10 Things You Need to Know About Supplemental Oxygen Before You Start Oxygen Therapy at Home
Home oxygen therapy is a normal part of daily life for many people with COPD. But if you're new to oxygen therapy, or about to begin using it soon, having to make that change can seem daunting or even downright scary.
After all, home oxygen therapy is a big responsibility and having to use it can feel like a major intrusion into your life. There's a lot to learn and a lot to adjust to—but the good news is you don't have to do it completely on your own.
In this guide, you'll find all kinds of helpful tips and information that everyone using home oxygen therapy should know, including how to use oxygen safely, how to prepare for emergencies, and what kinds of side-effects you can expect. You'll also find lots of helpful advice for easing the transition to long-term oxygen therapy, including how to make your home more oxygen therapy-friendly, and how to make your oxygen equipment more comfortable to wear.
With all this information at your disposal, you'll be able to get a jump-start on learning the ropes and hopefully feel more confident about having to use supplemental oxygen. Our goal is to give you a good idea what to expect and how to prepare for oxygen therapy so it won't feel quite so difficult or overwhelming to do.
Throughout this guide, you'll find links to a variety of helpful online resources, including guides to related topics that we've published in the past. To see these and many of the other practical guides we've posted on oxygen therapy and COPD, check out our Respiratory Resource Center.
Using Oxygen Can Create a Serious Fire Risk
One of the first things you should know about oxygen therapy is that concentrated oxygen can be very dangerous if you don't handle it properly. The percentage of oxygen you get during oxygen therapy is much higher (up to 100 percent) than the oxygen in ambient air (about 21 percent), and at such high concentrations, it is a major fire risk.
Contrary to popular belief, oxygen itself isn't actually flammable; however, concentrated oxygen makes other substances that it comes into contact more flammable in a couple of different ways. First, it makes substances that are already somewhat flammable much easier to ignite; second, it causes fires to burn bigger and hotter, and can even cause explosions.
For example, petroleum jelly is not generally very flammable in normal situations, but, in the presence of concentrated oxygen, it can catch fire if exposed to an errant spark or flame. That's why doctors advise patients not to use petroleum-based products on their lips while using supplemental oxygen and to use water-based products (e.g. KY jelly) instead.
Because of this risk for fire, you need to be extremely careful about keeping your supplemental oxygen at least 10 feet away from flames, high heat, and other fire hazards. This applies to your oxygen tanks when they're in storage or in use, and to the concentrated oxygen that flows through the tubing and into your mouth or nose.
Even a small flame or spark can cause an accidental fire if it happens near the stream of oxygen coming from your oxygen supply. Even cooking over the stove while using oxygen is risky, as is using electronic devices that have the potential to produce sparks (this is why you should never use an electric shaving razor while using supplemental oxygen).
This is also why it's important to never, ever smoke (PDF link) while you're using oxygen; it could ignite the concentrated oxygen as it flows from your nasal cannula or mask and cause severe burns. Additionally, you should never allow anyone else to smoke near you while you're using oxygen nor anywhere inside your home.
You should be cautious about potential oxygen leaks, which can cause oxygen to build up in high enough concentrations in the air to pose a serious fire risk throughout your home. Leaks can come from oxygen tanks in storage or from your oxygen delivery system; that's why you should always assemble your oxygen delivery equipment carefully and never leave your oxygen running when it's not in use.
Experts also advise anyone who uses supplemental oxygen—or has an oxygen supply in their home—to put up warning signs in, around, and even outside their house. This helps remind household members and visitors to be cautious, but also to warn emergency personnel about the hazard in the case they need to enter your home during a fire or other emergency.
You also need to be careful about how any oxygen tanks you are using or keeping in storage are positioned and secured. You should always store oxygen tanks in a well-ventilated space (never in an enclosed area like a closet) where they will not be in danger of shifting, falling, or getting damaged in any way.
These are some of the most basic safety considerations, but there is much more you should know. Luckily, you can find much more detailed oxygen safety instructions and advice in our comprehensive oxygen safety guide.
You can also find many more resources online, including this one (PDF link) from the New York State Office of Fire Prevention & Control and this guide on oxygen cylinder safety (PDF link) from Intermountain Healthcare.
