Welcome to Pulmonary Rehab

Oxygen Therapy

Babette Parthum, RRTClinical CoordinatorRespiratory Therapy

What is Oxygen Therapy?● A treatment that provides you with extra oxygen.● Normally your lungs absorb oxygen from the air.● Some diseases and conditions prevent you from getting

enough oxygen.● Your doctor and respiratory therapist will determine

whether you need oxygen at home based on arterial blood gas testing and/or pulse oximetry.

● Oxygen therapy is considered a medicine, therefore it must be prescribed by your doctor.

Reasons for Oxygen Therapy

● Decreases shortness of breath and fatigue

● Improves sleep in people with sleep-related breathing disorders

● Increases the lifespan of some people with COPD

● Decreases the work of the heart

Who Needs Oxygen Therapy● Somebody who has low blood oxygen levels● Certain conditions that admit you to the hospital

o Acute conditions Pneumonia Asthma attack or Reactive Airway Disease RDS

o Chronic conditions COPD Heart failure Cystic Fibrosis Sleep Apnea

Oxygen Therapy Systems● Compressed Gas

o Stored under pressure in metal cylinders

o Cylinders come in many sizes

o Can be placed in a small wheeled cart or a shoulder bag

● Liquido Very coldo When released from its container, it becomes a gaso Evaporates easily

● Concentrated Formo Cost less because they do not require oxygen refillso Filter out the gases in the air and only store oxygeno Powered by electricity

Oxygen Delivery DevicesNasal Cannula - small flexibleplastic tubes that direct oxygen into each nostril● Can be delivered from 1-6 liters

Giving a range of 24-44%● Patients with COPD should not

exceed 3 liters. If more is required, need to seek medicalattention.

Venturi Mask - mixes oxygen with room air, provides an accurate and constant oxygen delivery.● Delivers an oxygen range of

24-50% with 4-15 liters of oxygen.

● Used on COPD patients who require > 3 liters on a nasal cannula or patients with anincreased work of breathing.

CPAP - Used as a treatment for obstructive sleep apnea● Provides a constant pressure (set

by your physician according to the results of a sleep study) in your lungs on exhalation to prevent airway collapse.

● Nasal mask that fits over your nose

● Full face mask that fits over nose and mouth

● Nasal pillows that fit in both nostrils

BiPAP- bilevel positive airway pressure, non-invasive ventilation● Provides a constant pressure on

inhalation and exhalation to keep the upper airways open.

● A higher pressure (IPAP) is used to breathe in and a lower pressure (EPAP) is used when breathing out.

● BiPAP is used to increase oxygen and decrease CO2 levels.

● Utilizes the same types of masks and nasal pillows as the CPAP

Safety Measures for Oxygen UseThree elements are needed to start a fire● A fuel source● Oxygen● Heat source

Safety Measures for Oxygen UseTherefore if you are wearing oxygen, you should never:o Smoke or be around people who are smokingo Use paint thinners, cleaning fluids, gasoline,

aerosol sprays, and other flammable materialso You should stay at least 5 feet away from gas

stoves, cleaning fluids, gasoline, aerosol sprays, and other flammable materials

Risks of Oxygen Therapy● Dry or bloody nose - ask your provider if a

humidifier can be added to your device; use a saline nasal spray

● Skin irritation from the nasal cannula or face mask - ask if there is an alternate device that will fit better or ask for a gel or device that is designed to lessen skin irritation

Risks of Oxygen Therapy● Risk of fire - Oxygen by itself is not explosive,

but it can worsen a fire. o Compressed oxygen gas cylinders can

explode if exposed to heato The presence of oxygen can cause a small

fire to quickly get out of control

Picture courtesy of republicanherald.com

Living with Oxygen Therapy● Portable oxygen units make it easier for you to move

around and enjoy many of your daily activities.● Portable oxygen units make it easier for you to travel.

o You will need to plan aheado Contact your transportation carrier to find out their

specific rules.o Talk with your doctor and home equipment provider.

They can help you plan for your oxygen needs, ensure you have enough oxygen to last throughout your trip, and fill out any required medical forms.

Ongoing Care● Visit your doctor regularly● Your doctor can adjust your oxygen therapy as

needed● Never adjust the amount of oxygen you are

taking or adjust the flow rate of your oxygen on your own

● Discuss any problems or side effects with your doctor

Ongoing Care● Know when to contact your doctor or seek emergency

careo Increased shortness of breath, wheezing, or other

changes from your usual breathingo Fever, increased mucus production, or other

symptoms of an infectiono A blue tint to your lips or fingernails. This is a sign

that your body is not getting enough oxygeno Confusion, restlessness, or more anxiety than usual

Conclusion● Understand that a chronic condition (ie COPD, Asthma)

that does not require home oxygen may become acute (exacerbation of COPD, severe asthma attack) and require temporary hospitalization with oxygen

● Understand the need for BiPAP during hospitalization● Understand that too much oxygen for a patient with

COPD can be just as dangerous as not enough oxygen● Know the safety measures and risks of home oxygen

therapy

References

● American Cancer Society● American Thoracic Society● COPD foundation● NIH: National Heart, Lung, and Blood

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