Medical oxygen may be provided from tanks, oxygen concentrators or liquid oxygen systems.
Oxygen tanks are metal tanks that store compressed oxygen and can be used in and out of the home.
The smaller the tank, the less oxygen it holds.
Your healthcare provider will recommend the right size tank for you based on how much extra oxygen your body needs.
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Large freestanding or stationary oxygen tanks
These are occasionally provided as a back-up for
people prescribed long-term oxygen therapy, in case
there is a problem with their concentrator or a lengthy
Portable oxygen tanks
These are smaller cylinders that can be used when leaving
the home. They can be wheeled, attached to a wheeled walker
or wheelchair or may be carried in a bag or backpack.
Oxygen tank / Cylinder system
- Inexpensive to buy
- Expensive to operate
- Needs year-round supply of cylinders
- Training and maintenance needed
- Can store oxygen
Tanks of oxygen are produced by a relatively expensive industrial process. An oxygen tank needs a special valve (regulator) to release the oxygen in a controlled way and a flow meter to control the flow.
Without a flow meter, the use of oxygen from tanks is very wasteful; without a regulator it is also extremely dangerous.
Not all oxygen tanks are the same; there are at least five different kinds of tank in use in different countries. A regulator will fit only one type of oxygen tank.
Oxygen tanks are appropriate for the:
delivery of continuous high flow or intermittent low flow of oxygen to patients who require <5 hours oxygen therapy per day
emergency back-up supply for patients using oxygen concentrators.
Precise information on the type of oxygen tank in use should be obtained from the local oxygen supplier before ordering regulators. This should be confirmed by someone with technical knowledge who works in the hospital, such as an anesthetist, chest physician or fully trained hospital technician.
An international standard exists for the identification of oxygen tanks, which specifies that they should be painted white. Unfortunately, the standard is widely ignored. Medical oxygen tanks originating in the USA are normally green, while those originating in Commonwealth countries are usually black with white shoulders.
Tanks of industrial oxygen should also be identified clearly, but this is not always the case.
How to use an oxygen tank
When your oxygen is delivered by the company, the supplier will show you how to begin the flow of oxygen and also turn it off.
To get started at home with a metal tank, attach the regulator or conserver if you use one.
Then attach your nasal cannula or face mask and turn on the oxygen to the prescribed flow rate. If you are using a conserver, you won’t feel oxygen flow out of the nasal cannula until it is connected and you take a breath.
Your tank will have an oxygen regulator that shows you how much oxygen is left in your tank.
Keep your eye on the regulator so you know when you are close to running out of oxygen.
Take care your equipment by washing your nasal cannula or face mask weekly with mild dish soap and warm water and let air dry. Clean them more frequently if you are sick. Be sure not to get water in the tubing and replace it if it is damaged. You can get replacement tubing from your oxygen supplier.
Safety precautions with use of oxygen tanks
- Store oxygen tanks in a cool, ventilated room.
- Do not cover tanks with cloth or plastic.
- When a cylinder is almost empty, close the valve and mark the cylinder as empty.
- Do not store full and empty tanks together.
- Handle tanks carefully to avoid dropping.
- Do not permit oxygen use near an open flame.
- Keep oxygen equipment and delivery point at least 3 metres from radiators or other heat sources.
- Do not permit smoking near oxygen equipment.
- Do not permit alcoholic solutions, oil or grease to come in contact with oxygen supply devices.
- Use the correct regulator and pressure gauge.
- Before connecting the regulator, open the cylinder momentarily, with the valve pointing away, to remove any dust which may be in the outlet.
- Check with the State Department of Transport regarding the transport of oxygen tanks in cars as the safety standards may vary from state to state, but always secure a cylinder carefully if transporting in a car to prevent it becoming a projectile or explosive device.
- If electrical appliances, e.g. electric blankets, are in use, ensure their regular maintenance.
Tips for oxygen users
Oxygen therapy can help. Some people with lung diseases do not get enough oxygen into their blood. Low levels of blood oxygen mean that vital organs are being deprived of oxygen and this can cause damage over time. Blood tests are used to confirm if this is the case. Home oxygen therapy can help those with confirmed low blood oxygen by ensuring enough oxygen gets to vital organs. In some cases, home oxygen therapy can also make everyday life easier and more enjoyable.
Regular medical reviews are vital. It is important to have your oxygen prescription checked by a respiratory specialist at least once a year. Or, if you feel your condition has changed, make an appointment to see your doctor earlier. Do not adjust your oxygen flow rate on your own.