Whatever you do, make sure to learn everything you can about how to use your oxygen safely, ideally before you begin oxygen therapy at home. Make sure you understand their hazards and take the time to familiarize yourself with all the best practices for preventing accidents, leaks, fires, and burns.
Not Using Your Oxygen as Prescribed Can Be Detrimental to Your Health
If your doctor puts you on long-term oxygen therapy, it's because you actually need it. This might seem extremely obvious, but it's important to keep in mind anytime you're tempted to skip out on your oxygen therapy because it's difficult or inconvenient to do.
It's important to always do your best to use your supplemental oxygen exactly as your doctor prescribes, even if you don't want to and even if you don't feel like you need it that day. Home oxygen therapy isn't just about helping you breathe; it's also about protecting all the organs in your body from becoming oxygen deprived.
Unfortunately, research shows that only about 60% of COPD patients using supplemental oxygen actually use it for as many hours a day as their doctor prescribed. Most of the remaining 40% don't use their supplemental oxygen enough, and by doing so put their health at risk.
When someone with COPD has to use long-term oxygen therapy, it's because their lungs are too damaged to take in enough oxygen on their own. This results in hypoxemia, which happens when the amount of oxygen in your bloodstream falls below what's considered to be a healthy level (which can include blood oxygen saturation levels below 95 percent).
Usually, people with COPD don't need to begin long-term oxygen therapy until their blood oxygen saturation falls below about 90%. Having blood oxygen levels that low, especially over a long period of time, can cause a variety of serious health problems, including cognitive decline, cardiovascular disease, and pulmonary hypertension.
Severe hypoxemia also puts you at risk for tissue hypoxia, a serious condition that occurs when there's so little oxygen available in your blood that some parts of your body can't get the minimum amount of oxygen they need to function normally. In severe cases, tissue hypoxia can cause extensive, permanent organ damage and even death if it's left untreated for too long.
However, using supplemental oxygen helps reverse hypoxemia and return blood oxygen saturation to healthier levels, preventing tissue hypoxia and the various other health complications that hypoxemia can cause. And that is why using your supplemental oxygen exactly as you're supposed to is so important and so vital for your health.
Supplemental Oxygen Has Side-Effects and Risks
It's important to remember that supplemental oxygen is a drug that comes with some potentially serious risks. It might seem harmless because it's “just oxygen,” but, in reality, supplemental oxygen is a medicine just like any other and you should always treat it that way.
Supplemental oxygen works because it provides your lungs with air that has much more oxygen in it than the regular, ambient air you normally breathe. This makes it easier for your lungs to absorb oxygen from the air, raising your blood oxygen levels and making it easier to breathe.
However, breathing in highly-concentrated oxygen can, in some cases, cause dangerous respiratory imbalances, including oxygen toxicity, excess carbon dioxide build-up in the blood (a condition known as hypercapnia), and—in rare cases—an increased risk for death. These problems are most likely to happen if an error, such as incorrect dosing, causes you get an excessive amount of oxygen.
This can happen due to patient error (e.g. setting the flow rate on your oxygen tank too high or not following dosage instructions) or from doctor error (e.g. prescribing too high an oxygen concentration or too long a duration for therapy). To reduce this risk, most doctors start COPD patients on lower oxygen doses and increase them gradually as needed, while also carefully monitoring patients for signs of hypercapnea and other adverse effects.
That's why it's important to use your supplemental oxygen correctly and treat it with the same care and diligence that you would treat any other type of medication. That means always making sure you get your oxygen dosage right and follow your doctor's instructions for oxygen use exactly.
Luckily, serious adverse effects from home oxygen therapy are pretty rare, though the risk increases with higher oxygen concentrations and longer duration of use. However, there are some other more common—and much more mild—side-effects that can occur even if you use your oxygen 100 percent correctly.
Here are some of the more common side effects of using supplemental oxygen:
- Skin irritation
- Ear pain
- Nose bleeds
- Dry mouth, nose, and throat
- Reduced sense of taste
- Reduced sense of smell
Many of these side effects (e.g. dryness and abraision) are essentially discomforts caused by the oxygen equipment itself or how the oxygen is administered to your lungs rather than the oxygen medicine itself.
