Why we need oxygen?
In order to sustain life our bodies take in oxygen at each breath. Clean dry air at sea level contains about 21% oxygen, 78% nitrogen and small amounts of other gases. Oxygen molecules move from the tiny alveoli cells in our lungs into the bloodstream where they are circulated throughout the body by the heart. If a person suffers from a malfunctioning heart or lungs or both, they will generally require supplementary oxygen at some stage.
Our bodies need oxygen to metabolise (breakdown) our food into energy and heat. A result of metabolism is the production of carbon dioxide which we breathe out along with the other gases via the lungs.
Supplemental oxygen is ‘medical grade oxygen’. This means that it is above 85% pure oxygen. All supplementary oxygen equipment available from EasyOxygen produces ‘medical grade oxygen’.
What happens if we have insufficient oxygen?
Oxygen is vital to life. If someone is under oxygenated it will impact all body systems and make everyday tasks much more difficult to carry out, as well as place additional stress on the body. If not addressed, under oxygenation (hypoxia) will have severe ramifications for your health.
What are the main diseases that lead to the need for supplemental oxygen?
The demand for supplemental oxygen therapy is increasing as more people age, and some medical conditions become more prevalent.
Lung disease affects 2.6 million Australians impacting on many people’s lives as well as their families.
The most common category of lung disease is Chronic Obstructive Pulmonary Disease (COPD), where it is estimated that one in seven Australians over 40 years of age suffer from some form of it. COPD is a progressive and irreversible lung condition and includes diseases such as ‘chronic bronchitis’, and ‘emphysema’, or a combination of the two, where damaged lung tissue and narrowing of the airways makes breathing difficult. Whilst the disease cannot be cured, its rate of progression can be slowed down through things such as a healthy diet, and exercise.1
It is estimated that one in 17 Australians is likely to develop lung cancer before 85 years. Forecasts predict that this figure will increase in the future. 2 Asthma sufferers represent currently 10% of the population (about 2.5 million people), or 1 in 9 Australians. 3 There are also several other less common forms of lung disease including asbestosis, interstitial lung disease (most commonly affects children), pulmonary arterial hypertension, and pulmonary fibrosis.
USEFUL LINKS BELOW
- Accessed 31 July 2017 from Lung Foundation Australia Fact Sheet at: http://lungfoundation.com.au/wp-content/uploads/2013/12/LFA-Generic-Brochure-February2014.pdf
- Accessed 1 August 2017 from Cancer Australia at: https://lungcancer.canceraustralia.gov.au/statistics
- Accessed 2 August 2017 from Asthma Australia at: https://www.asthmaaustralia.org.au/qld/about-asthma/what-is-asthma-/statistics
Your prescription - what does it mean?
Oxygen must be prescribed by your Doctor or Specialist. Oxygen is deemed to be a medical drug and an oxygen concentrator cannot legally be supplied to a person without a prescription.
This serves to protect the person from potentially improper use of oxygen. Commonly people mistake ‘breathlessness’ as an indication of a lack of oxygen, however it may be symptomatic of severalother underlying health conditions. In these cases, supplementary oxygen may at best not be helpful and at worst could be harmful.
Oxygen is a gas and is generally prescribed in ‘Litres per Minute’ (LPM). The majority of people are prescribed at 2LPM, however an individual prescription can vary quite widely with doses as low as 0.5 to 1 LPM up to and above 5LPM. Often as a medical condition worsens an individual may need to increase the dose, although NOT without the advice of their doctor.
Scripts may also refer to a ‘nocturnal’ rate whilst you are sleeping as well as an ‘exercise’ rate where you are physically active. Scripts may be for 24 hours/day, 16 hours or less per day or even only on exercise/activity. So, as you can see there is a wide variety of oxygen prescriptions to address the diverse oxygen supplementation needs of different people and their respective medical conditions.
Oxygen concentrators, how do they work?
The EverFlo is your night time companion. Plugged into the power it will quietly and continuously provide you with medical grade oxygen whilst you sleep. Suitable for use with CPAP machines
All oxygen concentrators work by drawing in the surrounding air and passing it through an external broad particle filter to remove any airborne particles and ambient air pollution. The filtered air is then passed through a molecular sieve bed. The nitrogen is extracted and the oxygen stored under pressure. The oxygen is then concentrated to the level of medical grade oxygen. A distinctive intake and purge cycle can be heard as the concentrator works. As the concentrator is continuously taking in air and storing oxygen there is no need for a large storage capacity. The main requirement is to have a reliable energy supply.
How is supplementary oxygen supplied?
Supplementary oxygen is most commonly supplied in one of three ways, or a combination of two of the three.
- Home oxygen - the stationary in-home concentrator is a well established piece of equipment and is generally quite affordable.
- Gas cylinders are used by some people and are commonly supplied as part of a government funded home oxygen support program. The cylinders vary in size, but once emptied, need to be refilled.This is usually at a cost to the user once they have exceeded their quota. Cylinders can also be difficult or cumbersome for somepeople.
- The portable oxygen concentrators (POCs) that have been developed over the last ten years are continually improving in reliability, output and weight. POCs are becoming more widely used and hence better known, providing a user with oxygen in a more convenient and mobile way.
