Home oxygen therapy

How home oxygen therapy can help

If you have a health condition that causes low levels of oxygen in your blood, you may feel breathless and tired, particularly after walking or coughing. Fluid may also build up around your ankles.

Breathing air with oxygen increases the amount of oxygen in your blood.

This makes it easier to carry out activities that might otherwise be difficult, and helps reduce your symptoms.

Oxygen therapy also helps prevent damage to the heart and brain, which can be caused by low levels of oxygen in the blood. 

It can help people with a range of health conditions, such as:

• chronic obstructive pulmonary disease (COPD)
• pulmonary fibrosis
• heart failure
• obesity-related hypoventilation
• severe long-term asthma
• pulmonary hypertension
• conditions affecting the nerves and muscles or ribcage
• cystic fibrosis

People who have oxygen therapy have different requirements. For example, you may only need oxygen for short periods during the day when you're walking about (ambulatory oxygen), or you may need it for longer periods during the day and night.

When oxygen therapy shouldn't be used

Oxygen therapy shouldn't be used to relieve breathlessness if your oxygen levels are normal.

This is because it can decrease your fitness level and cause a delay in finding out what's making you breathless.

Oxygen therapy assessment

If you have a long-term condition and your doctor thinks oxygen therapy might be helpful, you'll be asked to visit your nearest oxygen clinic for an assessment.

The amount of oxygen in your blood will be measured by taking a blood sample from your earlobe or wrist, or by attaching a sensor to your finger (a pulse oximetry test).

You may also be asked to breathe into a device called a spirometer during a lung function test. Regular oxygen treatment may be recommended if your blood oxygen level is low.

If you decide to have oxygen treatment at home, a healthcare professional at the clinic will help you work out how much oxygen you'll need and for how long. They'll also discuss the different ways you can take it.

Once you've agreed this with the clinic, they'll complete a home oxygen order form for you. It's similar to a prescription, and gets sent to the company delivering your oxygen and equipment.

You'll be asked to fill in a consent form, plus a form that asks a number of safety-related questions, such as whether you've had any falls recently. The forms are needed to make sure oxygen is installed in your home in the safest way possible. 

The oxygen clinician will need to share some information about your requirements with the NHS and other key organisations, including the home oxygen supplier, your local fire and rescue service, and your electricity provider.

An engineer will visit your home to install the equipment, check that it's working properly, and explain how to use it. They'll also carry out a risk assessment and provide you with other important information, such as how to order oxygen refills.

Large oxygen cylinders

Oxygen cylinders will probably be prescribed if you only need oxygen for short periods to relieve attacks of breathlessness after an illness.

Oxygen is breathed in through a face mask or soft tube inserted into your nose (nasal cannula). You can talk, eat and drink while using a nasal cannula.

The use of oxygen cylinders should be regularly reviewed, and treatment should be stopped if your blood oxygen levels have returned to normal.

Oxygen concentrator machine

An oxygen concentrator machine is suitable if you'd benefit from having oxygen for many hours a day, including while you're asleep. It ensures you have a source of oxygen that never runs out.

The machine is about 75cm (2.5 feet) high and plugs into an electrical socket. It filters oxygen from the air in the room and delivers it through plastic tubes to a mask or nasal cannula.

Long tubing can be fixed around the floor or skirting board of your house, with two points where you can "plug in" to the oxygen supply. When the machine is installed, the engineer or nurse will discuss the length of tubing needed. 

The machine is very quiet and compact. The engineer will explain how to use it and answer any questions you have.

A back-up oxygen cylinder will be provided in case there's a problem with the oxygen machine or there's a power cut. Regular maintenance checks will also be carried out to ensure the concentrator is always working properly.

Portable (ambulatory) oxygen

It may be possible to use a small, portable oxygen cylinder outside your home. This is called portable oxygen or ambulatory oxygen.

You'll need to be assessed to see whether you're able to use portable oxygen and whether it's likely to be beneficial.

Portable cylinders can deliver oxygen at a wide range of flow rates. Your oxygen healthcare professional will be able to advise you about the flow of oxygen you need. Regulators or conserving devices can be fitted to your cylinder so it lasts longer.

When full, portable oxygen cylinders weigh just over 2.3kg (5lbs) and hold just under two hours of oxygen (at a rate of 2 litres a minute).

Going on holiday

As long as you're well enough to travel and you plan in advance, you should be able to go on holiday while using oxygen.

Speak to staff at your local oxygen clinic as soon as possible if you're thinking about going on holiday, particularly if you want to go abroad.

They can advise you about what you need to do to stay safe while you're away. For example, you'll need to take your usual medication and a copy of your home oxygen order form.

Before travelling, you should tell the travel company that you use oxygen as they may need to make certain arrangements in advance. Travel insurance is essential.

If you're going on holiday in the UK, talk to your oxygen supplier to see whether it's possible for oxygen to be delivered to your destination. Try to give them as much notice as possible.

The British Lung Foundation website has more information and advice about going on holiday with a lung condition. You can also read more about what you need to consider before you travel.

Safety advice

Oxygen is a fire hazard, so you need to take precautions if you're using oxygen at home.

For example:

• never let anyone smoke while you're using oxygen
• keep oxygen at least six feet away from flames or heat sources, such as gas cookers and gas heaters
• don't use flammable liquids, such as cleaning fluid, paint thinner or aerosols, while using oxygen
• don't use oil-based emollients, such as Vaseline, when using oxygen
• install fire alarms and smoke detectors in your home and make sure they're working
• inform your local fire brigade that you have oxygen at home
• keep oxygen cylinders upright to prevent them being damaged

Home oxygen suppliers

There are four companies in England that provide home oxygen services for the NHS. Each covers a certain geographical area.

Your oxygen treatment clinic will organise your oxygen supply from one of the suppliers below:

• Air Liquide :
  • 0808 143 9991 for London
  • 0808 143 9992 for north west
  • 0808 143 9993 for East Midlands
  • 0808 143 9999 for south west
• Baywater Healthcare : covers Yorkshire and Humberside, West Midlands and Wales (0800 373 580)
• BOC : covers the east and north east of England and Northern Ireland (0800 136 603)
• Dolby Vivisol : covers the south of England (0800 917 9840)