Why do people need Oxygen?Oxygen is used for patients who cannot keep their oxygen levels in their blood elevated. Oxygen therapy decreases the work of breathing, and decreases the work of the heart. These patients are usually short of breath (S.O.B.), may have difficulty performing daily activities and chores, and/ or may have a bluish tinge to their lips or nail beds. They may also fatigue easily.
How do you know if you need oxygen?The determination to put a patient on oxygen or not, is made by the patient's doctor, the hospital, the nurse or the respiratory therapist who cares for them at home or in a laboratory. We determine if a patient needs oxygen by testing them in one of two ways:
1.) Arterial Blood Gas (ABG): this is an "invasive" procedure where a needle is inserted into the patient's artery at either the wrist or the front side of the elbow. This is not done in the homecare setting.
2.) Saturation Test (SAT): this is a "non-invasive" procedure, which involves putting a small clip onto one of the patient's fingers and seeing how much oxygen is "saturated" in the blood. It is read as a percentage. Any patient who has a SAT of 88% or less is a candidate for oxygen.
Respiratory Assessments: This service is provided by Sunshine’s Respiratory Therapists for patients whose physician indicates concerns regarding the patient’s respiratory status. Patients may request their physician to order a respiratory assessment. If a patient wants their oxygen levels checked at the time of the assessment the doctor would fax Sunshine to do either a complimentary oximtery or to a qualifying oximetry through an IDTF, Independent Diagnostic Testing Facility. For more information on IDTF’s please visit: http://www.dmt-idtf.com/index.html. Any patient may choose to purchase their own finger oximeter, we sell them retail. These are not used to qualify a patient for oxygen, but rather as “spot checks.”
Is it True that if I use my oxygen too much, I will become addicted to it?There is no evidence that if a person uses oxygen that their bodies will become addicted to oxygen. Using oxygen as prescribed will stabilize the person’s condition and may actually prevent further health issues that may arise to insufficient oxygen in the body.
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 Oxygen Concentrators.These units are made to be used in the home. They plug into a three-prong outlet in the patient's home and make their own oxygen while they are running. This gives the patient an indefinite supply of oxygen. These units are equipped with alarms that will sound if the "purity" of the oxygen produced by these machines is less than 85% and they will also alarm when the machine requires maintenance or if there is a power failure.
Self-Filling Oxygen Systems.These units are a combination of an oxygen concentrator and a separate piece that fills gas cylinders at home. These are very efficient systems that allow patients to be extremely independent. Patients on these systems have to be able to tolerate a "conserver" or "conserving device."
 Portable Oxygen Concentrators.Smaller versions of standard concentrators. Used for patients with and extremely active lifestyle. Since airlines are no longer allowing passengers to carry their own gas cylinders or tanks on the airplanes, these systems are great for travelers. Please call us 14 days prior to airline travel to make arrangements for you flight.
 Gas Cylinders/ Gas Tanks.These aluminum cylinders are painted "green", which is the universal color for medical oxygen cylinders. Gas cylinders come in many different sizes, but the most common sizes you will see in the home are:
E-cylinders: large, pulled by cart by the patient or used in home as "emergency" oxygen source if there is a power failure.
M-6 cylinders: small, 4 pound cylinder usually used with a "conserver" or "conserving device", used by active patients for portability.
 What is a Conserving Device?Oxygen is delivered to a patient in what is usually called "continuous flow." This means that whether or not the patient is inhaling or exhaling, the flow of oxygen is "continuously" entering the body. With a "conserver", a patient will only get a flow of oxygen when they inhale, but now when they exhale. For patients who want to remain active outside the home, this is the best way to go. HOWEVER . . . a patient has to be tested via "pulse oximeter" to determine if the patients SAT remains above 90% while on the conserver. This order needs to be written by the patient's doctor. Conservers are: lightweight and last much longer than standard continuous flow oxygen cylinders. The "conserving device" is not the cylinder itself, but the "regulator" that attaches to the top of the cylinder. The regulator controls the flow and amount of oxygen that comes out of the cylinder.
Delivery Devices.Oxygen can be delivered to the patient by either a "nasal cannula" which is clear tubing with prongs that are inserted in the nostrils, or by a "mask", which is a vinyl mask that fits over the patient's nose and mouth. Masks can only be used if the patient is on 5 liters/min (LPM or L/M) or higher. Liter flows for patients are determined by the doctor.
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Overall, oxygen therapy is extremely safe to use in the home. It has been routinely used for decades in the home care setting with little incident. Our objective is to give the best care to our patients in their home and we respect and value your input to achieve this goal.
