COPD Oxygen

COPD is the acronym for Chronic obstructive pulmonary disease.

COPD is a common, preventable, and treatable chronic lung disease which affects men and women worldwide.

Abnormalities in the small airways of the lungs lead to limitation of airflow in and out of the lungs. Several processes cause the airways to become narrow. There may be destruction of parts of the lung, mucus blocking the airways, and inflammation and swelling of the airway lining.

COPD is sometimes called “emphysema” or “chronic bronchitis”. Emphysema usually refers to destruction of the tiny air sacs at the end of the airways in the lungs. Chronic bronchitis refers to a chronic cough with the production of phlegm resulting from inflammation in the airways.

COPD and asthma share common symptoms (cough, wheeze, and difficulty breathing) and people may have both conditions.

Long-term use of supplemental oxygen improves survival in patients with COPD and severe resting hypoxemia.

Long-term oxygen therapy (LTOT) increases survival and improves the quality of life of hypoxemic patients with chronic obstructive pulmonary disease (COPD) and is often prescribed for patients with other hypoxemic chronic lung disease.

How oxygen can help COPD

Home oxygen is not a cure for COPD. It’s not right for everyone and is only needed for a small number of people with COPD. But for
the COPD patients who need it, oxygen is a very good treatment.
Home oxygen is used the same way as your medication – it is prescribed by your doctor if the level of oxygen in your blood is low.

If used properly, oxygen helps you:
• live longer
• have less shortness of breath
• exercise more easily, which keeps you fit

When you go on oxygen therapy because of COPD, there are several ways that supplemental oxygen may be supplied:

Oxygen comes in different kinds of systems.
Your respiratory therapist and oxygen company can help you choose the one that is right for your routine and your budget.
With all the systems, you will need a tube delivering oxygen into your nose, called “Nasal prongs”.

Oxygen Tubes: You’ll likely start with what’s called a nasal cannula. This is a device that includes two small tubes that fit in your nostrils and a longer air tube attached to an oxygen tank. This is the most common oxygen therapy approach.

Oxygen Facemask: A facemask that covers the nose and mouth is for people who need much more oxygen or have trouble using the nasal tubes.

Home oxygen concentrator

An oxygen concentrator is a special machine
that “makes” oxygen. It takes oxygen from
the air and concentrates it (makes it
stronger).
If you have a home oxygen concentrator, you
need a backup oxygen supply (for example,
a compressed oxygen tank). If the electricity
cuts out, the oxygen concentrator won’t work.
• You need to plug it into the wall (it requires
electricity at all times).
• You will still need portable tanks to use
when you leave home.
• You need to keep the concentrator in an
open space.

Portable oxygen concentrators (POCs)

These are like home oxygen concentrators,
but they’re smaller and easy to carry.
Portable oxygen concentrators:
• are lightweight
(about 5 to 10 pounds/2 to 4 kg)
• operate on batteries
• can plug into a car lighter electrical outlet
• are available to rent, for example for trips
• are expensive to own
• need extra testing make sure you are
getting enough oxygen

Liquid oxygen

Liquid oxygen is oxygen in liquid state. It is
then poured into tanks.
• You need regular delivery.
• The home bulk system can hold a lot of
oxygen.
• Liquid cylinders are portable and lightweight.
• You can refill the cylinders at home from
the bulk system, then go out.
• The oxygen is not at high pressure.
• You need to follow safety instructions
when filling the portable unit.

Compressed oxygen cylinders

Oxygen is squeezed into a tank at high
pressure. The company delivers tanks to your
home.
• The oxygen tanks are not very portable
• The oxygen tanks are heavy and bulky –
you can’t easily walk around with them.
• You need somewhere to store them.
• You need fresh tanks delivered often.

COPD oxygen therapy supply guidelines 

Check Your Oxygen Supply
Before you check your oxygen supply, wash your hands. You need to make sure that your hands are not contaminated with any germs that could lead to infection if they got into your oxygen therapy machine.

Next, pressurize the oxygen tank or turn on your concentrator (the instructions to follow at this point will be given by the medical supply company or your doctor).

Then, check the gauge on your device to determine how much oxygen you have left and when you will need to get more.

If you have a humidifier bottle, check the water levels. If it is below half full, refill it with distilled water. Ask your medical provider how to clean and refill the bottle to ensure that no germs get inside of it.

Attach the Tubing
If you are getting oxygen through a nasal cannula, attach it to the unit and make sure that the tub is not bent or blocked in any way. This will ensure that all the oxygen that you need gets through the tube and into your lungs.

Set the Flow Rate
The flow rate that you need will be highly personalized. Speak with your doctor about your needs before you set up your oxygen equipment.

When you’re ready, you can set the rate on the machine. Usually, you will only have to set it once when you are setting up the equipment. The rate does not have to be adjusted unless your doctor tells you to.

Putting the Cannula in Your Nose
Wash your hands again before you put the cannula in your nose. Keeping your hands clean will help prevent any germs from getting into your nasal passages or the tubes.