Oxygen does not always relieve breathlessness. There are many reasons why people have trouble breathing. Home oxygen therapy may relieve shortness of breath for some people, but for many it does not. Sometimes you need a combination of therapies to help relieve breathlessness. Ask your doctor, respiratory nurse, or physiotherapist to fully explain the benefits you can expect from oxygen.
Oxygen is not addictive. Home oxygen therapy is not addictive, and it will not weaken your lungs. You will get maximum benefit by using oxygen for the amount of time prescribed by your doctor.
There is a range of oxygen equipment available. There are two main types of oxygen equipment. The most common is the oxygen concentrator which filters nitrogen out of the air to deliver almost pure oxygen. Gas tanks filled with oxygen are also widely used and come in a range of different sizes. The smaller tanks are light enough to take with you when leaving the house and often go by the name portable oxygen tanks.
Some oxygen equipment is funded. Many home oxygen users will qualify for government funded equipment. However, qualifying rules are different in every state. If you need extra equipment, you can purchase or hire it direct from an oxygen supplier. Ask your doctor or a member of your healthcare team for help in working out the equipment that is best for you.
Oxygen is safe to use but can make things burn more intensely. Do not put yourself or your oxygen equipment near any sources of extreme heat, flames, or devices which could cause a spark, including a lit cigarette or e-cigarette. A study in the US has shown that smoking is by far the largest cause of serious burns in people using home oxygen.
Avoid smoking and being around smokers. Cigarette smoke is very damaging to the lungs. Quitting smoking is the single most effective thing you can do to help your condition. It is also important to avoid other people’s cigarette smoke.
Plan what to do in an emergency, such as a power blackout. The most important thing to remember is to try to remain calm and not panic. Although losing power will be annoying, most oxygen users (even those on oxygen for 18 hours a day or more) are safe without their oxygen supply for many hours if they rest. Call an ambulance if you need urgent assistance.
Tips for Leaving home with an oxygen tank
Continue with everyday life.
Although it may take a while to get used to your oxygen equipment, try to continue with your normal routines as much as possible.
Many people do not need to use their oxygen during trips outside the home.
For those who do, feelings of self-consciousness about using oxygen equipment in public are usually short lived.
Once your confidence improves, the benefits should start to outweigh any downsides.
Keeping active is good for your health. Regular physical activity is very important for those
with lung disease to help you perform activities of daily living more easily. Activity does not need to be strenuous.
Good activities include walking the dog, an outing, or even just doing jobs around the house.
A pulmonary rehabilitation program can also teach you how to exercise more easily.
Traveling with oxygen equipment is possible and requires planning. Some of the things to check before booking a trip are: how to correctly transport your equipment, whether you can use your portable oxygen during the journey, and how to arrange an oxygen supply at your destination. You may also need a letter from your doctor stating that you are fit to travel.
- Don’t be too ambitious about your outings until you gain confidence.
- Mentally walk yourself through every aspect of your outing so you can think through
any potential problems before they arise. Think about where you are going to park the
car, whether there are stairs to climb or a lift nearby, and if you can take your wheelchair
or walker with you.
- Work out how long a portable tank may last for, so you know how many to take
with you. To do this, monitor your usage closely for a while.
- Take note of how many
minutes a typical tank is lasting and then average out the results.
- Take a spare battery for your OCD if it is battery-run.
- Toolkit. If you are taking out more than one tank, take with you the correct tools
you need to attach the flow regulator or the conserving device to the full tank and
the valve handle to turn the tank on and off.
- Trial it at home. Practice using your equipment and changing tanks at home first.
- If you are taking out more than one tank, take with you
the correct tools you need to attach the flow regulator or the
conserving device to the full tank and the valve handle
to turn the tank on and off.
Traveling with an oxygen tank
Transporting portable tanks
Ask your supplier for instructions on how to safely transport your oxygen tanks.
Check with the airline or travel provider to ensure they will allow your tank/s on
board as luggage.
Alternatively, arrange to hire tanks at your destination.
Portable tanks should not be taken overseas, as other countries may not be able to
Try to avoid places that cannot provide smoke free restaurants and accommodation.
Check that your accommodation provider will allow oxygen cylinders to be delivered
and stored on their premises.
Check access to the room. Do you need to climb flights of stairs to get there, or
there is a lift
Many airlines do not allow you to take your own portable oxygen tanks on board.
Instead, you may need to hire an aircraft approved oxygen tank or arrange in-flight
oxygen through the airline. These arrangements can take time.
If you are using the airline’s own in-flight oxygen equipment, they may not allow you to
take it off the plane. So, if you have a stop-over on your journey, you will probably need
to arrange a different oxygen supply for the time you spend on the ground in between
flights. Direct routes are easier for this reason.
