Oxygen therapy | Life with PF

Key facts

Oxygen therapy can reduce breathlessness to help you stay more active
Oxygen is stored and used in different ways, such as by using a mask or a nasal cannula
You may need to prepare your home for oxygen therapy and make extra arrangements when travelling with oxygen

Breathing disorders such as pulmonary fibrosis can affect the movement of oxygen from the lungs into the blood. This means that the oxygen level in the blood may drop, and the body’s organs, tissues and cells may not get the amount of oxygen they need. This can lead to you feeling tired and being less active.

Your healthcare team may recommend supplemental oxygen to help you breathe more easily. Oxygen therapy keeps the level of oxygen in your blood above a certain level, which reduces breathlessness. It can, therefore, help people with pulmonary fibrosis to stay more active throughout their day.

Together, you and your healthcare team can decide when oxygen may be needed and what type of oxygen delivery should be used.

Quick Tip

Your healthcare team should always be your point of contact when discussing oxygen therapy. If you think you need oxygen or higher doses of your oxygen, speak to your healthcare team who can talk to you about the options available.

Getting ready for oxygen therapy

Oxygen therapy will change how you approach your day-to-day life. Getting around the house and going out may become more of a challenge. However, with some advice and preparation, the transition can be made easier.

At first, you may only need oxygen to do physical activities, such as gardening or taking a walk. However, depending on your overall health, oxygen therapy may be needed throughout the day, even when you are resting.

As oxygen is considered a medicine, it must be prescribed by a doctor. Based on a series of tests, the prescription will provide details of how much oxygen you need and how often you will need it.

Your respirologist, as part of your healthcare team, will also discuss which type of oxygen and delivery system best suits you.

Types of oxygen delivery

Nasal cannula
Small plastic tubes, or prongs, that fit into both of your nostrils.

Face mask
Fits over your nose and mouth and straps onto your head.

Oxygen storage and transport

Oxygen concentrator
A small machine that provides just oxygen by removing all other gases from the air.

Compressed gas
Oxygen is stored under pressure in different-sized tanks. Some tanks are small enough to carry around in a backpack.

Liquid oxygen
Oxygen can be used in small tanks and refilled from large containers delivered to your home.

The right choice for you depends on several things, including how much oxygen you need, when you need it, where you live and your access to electricity.

Although you may be prescribed extra oxygen over the long term, this doesn’t mean that you must limit your daily life. Often, patients without exercise-induced hypoxemia find that when a prescription of supplemental oxygen is made, it helps them increase endurance during high-intensity exercise.

Oxygen at home
Because oxygen is stored in pressurized containers, there are certain safety measures you will need to take when using oxygen at home. Try to follow these tips when using your oxygen to avoid any hazards.

There are four key considerations when using oxygen at home

Smoke detectors
Install smoke detectors in every room.

Extinguishers
Keep fire extinguishers in an accessible place.

Oxygen tank
Store the oxygen in a clean, dry place — at least 2 metres (6 feet) away from any heat, electricity or fire.

Smoking
Do not smoke near an oxygen tank.

Below are several tips for using different types of supplementary oxygen. Although this list may appear overwhelming at first, using your oxygen system correctly and safely is very important to make sure that you avoid hazards and receive the full benefit of your oxygen therapy.

Take your time to understand this information. Not all of it will be relevant to you, but it should give you some useful tips for using your oxygen system safely and correctly.

Most importantly, you should always follow all instructions and guidelines supplied with your oxygen, as well as local laws and regulations.

