Introduction

Home oxygen therapy is prescribed for some patients who have low oxygen in their blood and need more oxygen than is available from room air alone. Low blood oxygen may be due to a number of chronic, mainly respiratory, conditions the most common of which is Chronic Obstructive Pulmonary Disease or COPD.

In Scotland home oxygen can only be prescribed by an authorised prescriber from the hospital, usually a respiratory consultant although it can also be prescribed by a paediatrician, neurologist or cardiologist. GPs cannot prescribe oxygen therapy.

Oxygen will not help your breathlessness if your blood oxygen levels are normal. But if you have a condition that means the level of oxygen in your blood is low, oxygen treatment can make you feel better and live longer.

How oxygen therapy is given

Oxygen therapy can be given in a number of ways including:

  • nasal prongs placed in the nose with the tubing secured over the ear (nasal cannula)
  • face mask placed over the nose and mouth
  • alongside other therapies to help people sleep and breathe

How home oxygen therapy 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 (cyanosis).

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. It also helps reduce the symptoms mentioned above.

Oxygen therapy can help people with a range of health conditions including:

People who have oxygen therapy 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 - long term oxygen therapy (LTOT).

Oxygen therapy assessment

If you have a long-term medical condition and your doctor thinks oxygen therapy might be helpful, you'll be asked to visit the hospital 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. Other tests may be performed including:

  • a spirometry - this measures the total amount of air you can breathe out from your lungs and how fast you can blow it out
  • pulse oximetry - a sensor is attached to your finger to measure oxygen levels
  • a walking test on a treadmill

Oxygen therapy may be recommended if the amount of oxygen in your blood is low. It's important that home oxygen therapy is only given if test results show that it's needed.

If you are prescribed oxygen therapy at home, a healthcare professional at the hospital will decide how much oxygen you’ll need and how long you’ll need it for. They'll also discuss the different ways the oxygen can be provided. This may involve a joint assessment at home with your respiratory nurse and the oxygen supplier Dolby Vivisol, or with other oxygen specialists.

By agreeing to go on oxygen therapy some information about your oxygen requirements will be shared with other NHS organisations and with the oxygen contractor Dolby Vivisol. They'll send an engineer to your home to install the equipment and explain how to use it. They'll also deliver new supplies of oxygen if you need them and check your equipment every so often.

Once your oxygen requirements have been assessed, the hospital will complete a Scottish Home Oxygen Order Form (SHOOF) and send it to the oxygen contractor. This is like a prescription.

The oxygen equipment will be delivered to your home by a Dolby Vivisol engineer. They'll explain how it works and go over some of the safety aspects of using oxygen.

Going on holiday

If you're going on holiday within the UK you can request that a secondary supply is placed at your holiday destination. You should email Dolby Vivisol and provide them with the details of your holiday. Tell them where you are going and provide the full postal address, contact name and telephone number. It is your responsibility to obtain permission of the property owner to have oxygen installed before you arrive and to have it uplifted after you leave.

You should allow up to 3 weeks notice to allow suitable arrangements to be made.

The home oxygen service provides a holiday oxygen service within the UK. If you are going to travel outside the UK and need oxygen, it is your responsibility to arrange this. You may need to pay for this. Some airlines charge up to £200 per flight for inflight oxygen, so check before making any plans.

Always check with your doctor before going away to make sure you're well enough to travel.

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

Useful contacts

Removal of equipment

If the oxygen equipment needs to be removed for any reason, please phone Dolby Vivisol on 0800 833 531 and they will make the arrangements, if appropriate.

Contact Dolby Vivisol

To contact Dolby Vivisol at their Patient Contact Centre, please call 0800 833 531 (freephone). Their working hours are Monday to Friday 9.00am - 5.00pm. They have a 24 hour freephone helpline to address any of your urgent enquiries. This number is free to call from landlines, however there may be a charge if you are calling from a mobile phone.

Any home oxygen query should be addressed to:

Dolby Vivisol, North Suite, Lomond Court, Castle Business Park, Stirling, FK9 4TU.

Telephone: 0800 833 531

Email: oxyadminSCO@dolbyvivisol.com

www.dolbyvivisol.com

The Home Oxygen Service is managed by National Services Scotland who can be contacted below:

Home Oxygen Service, Health Facilities Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 3EB.

