Oxygen Systems Part 2

Yesterday, I presented all the different oxygen systems available for those of us who need oxygen therapy. The next step is to determine which is the best system not only for now but for the future as you will probably demand more as the disease continues on its path.

A note: portable oxygen systems are selling on late night info-commercials and they mention that Medicare will pay for them. Please know that if your numbers on the 6-minute walk test determine you need supplemental oxygen, Medicare pays for a system. If you only want a portable oxygen system (POS) as your oxygen delivery system, you will not get anything else. The problem is that these are very tender systems, which break down and then what? You are stuck without oxygen. Most people who have a POS pay out of pocket for them as a travel or daytime oxygen system then have a concentrator at home.

The questions that are asked to determine which system would be right for you:

• When are you using your oxygen?
• At night, daytime and/o exertion only?
• How do you determine your needs? Your MD can test your oxygen saturation with an oximeter or ABG. MD can also order an over night oximetry to determine needs at night. All pulmonary rehab programs have the patient begin and end the 8-week course with a 6-minute walk. 
• Medicare used an O2 sat of 88% or less to qualify you for supplemental oxygen.

Now the next questions is do you need continuous or pulse dose. Continuous is a continuous flow of oxygen at a certain liter lever. Pulse dose, also call on demand, kicks in a short burst of oxygen when the patient inhales. The problem is that some of us (me) do not have the strength (shallow breather at night) to kick in the oxygen and alarm bells go off at night if I am using a pulse dose. Continuous uses the oxygen at a faster rate while the pulse dose uses it at a much lower level.

• Each patients needs differ, so to insure the equipment meets your needs, a RT should assess you with the appropriate equipment to insure you are able to maintain the oxygen saturation your doctor wants to achieve for you.
• The assessment should test you at an "at rest" state and with exertion.
• If you do not keep your O2 saturation at or above the level your MD has ordered, the you are at risk of damage to your heart and other problems. 

How to Administer:
Cannulas - wide variety, different lengths and sizes of the prongs that sit in the nose and can be 37 feet long.
Oxygen Masks - usually need a flow of 6 lpm or higher to flush out the CO2, cannot use with pulse dose.
Tubing - longest you can use is 50 feet. Anything longer will reduce the liter flow to you.

There are other things available for problems such as patients needing high flow tubing and oxymizers and conserving devices.

Just another note: Most people at the support group had a large concentrator to produce oxygen while they were at home and small gas cylinders to be used when they were out into the world. I have a liquid oxygen system, which includes a reservoir that I have filled every two weeks. The problem is that it does dissipate where gas cylinders do not. But, my liquid oxygen is 100% pure oxygen, the Helios Marathon container I use can hold the oxygen up to 17 hours. Not bad. I will try to stay with my system until death but I do want to buy a POS so we can travel on the spur of the moment.

I hope this information was helpful!