You Can Make Oxygen Therapy More Comfortable
Unfortunately, many people experience discomfort when using supplemental oxygen, particularly after wearing the equipment for long periods of time (as many oxygen patients must do). This is one of the main reasons why some patients aren't consistent about using their oxygen therapy or simply don't use their oxygen as much as they should.
Some of these ailments are caused by pressure and skin chaffing where equipment (such as over-the-ear straps and tubing, nasal cannulas, or oxygen masks) touches the skin, particularly around the mouth, nose, and ears. Many patients also complain about the longer length of tubing that hangs down from their mask or nasal cannula, which can restrict movement and easily get snagged or pull on the ears.
Another common source of discomfort is the air that comes from the oxygen supply, which tends to flow faster and be less humid than breathing ambient air. Over time, this constant flow of dry air can dry out your lips, mouth, nose and throat, which can lead to nosebleeds and split lips.
While this all might sound very discouraging, there's no need to despair! You don't have to suffer without relief, because there are many different techniques you can use to reduce and mitigate all of these common discomforts and more.
For example, you can modify your oxygen delivery equipment to reduce ear pain and irritation by adding padding under the tubing on your ears. You can reduce skin chaffing by covering problem areas of tubing with fabric wraps or fabric tape.
You can prevent extension tubing snagging and keep it out of the way by clipping it to your back or running it under your clothes. You can also get specialized equipment designed specifically for better comfort, including nasal cannulae made from softer plastic tubing that's gentler on the skin.
To reduce nose and throat dryness, you can use a humidifier bottle to add moisture to the air coming from your oxygen delivery device. You can also use a variety of (non-petroleum) topical ointments, lip balms, and creams to treat dry skin on and around your lips, mouth, and nose.
While these techniques might not eliminate all your discomfort completely, they can make oxygen therapy much more comfortable and much more tolerable to use. These are also just a few of many possible solutions that you could experiment with and adapt to your personal needs.
For even more practical tips and suggestions, check out our comprehensive guide about how to make oxygen therapy more comfortable, which includes more detailed information about specialized oxygen products and comfort-improving techniques.
It Can Help to Clear Some Extra Space at Home
Home oxygen therapy requires a lot of equipment, and that equipment takes up space—and a lot of it. We're not just talking storage space (even though you'll need that too), but also space for you to move around with your equipment freely.
Using oxygen at home requires a good deal of lugging equipment and tubing around, and you don't want to feel restricted or at risk of getting tangled up everywhere you go. Because of this you might need more wide-open space in your home than you needed before after beginning home oxygen therapy.
To get the extra space you need, you might need to clear out some clutter, re-arrange your furniture, or even re-think the overall setup of your home. Try to do this with consideration for how you personally use and move through the space, looking for ways you can make it easier to navigate your home without running into obstacles that could crowd you, trip you up, or snag on your oxygen tubes.
You should also be thoughtful about where you run your oxygen tubing, especially anywhere it lies across the floor. Do your best to keep your extension tubing from running across main walkways and other places where it could cause you or someone else to trip.
Finding the best arrangement might take some trial and error, but it's worth taking the time to get it right. After all, a living space that's cramped or difficult to navigate is not only frustrating (and affects your quality of life), but it's also a potential safety hazard.
You'll Need to Work With a Medical Supply Company to Get Your Oxygen & Supplies
Getting a prescription for supplemental oxygen is just the first step to starting oxygen therapy; the next step is to actually get the oxygen and the rest of your oxygen delivery equipment. Unfortunately, you can't get what you need simply by visiting a regular pharmacy like you can with most other prescriptions.
The good news is that you can get all your oxygen and equipment delivered straight to your home, but the bad news is that you'll likely need to arrange that delivery yourself. This can be a bit tricky, since it requires working with your insurance company (or medicare provider) to find an eligible medical supply company that offers what you need.
Keep in mind that different medical supply companies often have different prices andd different selections of equipment. Before choosing a supplier, make sure you know exactly what kinds of products they have, including what oxygen supply devices they offer (e.g. home oxygen concentrators or portable oxygen tanks) and other oxygen delivery equipment (e.g. types of plastic tubing, oxygen masks, nasal cannulae, humidifier bottles, etc.).
