Home oxygen therapy is a serious medical treatment designed for individuals experiencing hypoxemia, or abnormally low levels of oxygen in the blood. This therapy is a prescribed drug intended to increase the oxygen saturation in the patient’s bloodstream. Establishing a home oxygen supply requires careful planning and coordination with healthcare providers to ensure equipment is available for use in an emergency or for long-term chronic conditions. A reliable plan is necessary because respiratory distress can escalate quickly, making immediate access to supplemental oxygen a matter of health and safety.
Securing the Necessary Medical Prescription
Oxygen is classified as a drug by regulatory bodies and therefore cannot be obtained without a physician’s prescription. This medical order must specify the required oxygen flow rate, measured in liters per minute (LPM), and the duration of use, which can range from use only during sleep to continuous, 24-hour therapy. Securing home oxygen requires a comprehensive evaluation by a qualified medical professional, such as a physician, nurse practitioner, or physician assistant.
This evaluation determines medical necessity, which typically involves laboratory testing to document the level of hypoxemia. The most common tests are pulse oximetry, which measures the oxygen saturation of peripheral blood (SaO2), and an arterial blood gas (ABG) test, which measures the partial pressure of oxygen in the arterial blood (PaO2). Coverage criteria often require the SaO2 to be at or below 88% while breathing room air, or a PaO2 at or below 55 mm Hg. If the oxygen saturation only drops during activity or sleep, the prescription will be tailored to those specific times.
The prescription serves as the medical authorization and must document the underlying condition, such as chronic obstructive pulmonary disease (COPD) or diffuse interstitial lung disease. The physician’s documentation must confirm that the patient is in a chronic stable state, or if the patient is being discharged from a hospital, the qualifying test must have been performed within two days prior to discharge. This process ensures that the prescribed flow rate is appropriate for the patient’s specific physiological needs.
Understanding Home Oxygen Delivery Systems
Once the prescription is secured, patients must choose from three primary types of systems suitable for home use, each offering distinct advantages and limitations. The most common stationary option is the oxygen concentrator, which draws in room air, filters out nitrogen, and delivers concentrated oxygen. Concentrators provide an unlimited supply of oxygen as long as they are connected to a continuous power source, making them reliable for stationary, long-term use. However, they require electricity to operate and usually have a maximum flow rate of 10 liters per minute (LPM).
Compressed gas tanks store oxygen as a highly pressurized gas in metal cylinders. These tanks do not require electricity, providing a ready-to-use supply that is unaffected by power outages, which is a significant advantage in an emergency. The primary drawback is that the supply is finite; the tanks must be replaced or refilled when empty, and the large stationary tanks can be awkward and heavy.
Liquid oxygen systems store oxygen in a super-cooled, liquid state. This allows for a much greater volume of oxygen to be stored in a smaller container compared to compressed gas. Liquid oxygen can be transferred into small, lightweight portable units, offering high flow rates and excellent mobility for active users. However, the liquid is extremely cold and can cause frostbite upon contact. Furthermore, the liquid naturally evaporates over time, meaning the supply diminishes even if the system is not actively being used.
Navigating Suppliers and Coverage
Acquiring home oxygen involves working with a Durable Medical Equipment (DME) provider, a specialized company responsible for delivering, setting up, and maintaining the equipment. The DME supplier acts as the logistical link between the patient and the physician’s prescription. They ensure the prescribed concentrator or tanks are installed correctly and that the patient receives proper instruction on operation.
Coverage for home oxygen is frequently managed through insurance, such as Medicare or private health plans, which classify the equipment as Durable Medical Equipment. Reimbursement is strictly tied to the documentation of medical necessity provided by the physician, including the qualifying blood gas or oximetry test results. For Medicare, the initial coverage period is often limited to a few months or a year, after which the need for continued therapy must be periodically recertified by the physician.
Most patients will rent the oxygen equipment from the DME provider. This arrangement typically includes maintenance, repairs, and the regular delivery of replacement tanks or liquid oxygen refills. The decision between rental and purchase often depends on the expected long-term need and the specific terms of the insurance coverage.
Essential Safety and Usage Guidelines
The presence of highly concentrated oxygen in the home significantly increases the risk of fire, as oxygen supports and accelerates combustion. Oxygen itself is not flammable, but it causes materials like fabric, hair, and grease to ignite more easily and burn hotter and faster. Therefore, strict safety protocols must be followed to prevent accidents.
All oxygen equipment must be kept at least five to ten feet away from any heat source, open flame, or spark-producing device. This includes gas stoves, candles, fireplaces, electric razors, and hair dryers. Smoking is strictly prohibited by anyone in the room where oxygen is being used or stored, and “No Smoking” signs should be posted prominently.
Patients should use only water-based lotions, creams, and hand sanitizers, avoiding petroleum-based products like petroleum jelly. Oils and grease can easily ignite in an oxygen-rich environment. For concentrators, power cord safety is important; they should be plugged directly into a wall outlet without using extension cords. The unit must also be kept several inches away from walls or curtains to ensure proper ventilation.
Finally, never adjust the prescribed flow rate on the equipment without explicit instructions from a physician. Immediately seek professional medical attention if symptoms of shortness of breath or distress worsen despite the use of the oxygen.