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Coordinating Committee in Hospital Authority

In Occupational Therapy

Safety Guideline for Users : Medical Oxygen

Systems at Home and

At Public Places

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Content

Introduction p.3

General Considerations p.4

Using Oxygen Therapy at Home p.6

General Safety Considerations p.6

Regarding Stationary Systems

General Consideration in Handling p.8

Portable Oxygen Systems

Travelling with Portable Oxygen Systems p.10

General Safety Considerations p.11

When Travelling with Oxygen

In The Event of Incident or Emergency p.15

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In The Event of Incident or Emergency

1. Evacuate the area when there is a fire.

2. Stop the vehicles and switch off

the engines.

3. Get out of the public places or

vehicles immediately or as in-

structed by helpers on site.

4. Remove the ambulatory oxygen

from the site if safe to do so.

5. Notify the emergency ser-

vices and inform them of

the presence of ambula-

tory oxygen on site if not

removed.

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13. Since the release of oxygen from cylinder

could accelerate fire, it should kept be

away from sources of heat and po-

tential sparks.

14. In no circumstance that smoking or

open flames should be permitted in pas-

senger compartment when medical oxygen is present.

15. Consider to use shorter length of oxygen

tubing with portable oxygen devices for

outdoor activities and keep the cylinders

close to the users when they are in use.

16. Do not leave the portable oxygen sys-

tems unattended when the valves of

the cylinders are opened.

17. When not in use, ensure the valves of the cylinders are se-

curely closed and check for leaks.

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Introduction

Medical oxygen is an essential requirement for some people

who have respiratory diseases. In Hong Kong, home oxygen ther-

apy for needed persons is primarily a medical prescription and

has been handled under professional standards. Although home

oxygen therapy is increasingly widespread, the knowledge about

it is not. Proper and safe use of home oxygen therapy is impera-

tive to enhance its effectiveness thus, in effect, improving quality

of life for the users. On the contrary, improper operation and

poor safety awareness on use of medical oxygen systems will im-

pose fire hazards which may startle public concern. When initiat-

ing the therapy, it is usually the responsibility of the medical pro-

fessionals to educate and assist the oxygen users as well as their

caregivers to use the oxygen therapy delivery systems correctly

and safely at home and whilst travelling.

The purpose of this document is to provide guidance that can be

given to oxygen users and their caregivers in order to promote

safe use of medical oxygen therapy supply at home environment,

during travelling and visiting public places.

Introduction p.3

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General Considerations

1. Medical oxygen is a safe

product when it is used

properly.

2. Oxygen is stable in atmos-

phere. It does not burn or

explode; however, it will

enhance burning when present in a fire.

3. Oxygen therapy is not indi-

cated for patients who

continue to smoke, for

the fear of fire hazards

and the possibility that

poorer prognosis con-

ferred by smoking will

offset treatment benefit.

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9. The cylinders should not be dragged, rolled or being carried

by the valves or regulators.

10. Portable oxygen systems, especially the compressed oxy-

gen cylinders, are recommended to be operated in non-

smoking areas in public places, including on public transpor-

tation vehicles.

11. It is also preferable for the users to sit near open windows

or in areas with better ventilation while the portable oxy-

gen systems are in use. However, the exits and aisles should

never be obstructed.

12. When travelling on public vehicles, the oxygen users should

make sure the oxygen cylinders are secured from free

movements when the vehicles are in motion.

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5. The users and the transport providers should be aware of the

appropriate precautions to be taken while ambulatory oxy-

gen is in use in private or public vehicles as well as in the

event of an incident.

6. Oxygen should only be transported in cylinders which are

maintained in accordance with

manufacturers’ instructions. The

manufacturer’s instructions and

precautions are usually printed on a

label attached to a cylinder. Never

remove, obscure of alter cylinder

labels or markings.

7. The portable oxygen devices should be

carried in proper carrying bags to

keep the cylinders or vessels secured.

8. Medical oxygen cylinders are susceptible to valve damage

when they are dropped or knocked down forcefully. They

should be handled with care during loading and unloading

operations.

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4. Oxygen therapy is also not indicated for those patients who

do not undertake the appropriate discipline required for it.

5. All patients and concerned caregivers should be extensively

trained to use oxygen delivery systems safely.