Telephone: 0131 275 6860

Email: nss.oxycon@nhs.net

Types of oxygen therapy

Oxygen concentrator machine

An oxygen concentrator takes oxygen from the room air and concentrates it. The machine runs off mains electricity in your home. It is suitable for providing oxygen for many hours a day and whilst asleep. It filters oxygen from the air in the room and delivers it through a plastic nasal cannula.

The concentrator sits on wheels and when the machine is installed, it is usually supplied with around 40 feet of tubing to so that you can move easily around the house. If there is a recognised trip hazard, the engineer or nurse will discuss the length of tubing you’ll need. The tubing can be fixed around the floor or skirting board of your house, with points where you can "plug in" to the oxygen supply.

The oxygen is usually delivered through a nasal cannula which will allow you to talk, eat and drink. Sometimes a mask may be provided, which goes over the mouth and nose. These can also be used in combination if prescribed by your respiratory specialist.

Dolby Vivisol will repay the extra electricity costs that are used by the equipment. This will usually be paid quarterly into your bank once this has been set up. Nobody else will ask you for your bank account details.

A back-up oxygen cylinder will also be provided in case the machine breaks down. The machine will be inspected at least twice a year to make sure that it is always working properly.

Portable oxygen cylinders

If you think you may need oxygen to help you get around talk to your respiratory specialist. Not everybody needs portable oxygen so you will need to be fully assessed to see whether this would be helpful. This is also called ambulatory oxygen.

Portable oxygen cylinders contain oxygen under pressure. It is pressurised so that more oxygen can be put in the cylinder to provide oxygen for several hours. Typically a portable cylinder will last around 4 hours, but this will depend on the oxygen flowrate that you need.

Some small portable oxygen cylinders are available for children and small adults who need low flow rates. All cylinders will be provided with a backpack for easy carrying.

Other portable oxygen systems are available to meet a wide range of oxygen needs and individual circumstances. Speak to your respiratory specialist if you have any questions about this.

Safety

Oxygen supports combustion and is a fire accelerator. Follow these rules when using your home oxygen therapy to stay safe.

Do:

  • keep at least 10 feet (3m) away from sparking objects, flame, flammable materials and extreme heat
  • make sure you turn off your oxygen supply when not in use, even for short spells
  • allow at least 15 minutes to properly air clothing or 30 minutes to air bedding once you have turned off your oxygen before it is safe to go near any hot objects or flames, for example cooking. Oxygen may build up in material and make it more likely to catch fire, so allow time for it to wear off
  • make sure oxygen is used in a well-ventilated room and not in a confined area
  • make sure the firebreak (where provided) stays in the tubing, as left by the Dolby Vivisol engineer. This piece of white plastic should have the blue arrow pointing towards the patient. It helps stop a fire spreading up the tubing if one end catches fire
  • take care not to slip or trip up over your tubing. Be extra careful around doors and furniture

Do not:

  • smoke or let anyone else smoke near you. Not only will smoking make your condition worse, it is extremely dangerous when oxygen is being used
  • Use electronic cigarettes while undergoing oxygen therapy. Batteries of electronic cigarettes should not be charged near a patient undergoing oxygen therapy or near the oxygen source itself
  • apply oil or grease to the equipment. Keep all equipment clean using a damp cloth and a mild detergent, allowing equipment to dry properly before using. Make sure your hands are clean when handling your equipment
  • use face or hand creams that are oil based. Only use water based creams. If you are unsure ask your pharmacist
  • leave your mask or cannula in your lap or lying on the bed or chair for any length of time
  • let your tubing get trapped as this can reduce the flow of oxygen or even stop it
  • let anyone tamper with your oxygen equipment or change the flow rate ordered by your healthcare professional
  • cover or hang items on your concentrator or other oxygen equipment

Remember: in case of fire, immediately get out of the building. Only take your oxygen equipment with you if it does not make it more difficult for you to leave. Stay out of the building. Phone the fire and rescue services and let them know you are using medical oxygen. If you feel unwell, or you need emergency oxygen, ask for an ambulance immediately by phoning 999.