In-home versus portable oxygen concentrators
Home or stationary oxygen concentrators are a very cost effective way to receive supplemental oxygen. Units such as the Philips Everflo or the Newlife AirSep Intensity must be connected to mains power. The user receives oxygen via a nasal cannula or oxygen mask.
The nasal cannula or mask is connected to oxygen tubing, most commonly 15 or 30metre in length. The in-home concentrators have wheels so they can be readily moved about the house. The user has to navigate their daily life being ‘attached’ to the concentrator.
Home oxygen concentrators produce continuous flow oxygen with machines varying in output from 0.5 LPM through to 5 or 10LPM. Oxygen can be supplied via a nasal cannula - a piece of plastic tubing with two curved nasal prongs that sit in the front of the nostrils or by way of a face mask. This works reasonably well for most people whilst at home or asleep.
See related video for Philips Everflo. Credit: Med Equipment Direct.com
However, the capacity to be mobile outside of the home is severely restricted. Oxygen gas bottles are commonly provided to assist with mobility out of the home, but these can be heavy and awkward. Often as a person adjusts to their changed circumstances where they now require supplemental oxygen, they start to look for a more versatile and cost effective source of oxygen. A supply of oxygen that will enable them to move about more freely and return to a more active lifestyle.
Portable oxygen concentrators
Portable oxygen concentrators (POCs) are a relatively new means of supplying supplemental oxygen whilst giving an individual greater personal freedom. As the technology improves, the POCs are reducing in size and weight.
Weight and size reduction is made possible by supplying pulse oxygen. This is where your breath triggers the release (pulse) of oxygen. The use of pulse delivery significantly lessens the demand for oxygen. The majority of people can comfortably use pulse delivery oxygen whilst out and about, although it is recommended that you check with your Doctor first. Many people will combine a continuous flow machine at home and maybe at night with a pulse delivery portable concentrator if out during the day.
As a pulse delivery unit requires the user to breathe in order to ‘trigger’ the release of oxygen, a pulse unit will not work with anyone who breathes through their mouth as the ‘trigger’ will not be activated. Quite often a person can manage a pulse unit whilst out and about through the day as the unit will alarm if it does not detect a breath. A firm breath will generally reset the unit and stop the alarm.
However, this will not be a suitable unit for sleeping if you are a mouth breather, as you will be continually woken up. It is also important to understand that selecting a portable concentrator based on size and weight alone is NOT always going to best meet your oxygen needs. This is especially important when you are ambulant. Forsome people their oxygen need increases rapidly on activity and they may require a higher output POC.
The other area of ‘potential confusion’ is the ‘bolus size’. The bolus is the amount of oxygen discharged by the POC when the trigger is activated based on a breath. A higher setting on your POC means a larger bolus.Some people have a higher respiratory rate on exertion and may ‘out breathe’ a POC. Hence the unit may alarm frequently.
How a Portable Oxygen Concentrator works.
EasyOxygen POCs all produce the best output of oxygen available in the marketplace for their size and weight.
Portable concentrators generally feature at least two ways of carrying the unit usually by handle or shoulder strap, with some models allowing for a backpack. The heavier units are supplied with a trolley.
All of the POCs available for purchase from EasyOxygen are able to be used whilst flying, although the airlines do require you to complete a form in advance of travel. It is always advisable to check if the POC is approved for travel by the respective airline before booking. ALSO check with your Doctor as oxygen levels reduce with altitude and the POC may require a higher dose setting or may not be able to meet your oxygen needs.
A POC can generally be used with a walker, wheelchair/power chair or a mobility scooter, either carried in the basket or using the straps.
"My Simply Go Mini goes everywhere with me. The extended battery life gives me up to 9 hours of oxygen at 2LPM and that’s plenty of time to do most things. I can’t recommend the unit highly enough."
"The Simply Go provides a single solution for anyone requiring continuous flow whilst sleeping but can comfortably manage pulse flow throughout the day"
The hybrid oxygen supplementation solution
There are several oxygen concentrators that are able to produce continuous flow oxygen as well as pulse oxygen.
These units are a great solution for someone perhaps wanting to travel where bringing along the home oxygen concentrator is difficult or not practical. Whilst moving about through the day the unit can be switched to pulse delivery and provide greater operational battery time than possible with continuous flow delivery.
It should be noted that in order to keep the weight down continuous flow settings are at either a maximum of 2 as with the Simply Go or 3LPM (Sequal Eclipse 5) only. Also, as continuous flow delivery requires a much greater quantity of oxygen, battery life is much reduced on that setting. Both units provide good battery life if operated on pulse.
Generally, whilst sleeping these units need to be plugged into mains power, to ensure you have an uninterrupted sleep.
Whilst these units can produce both continuous and pulse flow oxygen it is important to understand that they are not designed to be used long term and replace the larger home oxygen concentrator!
Matching an oxygen concentrator to your needs
As detailed in the above sections, you require:
- Your script which indicates your oxygen dose in litres per minute
- How many hours a day you require oxygen
- Whether you require a higher dose on exertion Whether you need to use the concentrator while sleeping
- Whether you can successfully use pulse delivered oxygen
DOs and DON’Ts of Oxygen therapy
- DO avoid any open flame (oxygen is highly combustible)
- DO avoid using your concentrator in areas where people may be smoking
- DO only use a nasal cannula with a POC
- Do use either a mask or nasal cannula with an in-home concentrator
- DO treat the equipment with care
- DON’T get equipment wet