Compressed Gas. Oxygen gas is stored under pressure in large, heavy tanks or small, portable tanks. The large tanks are kept at home, while the small tanks can be carried with you.

*Tanks of Liquid Oxygen. Oxygen is stored in these tanks as a very cold liquid. The liquid changes to a gas when it is released from the tank. Liquid oxygen is more expensive than the compressed gas, but it takes up less space and is easy to transfer to portable tanks.

*Oxygen Concentrator. This is an electric device that separates the oxygen out of the air and concentrates it. It is not as costly as liquid oxygen, but you must have a tank of oxygen as a backup in case of a power failure.

You breathe oxygen from the tank or concentrator in 1 of 3 ways:

A nasal cannula is soft, plastic tubing that rests on your ears. Two thin prongs fit just inside your nostrils.

 

      

       Cannula                                                        Pendant                                   Oxyarm

 

A mask that fits over your nose and mouth may work best if you need a high flow of oxygen.

Transtracheal oxygen therapy requires the insertion of a small flexible catheter in your trachea (windpipe). The transtracheal catheter is held in place by a necklace. A humidifier is usually needed with transtracheal oxygen.

What is an Oxygen Concentrator?

Oxygen concentrators are stationary, electrical units that absorb nitrogen from ordinary room air and provide a continuous flow of oxygen.  These systems are less expensive than liquid oxygen and do not need to be refilled.  Typically, they are the most cost-effective source of oxygen therapy.  Approximately 80% of Medicare home oxygen patients use oxygen concentrators in the home; however, concentrators are not an ambulatory source of oxygen.

When ambulation is required, most patients rely on lightweight gaseous portable cylinders paired with a conserving device.  Some patients are provided only with a large, heavy, non-ambulatory E cylinder that is pulled around with a cart.  Unlike liquid oxygen, compressed gas cylinders do not evaporate.  This allows the patient to take along extra cylinders for extended outings, which is the key feature and benefit to compressed gas systems.  Eventually, the cylinders must be refilled or replaced by the homecare providers when the patient depletes the oxygen supply.

The Homefill II is a device that compresses the oxygen it receives from a concentrator into the cylinder connected to it. The following sections describe the compressor, concentrator, cylinders, and the process of filling cylinders.

Benefits of the Homefill II Portable Oxygen System

  • Unlimited portable oxygen - cylinders may be filled over and over. Cylinders weigh less than 5 pounds and last up to 5 hours (at 2 LPM equivalent flow).
  • No worrying about deliveries or running out of oxygen.
  • Promotes freedom and independence.
  • Safe and easy to use.
  • No liquid freeze-ups. Each cylinder has its own built-in regulator and conserving device - No need to change regulators.
  • No dragging cumbersome and embarrassing oxygen carts around in public.
  • Wear over the shoulder or around the waist. No batteries or maintenance required.

The Compressor


The Homefill II is a compressor that requires 2 amps of current and consumes 200 watts of power. It has about the same size footprint as a concentrator, stands 15 inches high, and weighs about 33 pounds. Its average noise level is less than 50 decibels. It takes up no more floor space than your concentrator if you purchase the optional table. Set the table over your concentrator and place the  Homefill II on top..


The Concentrator



The concentrator that accommodates the  Homefill II is Invacare's Platinum 5, a 5 Lpm concentrator . This concentrator can support your oxygen needs up to 3 Lpm while simultaneously allowing Homefill II to fill a cylinder. It requires 4 amps of electrical current and consumes 400 watts of electrical power. It has a footprint of 14 by 18 inches, stands 26 inches tall, and weighs 51 pounds. Its average noise level is rated at 60 decibels. The  Homefill II compressor and the  Platinum 5 concentrator are available in both 110 volt and 220 volt configurations.

The Cylinders



The Homefill II will fill only those cylinders that come with it, which are the M6 (or B), ML6, and M9 (or C) cylinder. The typical Homefill II user orders two cylinders. You need to determine and order enough cylinders to support your needs. If you travel, you must carry sufficient full cylinders with you, have a  Homefill II available at each destination, carry your concentrator and compressor with you, or you must temporarily rely on portable oxygen from a different source. The table at the end of this article should help you decide both what type and how many cylinders you should order.
Each cylinder has a contents gauge and a pneumatic conserver that are permanently attached to the cylinder.

The Contents Gauge


The contents gauge measures the internal pressure of the cylinder. When full, the internal pressure is 2000 psi (pounds per square inch), and the gauge's pointer is in the green area. When the pressure falls below 500 psi, the pointer is in the red area, indicating that in a very short time, the cylinder needs to be replaced.

The Conserver


 The EasyPulse  is the conserver that has been modified so that it can be permanently mounted on Homefill II cylinders. Although it has an Invacare label, it is a product of Precision Medical . Its rotary switch has seven positions: Off. CF (continuous flow), and five pulse positions.

When set to 2, the EasyPulse provides the 20 bpm (breaths per minute) user with a 28 ml pulse on each inhalation. If the user breathes either slower or faster than that, the volume of the pulse automatically adjusts so that the user receives the same volume of oxygen each minute. For example, at the same setting, the pulse of the 10 bpm user is 35 ml and that of the 30 bpm is 21 ml.

