Supplemental oxygen therapy, often supplied in a portable cylinder, requires a precise and safe setup for effective delivery. The system involves three primary components: the high-pressure oxygen tank, the regulator which controls flow and pressure, and the delivery device, typically a nasal cannula or mask. Understanding the correct connection procedure is crucial, as mishandling pressurized oxygen can create hazardous conditions and compromise personal safety.
Essential Safety Precautions Before Starting
Before manipulating any oxygen equipment, establish a safe environment to mitigate the risks associated with compressed gas. Oxygen is not flammable, but it is a powerful accelerant that causes other materials to ignite and burn intensely. Maintain a distance of at least five to ten feet between the cylinder and any potential ignition sources. These sources include open flames, gas stoves, lit fireplaces, and heat-producing electrical devices like hair dryers or electric razors.
The room should be well-ventilated to prevent the accumulation of concentrated oxygen, which increases the combustibility of surrounding materials. Pay strict attention to the presence of any oils, greases, or petroleum-based products on your hands or the equipment. High-pressure oxygen can spontaneously ignite these hydrocarbon residues. This means even a small smear of petroleum jelly, commonly used for chapped skin, can pose an explosion or flash fire hazard. Always use water-based lubricants for dry lips or nasal passages when undergoing oxygen therapy, and ensure your hands are clean and completely dry before touching the cylinder or regulator.
Step-by-Step Connection Guide
Begin the connection process by securing the oxygen cylinder in an upright position using a stand or cart. An unsecured tank that falls and damages the valve can release oxygen rapidly, turning the cylinder into a dangerous projectile. Next, remove the protective plastic seal covering the valve stem. Briefly “crack” the valve by quickly turning it open and closed to clear any dust or debris from the valve outlet.
Inspect the regulator for damage, ensuring the connecting pins and the washer (sometimes called a Bodok Seal) are intact and properly seated. The pin index safety system ensures the regulator only connects to an oxygen cylinder, preventing dangerous cross-connections. Align the two small pins on the regulator with the corresponding holes on the cylinder valve stem, then slide the regulator onto the tank post. The connection must be flush and secure, with the pins fully engaged.
Tighten the regulator’s T-handle or wing nut clockwise until it is snug, which creates an airtight seal with the washer. While a secure fit is necessary to prevent leaks, avoid over-tightening, which could damage the components. Once attached, slowly open the main tank valve by turning it counter-clockwise, typically two full turns, until it is completely open. Stand to the side of the cylinder while opening the valve.
Setting and Monitoring Oxygen Flow
Once the regulator is attached and the main valve is open, the system is pressurized. The pressure gauge indicates the amount of oxygen remaining in the tank, measured in pounds per square inch (PSI). A full E-cylinder, a common size for home use, typically reads around 2,000 PSI. The needle must not be in the red zone, which signals a critically low supply. Note that the pressure gauge reflects volume, not the flow rate being delivered to the patient.
The flow meter sets the actual rate of oxygen delivery, measured in Liters Per Minute (LPM). Locate the adjustment knob and the flow tube, which contains a small ball that floats with the moving gas. Set the prescribed flow rate precisely by adjusting the knob until the center of the floating ball aligns with the specified LPM number on the scale. Never change the flow rate from the level prescribed by a physician.
Connect the delivery tubing from your nasal cannula or oxygen mask to the regulator’s outlet port, ensuring a secure connection. A slight hissing sound or bubbles in a glass of water confirms oxygen is flowing at the set rate. After use, turn the main tank valve clockwise to the closed position first. Then, allow the remaining pressure in the regulator to bleed off by letting the flow meter run down to zero before removing the regulator.
Safe Handling and Storage of Cylinders
Managing oxygen cylinders when they are not in active use requires adherence to specific safety and storage protocols. All cylinders must be stored upright and secured, either in a rack, stand, or cart, to prevent them from falling and damaging the valve assembly. Securing the tank prevents the accidental release of high-pressure gas.
The storage location should be cool, dry, and well-ventilated, positioned away from direct sunlight or any potential sources of heat. Oxygen cylinders should not be exposed to temperatures exceeding 125°F (50°C), as this can dangerously increase the internal pressure. When transporting a cylinder, it must be secured in the vehicle to prevent rolling or tipping, and promptly removed from the car upon arrival to avoid heat buildup. Monitor the pressure gauge regularly and contact your supplier for a replacement tank before the needle enters the red zone.