Oxygen

How might oxygen help?
Types of oxygen treatment
Oxygen concentrators
Oxygen cylinders
Portable (or ambulatory) oxygen
Conservers
Liquid oxygen
How oxygen is supplied
Holidays and travels

How might oxygen help?
The air we breathe at sea level contains 21 per cent oxygen – a gas vital to every cell in our bodies. People with lung problems may have to work much harder to get all the oxygen they need and may suffer from low oxygen levels in their blood. The best way to treat this is to identify the reason for low oxygen levels and then treat the problem causing it.

Breathing in air with a higher concentration of oxygen can be used, in some people, to correct a low oxygen level in the blood. If you feel breathless and tired, particularly when moving around, you may have low blood oxygen levels. However you can also have low blood oxygen levels and not feel breathless.

Oxygen treatment does not make breathlessness better if the level of oxygen in your blood is normal.

Oxygen treatment is not helpful for everyone with lung problems and it is advisable to see a Respiratory Specialist who will assess whether extra oxygen is appropriate for your condition. If you are already on oxygen and have never been assessed, ask your GP to refer you to a specialist. The specialist will assess why you are breathless and check whether you have low oxygen levels. The amount of oxygen in your blood is measured by putting a peg-like device called an oximeter on your finger, or by doing a blood test. Your Respiratory Specialist will explain whether oxygen is a useful treatment for your condition and organise it for you if you need it. He or she will also review all other aspects of your treatment.

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Types of oxygen treatment
You can get oxygen from:

• An oxygen concentrator machine – a machine which extracts oxygen from the air
• Oxygen cylinders – these can be large or small and contain oxygen as a gas
• Liquid oxygen – this comes in a container and can be breathed in as a gas.

All of these forms of oxygen are available on the NHS, once you have been assessed. Equipment must be used according to the manufacturer’s safety instructions to avoid a fire risk, including no-one smoking near oxygen treatment. It is also important to remember that oxygen is a drug – too much oxygen can be dangerous. Do not alter the oxygen flow rate your equipment provides (unless instructed to do so by your specialist team) as this has been prescribed for you after an assessment.

You will be advised to use an oxygen concentrator if you need to use oxygen at home for a number of hours each day. This treatment is known as Long Term Oxygen Therapy (LTOT) and for adults is usually recommended for at least 15 hours a day. This is achieved by using oxygen overnight, and for several hours during the day.

An oxygen concentrator is a machine about the size of a bedside table. It filters oxygen from air in the room and plugs into your ordinary household electricity supply. The oxygen is then delivered by plastic tubing to a nasal cannula (short plastic tubes that fit into each nostril) or a mask. Long tubing can be fixed around the floor or skirting board, with outlets upstairs and downstairs so that you can have oxygen around the house.

If you are prescribed an oxygen concentrator, your doctor will notify the company which supplies them for the NHS in your area. An engineer from the company will install the concentrator and discuss with you the best place to put the machine and the tubing. This engineer will also explain to you and/or a friend or relative how to use the concentrator and answer any questions you have. The machine is very quiet and compact and uses normal electricity. The supplier of your oxygen service will reimburse some money towards your electricity bill to pay for the supply which the concentrator uses. A ‘back-up’ cylinder of oxygen is also provided in case of breakdown and the engineer will visit regularly to make sure the concentrator is working correctly.

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Oxygen cylinders
Oxygen cylinders contain compressed oxygen, and come with tubing and a nasal cannula or a mask. Cylinders are delivered to your home and have to be replaced when empty. They usually provide oxygen for up to eight hours, depending on how big the cylinder is and how high the flow of oxygen is set at.

Portable (or ambulatory) oxygen
People with lung problems who are using oxygen in the home may need to have a small portable cylinder so they can use oxygen when they go out. These cylinders weigh about 2-3kg (6-7lb) and come with a shoulder carrying case. The oxygen in them lasts for about three hours (depending on how high the flow of oxygen is set at). Your Respiratory Specialist will assess you to see if this is something that may be useful for you. As with any oxygen equipment, portable cylinders must be used according to the manufacturer’s safety instructions to avoid a fire risk.

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Conservers
A conserving device is designed to be attached to a portable oxygen cylinder to make the three hour supply last longer. The conserver device allows you to receive the oxygen supply in time with your breathing – you get a pulse of oxygen when you breathe in and no oxygen is wasted when you breathe out. Although this makes oxygen last longer, it is not suitable for everyone as it may not give you high enough levels of oxygen compared to having your oxygen in a continuous flow. Conservers are not usually suitable for children. Your Respiratory Specialist can advise you if you are suitable for this device.

Liquid oxygen
If you are using portable oxygen a lot, or if you need very high flows and your cylinders are not lasting long, your Respiratory Specialist, in discussion with the company who provides home oxygen, may recommend that you use liquid oxygen. This has to be delivered by lorry and decanted into a tank in your home, so is not always an option, for example if you live in a flat above ground level.

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How oxygen is supplied

All types of oxygen are provided by a single company for each region in England and Wales.In Scotland and Northern Ireland oxygen is ordered from pharmacies with a prescription. There are various different methods for collecting or having this delivered to you.

Your Respiratory Specialist will complete an order form describing your oxygen needs once you have been assessed. This form is called a HOOF (Home Oxygen Order Form) and is sent to the contractor providing oxygen in your area.You will need to sign permission for your medical and contact details to be shared with the contractor so they can provide you with the right type of oxygen at home. The company will then supply all equipment to your home.

For more information about oxygen suppliers in your area please see our information sheet on ‘Oxygen suppliers’ or contact our helpline on 08458 50 50 20.

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Holidays and travels
Do discuss travel plans, especially those that involve flying, with your Respiratory Specialist or GP before booking your holiday. With planning, oxygen can be arranged at holiday destinations in the UK using the NHS system. For more information about travelling with a lung condition please see our booklet ‘Going on holiday with a lung condition’, and information sheet ‘Air Travel with a lung condition’. You can also call our helpline for advice on travel on 08458 50 50 20.