Portable oxygen therapy (POT) is a medical treatment that provides supplemental oxygen to individuals who cannot get enough oxygen through normal breathing. This therapy is commonly prescribed for chronic respiratory illnesses such as Chronic Obstructive Pulmonary Disease (COPD) and pulmonary fibrosis, as well as severe asthma or congestive heart failure. The goal of POT is to raise the blood oxygen saturation to prescribed levels, which helps reduce symptoms like shortness of breath and fatigue, thereby improving daily quality of life. For new users, understanding the equipment and safety practices is the first step toward gaining independence and mobility with this life-sustaining treatment.
Understanding the Equipment Options
Portable oxygen systems primarily come in two types: Portable Oxygen Concentrators (POCs) and compressed gas tanks. POCs operate by drawing in ambient air, filtering out nitrogen and other gases through a molecular sieve, and delivering concentrated oxygen to the user. These devices require a charged battery or an electrical power source, but they offer an unlimited supply of oxygen as long as they have power.
Compressed gas tanks, or cylinders, contain a finite amount of 99.5% pure oxygen stored under high pressure, typically around 2,000 pounds per square inch (PSI) when full. Once used, the tank must be refilled or replaced, requiring logistical planning for supply management. Oxygen delivery is further distinguished by its flow mechanism: continuous flow or pulse dose.
Continuous flow delivers oxygen at a constant, adjustable rate, measured in liters per minute (LPM), regardless of the user’s breathing pattern. This method is often used for patients requiring higher volumes of oxygen or those with unstable breathing, but it can result in wasted oxygen between breaths. Pulse dose delivery, conversely, uses sensitive sensors to detect the start of inhalation and delivers a measured burst, or bolus, of oxygen per breath. Pulse dose systems are highly oxygen-efficient, making the devices smaller, lighter, and extending battery life, but the setting level does not directly equate to a continuous flow LPM setting. The specific flow rate and delivery mode are determined by a physician’s prescription.
Step-by-Step Operation and Setup
Before initiating therapy, confirm the device’s power status. For a POC, this means verifying the battery level indicator is sufficient, while for a compressed tank, the content gauge must be checked to ensure the tank pressure is adequate for the planned duration of use. The nasal cannula, a small tube with prongs, is then connected securely to the oxygen outlet port on the concentrator or the regulator on the tank. The prongs must be placed into the nostrils with the curve facing down to ensure the oxygen is directed properly.
To begin the flow, the device is powered on, typically by pressing a single button on a POC or slowly opening the tank valve by turning it counter-clockwise on a cylinder. Once the device is active, the flow rate must be set precisely to the doctor’s prescription. This involves adjusting a dial or digital control to the specified LPM for continuous flow, or selecting the correct setting number for a pulse dose device. Use the setting exactly as prescribed, as altering the flow rate without medical guidance can result in insufficient or excessive oxygen delivery, which can be detrimental to health.
Essential Safety Guidelines
Safety in portable oxygen use centers on managing the inherent fire risk created by an oxygen-enriched environment. While oxygen is not flammable, it vigorously supports combustion, causing materials to ignite more easily and burn more intensely. A strict “No Smoking” rule must be enforced, and all open flames, including candles, fireplaces, and gas stoves, must be kept at least five to ten feet away from the oxygen equipment and tubing.
Flammable materials, such as petroleum-based products like petroleum jelly and oil-based lotions, must be avoided on the face and chest because they can ignite easily in the presence of oxygen. Water-based products should be used as safer alternatives, and aerosol sprays, which are highly flammable, should never be used near the oxygen unit. Proper storage of compressed cylinders is also necessary, requiring them to be secured upright in a cart or stand to prevent them from falling, which could damage the valve and lead to an uncontrolled oxygen release. Finally, the long oxygen tubing itself presents a physical hazard, and users should manage the slack to prevent tripping or falling.
Daily Maintenance and Logistics
Routine cleaning is necessary to maintain hygiene and ensure the equipment functions optimally. The nasal cannula or nasal prongs should be cleaned at least weekly, or daily if the user has a respiratory infection, using warm water and mild soap, or a diluted white vinegar solution. Air filters on POCs are designed to be cleaned regularly, often weekly, by rinsing them under warm running water and allowing them to air dry completely before reinstallation.
Logistical planning ensures uninterrupted therapy. This involves consistent attention to power management and supply monitoring.
Logistical Tasks
- Regularly check POC battery indicators and avoid continuous charging after the battery is full.
- Monitor the pressure gauge on compressed tanks to anticipate when replacement or refilling is needed.
- Maintain a backup plan, such as having a spare charged battery or a backup oxygen tank, especially during a power outage.
- Proactively contact the supplier to order replacement supplies, including new cannulas and tubing, which should be replaced regularly to prevent cracks, leaks, or bacterial buildup.