Supplemental Oxygen
Our tissues are nourished and kept alive by the oxygen we breathe. For patients with cardiac and pulmonary conditions that hinder oxygen delivery, supplemental oxygen improves endurance and cognition and makes breathing easier.
Q: Do I need a prescription to buy an Oxygen Concentrator?
A: Supplemental oxygen is a drug and requires a prescription.
Patients needing supplemental oxygen at home require the following:
- An oxygen source (oxygen concentrator, tank, or canister of liquid oxygen)
- An oxygen delivery device, such as a nasal cannula
- A humidification source
- A pulse oximeter
- Back up equipment
The Oxygen Source
Most people requiring supplemental oxygen at home need a supply of bottled oxygen (e.g., tanks or liquid canisters) and a device called an oxygen concentrator.
When using tanks and liquid canisters, patients and caregivers must monitor them so that they are exchanged before they empty. Tanks and canisters may leak and use up gas more rapidly than expected.
Oxygen concentrators are little oxygen factories that distill oxygen from the air. With an oxygen concentrator, you don’t have to worry about the tank running dry or when the next tank delivery is scheduled.
Oxygen concentrators suck in air from the room, push it through filters that isolate the oxygen, and then return just the oxygen to the patient.
Stationary oxygen concentrators process air about ten times faster than portable oxygen concentrators. All oxygen concentrators require electricity.
When setting up an oxygen concentrator at home:
- Choose a flat surface and a location where it is not likely to get knocked over or tripped on.
- Locate the concentrator near an electrical outlet.
- Position the concentrator so that the entrainment ports are not at all occluded.
Concentrators deliver oxygen that is about 85%-95% pure. Oxygen delivered in the hospital or by a tank is close to 100% pure. When using a concentrator, patients may need a slightly higher flow from a concentrator than they need from an oxygen tank or used in the hospital.
Getting Oxygen to the User
Supplemental oxygen is delivered to the patient through a nasal cannula or a mask via tubing attached to the concentrator or tank. Nasal cannulas come in a variety of lengths. The Sunset Healthcare Nasal Cannula, for example, is available in 7-foot, 15-foot, and 25-foot lengths.
Consider keeping nasal cannulas of various sizes on hand. A 7-foot cannula may be perfect for car trips, while a 25-foot cannula may be ideal at home. Extension tubing such as this 25-foot set from Sunset can give you even more mobility.
Q: Can I use a nasal CPAP mask instead of an oxygen nasal cannula?
A: No. CPAP masks are not designed for use just with oxygen concentrators. CPAP masks are designed so that people would not breathe in their own CO2, and the flow of oxygen is not enough to release the CO2 from the CPAP mask. So, you need a CPAP machine to help release the CO2.
A CPAP mask does not have a safe or big enough exhalation port. And there is no place to hook your oxygen tubing to the CPAP mask without an oxygen enrichment adapter.
That said, supplementary oxygen can be bled into a CPAP or BiPAP machine with a small adapter, such as CPAP Oxygen Enrichment Adapter, placed between the gas outlet on the CPAP machine and the CPAP circuit.
Cannulas and CPAP oxygen adapters are compatible with oxygen concentrators and oxygen tanks.
Pro Tip: When using long lengths of tubing, it may be necessary to increase the flow rate of the oxygen from the tank or concentrator.
Humidify
Oxygen from tanks or concentrators is much drier than the air we breathe. That is because the air around us contains water vapor. Oxygen therapy may cause nasal dryness and nose irritation. Some people develop nosebleeds from dry gas.
Fortunately, humidifying oxygen is simple! A humidifier bottle screws onto the gas outlet on a tank or concentrator. Oxygen passes through the humidifier, picks up water vapor, and continues on through the oxygen tubing to the patient.
- Always use sterile or distilled water in humidifiers
- Never use tap water
- Clean the humidifier bottle daily
Making the Connections
Tanks and concentrators both have a flow meter and an oxygen outlet port.
- Fill the humidifier with sterile or distilled water.
- Screw the humidifier bottle onto the oxygen outlet port.
- Turn on the flow meter.
- Observe bubbles in the humidifier — the bubbles are an indicator that the gas is flowing as expected.
- Connect the nasal cannula, mask tubing, or extension tubing to the port on the humidifier.
- If using extension tubing, connect the nasal cannula or mask tubing to the extension tubing.
- Place the cannula or mask on the user.
Q: How do I plug an O2 tank into the CPAP?
A: If you wish to add oxygen to CPAP or BiPAP, here is an instructional video we’ve prepared for you:
When adding oxygen to CPAP or BiPAP, it is not necessary to humidify the oxygen if you are already humidifying the CPAP or BiPAP.
- Place the oxygen adaptor at the gas outlet on the CPAP/BiPAP machine.
- Connect the circuit to the adaptor.
- Connect one end of the oxygen tubing to the oxygen concentrator’s outlet port.
- Connect the other end of the oxygen tubing to the oxygen adaptor.
- Turn on the oxygen flow from the concentrator.
- Put on the CPAP mask.
Alternatively, you can place the oxygen adaptor between the circuit and the mask. This configuration can be beneficial if someone has a particularly high oxygen need as it puts the oxygen closer to the face.
Best safety practices:
- Use a pulse oximeter to monitor oxygen efficacy
- Have a backup oxygen source in case of power outages or malfunctions
- Keep spare cannulas, masks, and tubing on hand in case of breakage
Did you know you could rent an oxygen concentrator?