Once you secure the cannula, you will be able to feel the oxygen as you breathe. If you are not able to feel it, put the cannula in a glass of water. If there are bubbles in the water, it means that the oxygen is flowing, and the cannula is working as it should.

Cleaning your Equipment
Avoiding infection is important for people using oxygen therapy for COPD. Each piece of equipment that is part of your oxygen therapy needs to be cleaned regularly to keep it safe for you to use. Here is an overview of how often you need to clean each part.

Your cannula, air filter, and equipment need to be cleaned once a week.
The humidifier bottle should be washed with soap and warm water every time that you refill it.
Replace your cannula every two to four weeks.
The air filter should be replaced every month, and the tubing should be replaced every two months.
Your concentrator needs to be serviced by your oxygen supply company.

Possible Complications because of oxygen therapy

The biggest concern with oxygen therapy is the chance of fire.

If you’re on oxygen therapy at home or you take a portable tank outside:

  • Stay at least 5 feet from an open flame.
  • Don’t smoke or be near a smoker.
  • Try not to take your oxygen tank into a confined space.

 

There are also some side effects when you get oxygen therapy:

  • The skin around the facemask or nasal cannula can get irritated.
  • The inside of your nose might become dry.
  • You may get nosebleeds occasionally.
  • In the morning, you may wake up tired or with a headache.

In some cases, you can avoid these side effects. Check with your doctor first. The equipment may need to be changed if you’re having problems. If skin dryness is the problem, a humidifier in your room can help.

Chronic Obstructive Pulmonary Disease (COPD) and Travel

Checklist before you travel

  • Did you notify your doctor? If you’ve been in the hospital recently, check with your doctor for clearance before traveling.
  • Did you obtain the necessary paperwork to travel? (You might need a letter from your healthcare provider that verifies all of your medications, including oxygen.)
  • Do you have a copy of your oxygen prescription? Carry the prescription with you. You will need to show the prescription to travel personnel.
  • Do you have the name and phone number of the following healthcare professionals with you: your doctor, your respiratory therapist, your oxygen supplier, and home healthcare company representative (if applicable)?
  • Do you have enough medication with you? Remember to pack all medication and supplies in your carry-on luggage. Also always keep a list of current medications with you.
  • Are you wearing your emergency medical identification? 

Additional tips for travelers on oxygen therapy

Call your home healthcare company and tell them where you’re going and how you’re getting there. They can help you arrange for oxygen when you arrive.
Learn how to use your portable oxygen system and know how long the oxygen will last. Check ahead to see if you need oxygen refills to complete your trip.
Contact the travel carrier (airline, cruise ship, bus) when making your reservations to obtain information about your oxygen needs. There may be a fee related to oxygen use.
Personal portable oxygen concentrators can be taken aboard many airlines; check in advance to see if your air carrier allows this. Advance notice will be required.
If you have any questions, ask your healthcare provider(s).
Using oxygen doesn’t mean you can’t travel, but it does mean you have to plan.

Supplemental Oxygen for COPD - Freaquently Asked Questions

Does everyone with COPD need
supplemental oxygen?
No. Only people who regularly have a low
level of oxygen in their blood need
supplemental oxygen. A low oxygen level
is called hypoxemia.

How will I know if I need oxygen?
A test will be done to measure saturation
levels, the amount of oxygen in your blood.
If you have low oxygen levels your doctor
may prescribe oxygen. If you do not have low
oxygen levels, your doctor will not prescribe
oxygen because it will not help you.

How many hours a day do people use
home oxygen?
Some people use oxygen all day and night,
continuously. People who need to use
continuous oxygen should use it for at least
15 hours or more a day.
Some people only need oxygen at night,
while they sleep (nocturnal oxygen).
Some people only need oxygen while they
exercise or do any physical activity
(Exertional oxygen).

If I am on continuous oxygen, do I always
need the same dose (flow rate)?
No. You may need a higher dose of oxygen
(a higher flow rate) when you’re exercising or
sleeping. That’s because your natural oxygen
level may drop during exercise or sleep. You
may need a higher oxygen flow rate when
you are eating, getting dressed, doing
household chores as these activities makes
you spend more energy.

 

Is it okay to take more or less oxygen
than my doctor prescribed for COPD?

No. Follow the prescription exactly. Your
doctor or health care provider will talk with
you about if and when you should change
the flow rate. Extra oxygen could be harmful.
If you do not feel well on the amount of
oxygen you are currently using, please see
your doctor for a checkup.

Does being on oxygen mean I’m about to die?

No. Many people are on oxygen for years.
It helps them live longer.

What happens if I don’t use oxygen for as
long as I’m supposed to?

Your body can’t store oxygen. When you
don’t use oxygen, you miss out on the
benefits it gives you.

If I start using oxygen, will I need it forever?

No, not necessarily. Some people take oxygen
long term. But other people only need it for a
few weeks as they recover from a COPD flare up. Flare-ups are times when your symptoms
get really bad, for example if you get
pneumonia, or a common cold. If oxygen is
prescribed by your doctor when you are
otherwise well you may need to use it forever.