If you're not sure exactly what you need or what to look for, that's okay; your doctor should help you begin the process and prepare a detailed order (PDF link) for you to give to your insurance company and oxygen supplier. Your doctor can also walk you through the different equipment you will need and why you need them; for example, if you need high-flow or high-concentration oxygen, you might need to use an oxygen mask rather than a nasal cannula.
Most oxygen supply companies rent their oxygen equipment for 36-month (3-year) periods, at which point you can continue renting the equipment (for up to two more years) or switch to another supplier. During that 3-5 years, the company agrees to supply you with an adequate amount of oxygen, along with all other necessary supplies, and perform any required maintenance that your oxygen equipment needs during that period.
It's important to keep track of when your rental agreement starts and when you need to renew your contract (or find a new oxygen supply company), that way you can take care of it before the rental period expires. Being pro-active will help ensure that you don't have any gap or delay in your oxygen supply.
For more information and instructions for how to order your oxygen supplies, check out the following links:
- This article from Verywell Health tells you how to order oxygen through Medicare.
- This guide for choosing and ordering oxygen supplies (PDF link) from The LAM Foundation and COPD Foundation, which includes a helpful breakdown of the benefits and risks of 3-year versus 5-year contracts.
- Information about Medicare coverage for oxygen equipment from medicare.gov.
- This guide from our Respiratory Resource Center explains what you need to know about health insurance and oxygen equipment.
Keeping Your Equipment Clean and Maintained is Key
Unfortunately, your oxygen equipment won't stay in good shape all on its own. You'll need to perform some degree of regular cleaning and maintenance to keep your equipment working, clean, and safe.
First, you'll need to sanitize your oxygen mask, nasal cannula, and connector tubing regularly—at least once per week. You can do this by washing the equipment in warm, soapy water (to get off any mucus or grime), dunking it into a vinegar solution (to kill bacteria), and then setting it out to dry.
You should also clean your equipment (and possibly even replace your mask or nasal cannula) anytime you get sick with any kind of respiratory virus or infection. Failing to do so—or simply not cleaning your equipment often enough—allows dangerous viruses and bacteria to multiply and potentially get you sick.
You will also need to replace your nasal cannula or oxygen mask with a new one on a regular basis, usually about every two weeks. You will also need to replace your extension tubing about every 3-6 months, though you should always follow the instructions for the specific equipment you use.
You may also need to perform other cleaning and maintenance tasks, such as wiping down the outside of your equipment, replacing a home oxygen concentrator's filter, or checking oxygen tanks regularly for damage or leaks. Make sure you know what kind of maintenance you're responsible for and what kind of maintenance your oxygen supplier provides.
For more detailed information and instructions for taking care of your oxygen equipment, check out our how-to guide on Oxygen Equipment Cleaning and Maintenance.
You Need to Be Prepared for Emergencies
When you're dependent on supplemental oxygen to breathe and stay healthy, it's very important to make sure you always have access to your oxygen. That requires planning for emergencies like power outages and other situations that could affect your ability to use oxygen.
First, you should always keep an extra supply of backup oxygen in your home just in case you can't use your primary supply for some reason (e.g. if it's empty or malfunctioning). While you should never run out of oxygen in a normal situation, you should always be prepared for natural disasters and other emergency situations that could delay the delivery of your oxygen supplies.
If you use an oxygen concentrator that relies on power to work, you'll specifically need a backup supply that doesn't need electricity, such as a liquid or compressed-gas oxygen tank. That way, if there's ever a power outage, you'll always have a source of oxygen hold you over until the power comes back on.
You should also notify your electricity utility company once you begin oxygen therapy, especially if you have an oxygen concentrator plugged in at home. This gives you the opportunity to get on a priority service register, which can make you eligible for certain safety benefits like giving your home priority when restoring power after an outage; however, whether or not you can get any extra benefits depends entirely on your particular power company, so make sure to ask your local utility what they offer to be sure.
For a more detailed guide on how to prepare for emergencies when you rely on oxygen therapy, check out the Comprehensive guide to emergency preparedness for people with lung diseases from the American Thoracic Society
You Can Still Go Out & Stay Active on Oxygen