Below are tips to keep yourself safe:
Oxygen is not in itself combustible; however, it will accelerate a flame and make a fire burn hotter.
* Oxygen should not be used within 5 feet of an open flame.
* (Examples: candles, fireplace, wood burning stove, gas stove, cigarettes, lighters, etc.)
* Patients should never smoke while on oxygen. If a patient must smoke, they need to remove the oxygen source from their face and be without oxygen for at least 30 minutes before lighting up. Even though the oxygen may be off the face or turned off, the body and clothing can remain "oxygen rich" for up to 30 minutes!
* Oxygen signage should be posted on entry and exit doors of the oxygen patient's home. This is to alert anyone who enters that there is oxygen being used in the home, but more importantly, it is to alert the fire department, in the event of a fire, that oxygen is in use.
* Oxygen cylinders should be stored lying on their sides in a secure place (under a bed, etc.) or in a cart that cannot easily fall over. You must be careful when handling oxygen cylinders that you do not drop them, especially on their "stem." The gas in these cylinders is under pressure and can become projectiles if they are dropped and broken!
Maintenance
Nasal cannulas or masks are disposable items and need to be changed every other week or if they become soiled. Sunshine will provide the patient with enough supplies to make this possible. These supplies are at no extra charge to the patient.
* If a patient complains of "dryness" while on oxygen, call us or the doctor's office. A humidification bottle (sometimes referred to as a "bubble bottle") can be attached to the oxygen source. Oxygen is dry, colorless and odorless.
* Patients can have up to 50 feet of tubing attached to the oxygen source for moving around the house. No more than 50 feet can be hooked up.
* Oxygen sources (concentrator, self-fill unit, portable oxygen concentrators) require periodic maintenance from the manufacturer or Sunshine (we will keep track of the maintenance schedule.) The patient or caregiver only needs to clean the filters on the concentrator once per week in plain water and wipe down the unit with a damp rag to remove dust. Do not spray the oxygen source with chemical cleaners.
* Additional oxygen cylinders to replace empties are delivered by Sunshine when a patient needs them. Self-fill cylinders are filled as needed by the patient from their system.
Miscellaneous Supplies for Oxygen patients:
* Humidifier Bottle: for humidifying the oxygen coming into the patient. These bottles need to be filled with Distilled water and need to be emptied and cleaned each week or the patient can risk infection from a "water-born" illness.
* Carry Bags: for portables - there are various types of bags to make it easier for patients to carry their portable oxygen. Some bags are for over the shoulder, some can be used as waist pouches, and some can be used as a back pack. Ask us and we'll be happy to supply the appropriate bag for the patient's lifestyle.
Transporting Oxygen Safely in a Car
When traveling with an oxygen system in an automobile, remember:
* No smoking or open flames in the car.
* Secure tanks so that they cannot be easily moved. If a tank valve is bumped, the valve can be inadvertently opened releasing a large amount of oxygen rapidly
* Do not store oxygen tanks in an area of the car where temperature will exceed 120 degrees Fahrenheit. Leave the windows open a crack to allow for some ventilation if tanks must be left for an extended period of time during warm weather.
* Do not carry tanks in the trunk of a car. (To prevent damage to the tanks in a rear-end accident.)
* It is a good idea to carry an extra tank with you when traveling, just in case your trip takes longer than expected.
Patients Traveling with Oxygen
When you provide us with timely advance notice, we will help you make arrangements for oxygen services with one of our other nationwide affiliations. In order to allow us adequate time to make plans, please notify us by calling us at least 14 days before your travel begins; longer is even better.
If you are traveling with oxygen cylinders and other oxygen equipment provided by our company, the equipment and cylinders cannot be exchanged for equipment or cylinders from a non-Sunshine Pharmacy and Medical company. If we do not have allocation near your travel destination, we will assist you in finding another company. With your authorization, information regarding your treatment or payment will be given to the interim provider that relates to the equipment and services you will need at your destination. Depending on your insurance plan, you may be responsible for full or partial payment for your traveling oxygen services.
Sunshine Pharmacy and Medical can make your travel plans easier. Please contact us 7 days ahead of your scheduled departure and let us know what your needs will be. Sunshine Pharmacy carries the most extensive and cutting edge portable oxygen concentrators in the world. We have the ability to rent these items for periods of time ranging from 7 days to 7 months. Just give us a call and we’ll be happy to help you.
While it is possible to continue traveling while on oxygen, planning ahead is the key. Failure to make these arrangements in advance may lead to problems with getting oxygen while traveling.
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