According to its manufacturer, the EasyPulse extends the life of a cylinder by a factor of 3.5. For the 2 Lpm user whose breathing rate is 20 bpm, this means that a full M9 cylinder, which empties in 2 hours on continuous flow, will last about 7 hours with the EasyPulse . A full M6 or ML6, which empties in 1.4 hours on continuous flow, will last about 5 hours with the conserver.

It is known that there is a higher percent of oxygen in a cylinder that is filled by your provider than in a cylinder filled at home by you concentrator. The difference is so small that it had been clinically demonstrated to be the same. (J. Lewarski, et al. A clinical comparision of portable oxygen systems: continuous flow compressed  gas vs. oxygen concentrator gas delivered with an oxygen conserving device. (RC Journal 48:1, 2003)

The Filling Process

The Homefill II compressor fills an M6 or ML6 in about an hour and a half, and an M9 in about two and a half hours.

The compressor seems to be easy to operate for a person who reads the instructions and abides by the safety messages that appear in the users' instruction manual. There is also a 15 minute VCR video that describes the complete filling process and provides troubleshooting guidance.
After turning on both the concentrator and compressor and allowing them to warm up, place an empty cylinder in the compressor's cradle and connect it to the compressor. The five indicator lights on the compressor's control panel monitor the filling process to completion and note any problems along the way. When the process is complete, the color of the lights assure you of the amount and purity of the oxygen in the cylinder.

The cylinder is a cinch to connect to the compressor. All you do is put it on and press down until you hear a click.  To remove it, you merely pull the collar down to release the cylinder.

 Selecting the Right Number and Size of Cylinders

The following table shows the weight of an EasyPulse system with the M6, ML6, and M9 cylinders. It also shows the duration of these cylinders at its five pulse settings, assuming a breathing rate of 20 bpm, and its duration on continuous flow. Use this table to select the type of cylinder that is both not too heavy for you to carry and has the duration you expect at your prescribed setting. Once a type of cylinder is selected, you can calculate the number of cylinders you need to order with the Homefill.

TABLE OF EASTPULSE VALUES

                                          Duration (in hours) at 20 bpm (breaths per min)
                                         when set to the following:
------------------------------------------------------------------------------------------
Cylinder    Weight*             1      2      3      4      5      CF**
-------------------------------------------------------------------------------------------
M6                  4.5               9.2   4.9   3.6   2.9   2.5    1.4
-------------------------------------------------------------------------------------------
ML6                5.2               9.2   4.9   3.6   2.9   2.5    1.4
-------------------------------------------------------------------------------------------
M9                                    14.2   7.6   5.6   4.5   3.9     2.0
-------------------------------------------------------------------------------------------
* approximate weight in lbs., with full cylinder
** at factory-set 2 Lpm

What special precautions do I need to take?

Pure oxygen is a fire hazard. Keep a fire extinguisher close by, and let your fire department know that you have oxygen in your home. Oxygen makes any fire burn faster and hotter. Keep flammable items away from the oxygen supply, such as:

  • alcohol
  • aerosol sprays
  • cleaning fluid, paint thinner, or other solvents
  • perfumes
  • petroleum products such as gasoline or oil.

Keep oxygen at least 5 feet away from sources of flames, sparks, or high heat. Examples include:

  • cigarettes
  • gas stoves and heaters
  • candles
  • Lit fireplaces.

Never smoke while you are using oxygen. Warn visitors not to smoke near you when you are using oxygen.

The highest safe temperature for the oxygen tank and accessories is 125°F (52°C).

Take precautions to prevent leaks from tanks of oxygen. If you need oxygen at home, a technician will help you set up your system. Always follow instructions for attaching the regulator. The tanks should be secured so that they do not fall over. Carefully seal them whenever they are not in use. The company that supplies your home oxygen will assist you with a setup and delivery schedule for bringing replacement tanks to your home.

If you use a concentrator, tell your electric company so you will be given priority for repairs if there is a power failure. Clean the air filter on the concentrator at least once a week.

What else do I need to know if I am using oxygen at home?

Wash cannulas or masks once or twice a week. Use liquid soap and rinse thoroughly. Change to a new cannula or mask every 2 to 4 weeks.

If you are using a transtracheal catheter, check with your health care provider to learn how to clean your catheter and humidifier bottle.

Oxygen therapy dries the inside of your nose and mouth. Use water-based lubricants such as KY Jelly on your lips or in your nose. Don't use an oil-based product, such as petroleum jelly.

Make sure you have good dental and gum care.

To keep your cheeks or the skin behind your ears from becoming irritated, tuck some gauze under the tubing.

Do not drink alcohol. It may slow your breathing rate. It may also cause you to forget the rules for being safe with oxygen.

Make sure your health care provider knows all the medicines and supplements you are taking.

Do not change the flow of oxygen without your health care provider's approval. Too much oxygen does not help. It can cause you to breathe too slowly, which allows too much carbon dioxide to build up in your blood. Too little oxygen can worsen shortness of breath and be harmful. Talk with your provider if you think your oxygen level needs to be adjusted.

You can travel with oxygen, but will need a special small tank. Talk with your provider about your options. Call your health care provider if:

  • You have a lot of headaches.
  • You feel more nervous than usual.
  • Your lips or fingernails are blue.
  • You have unusual drowsiness or confusion.
  • Your breathing is slow, shallow, difficult, or irregular.
  • Call your health care provider or your oxygen supplier if you have any questions about oxygen safety.

The Invacare HomeFill II lets oxygen patients get out and enjoy life. Where will you go next?



 

    
                                       








 

 
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