6. The oxygen delivery systems are specifically designed to

safely contain the gas and to operate correctly under de-

fined conditions.

7. All oxygen delivery systems should be kept away from open

fames.

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Using Oxygen Therapy at Home

Oxygen concentrators are electrically powered units designed

to supply supplementary oxygen for needed users. Due to low

cost and reliability, oxygen concentrators remain as the most

commonly used stationary home oxygen delivery devices nowa-

days. It is also a common practice

in Hong Kong for oxygen users to

arrange portable oxygen devices, in

addition to the stationary systems,

to extend their mobility on oxygen

away from home or residence. The

most common portable oxygen de-

vice in Hong Kong is in the form of

a compressed gas cylinder, made of

steel or lightweight aluminum, fitted with a regulator or a con-

serving device.

General Safety Considerations Regarding Stationary Systems

1. It is strongly advised not to smoke in the same room while

there is oxygen equipment running.

2. Always keep the home oxygen device at a well ventilated

place at an indoor environment,

especially when it is running. The

air entrance of the device should

not be obstructed.

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General Safety Considerations When Travelling with Oxygen

1. The users are recommended

to discuss regarding their

medical conditions with

their physicians about their

plans for travelling on long

trips.

2. It is advisable to carry only sufficient amount of oxygen for

the journey and consider using conserving devices to extend

the use of the units.

3. Compressed oxygen cylinders are currently classified as

“category II” under the Dangerous Goods Ordinance in Hong

Kong. Oxygen users travelling with compressed oxygen cyl-

inders will subject certain restrictions specified by different

transport providers regarding transportation of “dangerous

articles”.

4. Limit the number of cylinders to be transported on board to

public vehicles to the extent of practicability.

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Travelling with Portable Oxygen Systems

Many oxygen users are still active and have the desire to

move out of home environment whenever they want to. Port-

able oxygen systems are designed to facilitate these people to

participate usual outdoor activities with the availability of am-

bulatory oxygen. The demand from the oxygen users to be

able to use the oxygen systems outside the home is constantly

increasing. These people require the ability to work, visit pub-

lic places, participate social activities and enjoy community liv-

ing as most able persons do. Only the difference is on the need

to use oxygen therapy for these activities.

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3. Keep the home oxygen devices including the oxygen tubing at

least 6 feet from open flames, stoves, space heaters or any

source of heat at home.

4. It is advisable to use microwave oven or

electric stove to cook while home oxy-

gen devices are in use.

5. If you have to cook with gas stove, you should keep the nasal

cannula away from the source of heat. Securing it behind the

ears or to the side of your clothing by a large clothing pin is

also advisable.

6. Do not bend down close to the burner while cooking and do not

leave the tubing with running oxygen near any heat source.

7. In order to ensure the oxygen concentrators

are operating in optimal functions, regular

maintenance procedure will need to be

performed by responsible personnel.

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General Consideration in Handling Portable Oxygen Systems

1. Under the Dangerous Goods (General) Regulations, approval

from Fire Service Department should be obtained before any

compressed gas cylinders and related valves to be put into use

in Hong Kong.

2. It is also under the Dangerous Goods Regulations that all oxygen

cylinders should be tested and examined within preceding 5

years by authorized bodies in Hong Kong and should be

stamped in specific manner as stipulated in the ordinance.

3. Under current restrictions, it is generally not recommended to

store more than two compressed oxygen cylinders at a resi-

dence.

4. Compressed oxygen cylinders must at all times be handled and

stored properly.

5. It is advisable to secure the cylinders properly to keep them

from falling or tipping over.

6. Cylinders should be stored with their valves closed and should

be protected from direct sunlight, open flames and elevated

temperature from the environment.

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7. Compressed oxygen cylinders should not be stored together

with other flammable items.

8. The users should be trained in the correct method on opera-

tion of the portable oxygen systems.

9. Do not handle oxygen cylinders or apparatus with hands or

gloves contaminated with grease or oil.

10. Do not use wax, cleaning sprays, polish or other lubricants

on the portable oxygen devices.

11. The users should also learn to inspect the cylinders to en-

sure it is free of cracks or leaks.

12. Cylinders which are dented, scratched, pitted or showing

any signs of discoloration, should be returned to vending

companies as soon as possible.