Oxygen Tank Equipment funding
Step 1: Your doctor will assess you to determine if you will benefit from
Step 2: Your doctor will write a prescription for your oxygen needs. This is usually in the
form of an application to one of the subsidised programs.
The subsidy of home oxygen equipment varies widely from state to state, so the
support you may be entitled to receive will depend on where you live.
There are several subsidy options that may be available to you.
- State government funding. Each state uses different criteria to decide who is eligible to
receive an oxygen equipment subsidy. In some states there is a central organisation that
manages subsidies and in other states these subsidies are run through local health
services or hospital boards.
- Federal government funding. The Department of Veterans’ Affairs and the Commonwealth
Department of Health also provide funded oxygen equipment under certain conditions
for war veterans and people in residential aged care facilities.
- Private health insurance. Some insurers provide subsidies for oxygen equipment.
- Palliative care. Some states fund oxygen equipment for patients who qualify under
palliative care criteria.
In most cases, your healthcare team will help you work through your funding options and
the equipment you may need. But, if this does not occur, ask for assistance from the doctor
who prescribed your oxygen or your local community health service.
Step 3: If you do qualify for funding, ask about the equipment you will receive.
Most states will provide a subsidized home concentrator to those on long-term oxygen.
Some will also provide a back-up oxygen tank in case the concentrator fails or there
is a lengthy power blackout or another form of emergency.
Some states also provide a limited number of portable oxygen tanks to use when
outside the home.
Oxygen Tank vs Oxygen Concentrator
In practice, there are two possible sources of oxygen for medical purposes:
Cylinders: derived from liquid oxygen
Concentrators: which separate oxygen from air.
Oxygen Concentrator system
- More expensive to buy
- Inexpensive to operate
- Needs only electricity
- Training and maintenance needed
- Cannot store oxygen, it provides oxygen only when
power supply is on.
In many places, oxygen concentrators are the most suitable and economical way of providing
oxygen, with backup cylinders in case of electricity failure.
Oxygen tanks can be used to supply oxygen during power cuts and concentrators cannot.
Without electricity, the flow of oxygen from a concentrator will stop within a few minutes.
The ideal oxygen supply system is one based primarily on concentrators, but with a back-up supply from
cylinders. If you use a home concentrator, your supplier might also provide you with a large “back-up” metal tank that can last 24 hours, should the power go out.
The need for oxygen
Oxygen is necessary to provide energy, not only for the metabolism of food, but also for all cellular activity. It is always indicated when patients experience acute hypoxemia to prevent death or irreversible brain damage, while efforts are made to reverse the cause of the hypoxemia
Home oxygen therapy should be prescribed only for patients with symptoms and signs of chronic hypoxemia. The patients should be thoroughly assessed and reversible factors treated. Objective evidence of hypoxemia at rest and its increase on exertion and at night is readily obtained. If a patient requires oxygen therapy for more than 4 hours a day at a flow rate of 2 L/minute (1 x E size cylinder a week), a concentrator rather than a cylinder should be prescribed. Patients and families should be instructed in the care and maintenance of the equipment, and the precautions to take when using oxygen. Home oxygen therapy is expensive, but correctly used, it can add quality, as well as years, to life.
Oxygen is a medicine. Just as you would
not adjust the dose of your tablets without
consulting with your doctor you should not
adjust your oxygen flow rate on your own.
The main aim of home oxygen therapy is to try to improve your quality of life. Many people
have reported feeling self-conscious about using oxygen equipment in public. Most of these
people also found, however, that these feelings were short-lived. Once they gained some
confidence, they found the benefits of oxygen therapy started to outweigh any downsides.
Here are some tips from oxygen users on ways to stay positive.
“Focus on what you can do with your oxygen equipment, rather than what you cannot.”
“As your circumstances change, go with the flow, rather than looking back to how life
used to be.”
“If you are on oxygen more than 18 hours a day, concentrate on the time you have off
oxygen each day and plan it carefully. Use the oxygen overnight so that you can have
up to 6 hours during the day when you do not need to use it.”
“Continue the everyday activities you enjoy as much as possible.”
“If you have been prescribed portable oxygen equipment, the sooner you leave the
house using it the sooner you will become used to it. Feeling self-conscious about your
oxygen equipment is normal, but don’t let it get in the way of enjoying life.”
“Use humor as a tool to cope with any reaction you get to your equipment. This is
particularly effective with kids. Some people even dress up their cylinders.”
“Join a support group and meet new people in the same situation as you.”