Below are some further precautions to take:

Post a “no smoking” sign in the room where you have your oxygen
Tell your local fire department that there is oxygen in the house
Make sure you have a working smoke alarm inside or directly outside the room where oxygen is being used
Keep a fire extinguisher close to your oxygen tank and make sure you and/or your caregiver know how to use it
Store your oxygen system in a well-ventilated area, such as in an open room rather than in a closet or cupboard
Remember to always turn off your oxygen when you’re not using it to avoid releasing any oxygen into a room or enclosed space. If the oxygen is turned on, don’t put the nasal cannula or mask on the bed or a chair, even for a few minutes
Use 100% cotton bed linen and blankets, as they are less likely to give off sparks from static electricity
Try to keep at least 3 metres (10 feet) away from an open flame, such as a fireplace, gas heater or stove, candles, etc.
Pay close attention to the gauges on your oxygen equipment to make sure they are not running low. If you are running low, tell your oxygen supplier so that they can deliver refills
Make a note of any questions you have about your oxygen delivery system. Stick them to your oxygen tank or in a place where you will see them. Be sure to ask your healthcare team and/or oxygen delivery person any questions you may have the next time you see them

Don’t change the flow rate on your oxygen from what your healthcare team prescribed; getting the right amount of oxygen for your personal symptoms is important
Don’t smoke while you’re using oxygen
Never cut your oxygen tubing and never use more than a 15-metre (50-foot) long tubing
Don’t store your oxygen in enclosed spaces such as in the trunk of a car

Avoid certain products and devices while using oxygen, for example:

Petroleum-based lubricants like Vaseline, Chapstick, or Blistex on chapped lips or nostrils
Electrical appliances such as hair dryers, curling irons, heating pads and electric razors
Flammable liquids, such as cleaning fluid, paint thinner and aerosols (for example hair spray or deodorant)
Alcohol-based hand sanitizers
Oil-based products, such as vapour rubs, oil-based hand lotions and petroleum jelly

Quick Tip

If you do not know which type of oxygen therapy you have been prescribed, ask your doctor or healthcare team who will be able to explain the type of oxygen you have been given and why.

Additional safety measures when using an oxygen cylinder delivery system:

Store the cylinder in an upright position, using a cart, or strapped into place, so that it will not fall over
Keep your cylinder in a place where it is not likely to get knocked over
Monitor your oxygen levels and plan ahead to ensure you don’t run short; always have backup tanks available

Additional precautions when using an oxygen concentrator:

Never use an extension cord to plug in your concentrator
Don’t cover the unit, and always keep it at least 15 centimetres (6 inches) away from the wall, curtains or anything else that might block the filter or prevent air circulation around it. This will prevent the unit overheating
Consider buying a backup generator in the event of power outage

If you are on oxygen therapy and you would like to travel, it is important to plan ahead.

Depending on how you are travelling, you may need to make certain arrangements. For example, there may be forms to fill in, additional charges (e.g., from airlines) or special procedures for the storage and transport of your oxygen equipment.

The following steps will help you prepare for travelling:

Your first step should always be to speak to your healthcare team about your plans, so they can discuss your fitness for travel
You will need to speak to your travel provider to guarantee that they can accommodate all your treatments, especially supplemental oxygen therapy
Contact a travel insurance provider to ensure you have an insurance policy in place to cover all eventualities, such as medical expenses, cancellations and personal equipment/belongings

Quick Tip

Talk with your healthcare team about being assessed for oxygen therapy. They can then advise you on when it is needed and what type of oxygen should be used.

In an aircraft, the air pressure is different than on ground level. If you need oxygen therapy at ground level, you will also need oxygen in-flight, and may need to increase the flow during the flight.

Even if you are not currently on oxygen therapy, it’s a good idea to have your healthcare team assess whether you will need in-flight oxygen if you are planning to fly.

If your healthcare team recommends in-flight oxygen, there are a few tasks you need to do before your flight. Some of these tasks may need to be done months in advance and even before booking airline tickets. For example, you will need to contact the airline and complete forms to ensure that you are ready to travel. You will also need to check the airline’s requirements for in-flight oxygen. You must talk to your insurance provider about oxygen while travelling — you may need or benefit from additional insurance.

Each airline has their own specific rules and policies regarding in-flight oxygen supply. The European Lung Foundation has a nicely organized “airline index” that lists all major airlines and their oxygen policies as well as contact information.

Fit-to-fly assessments

If you have an underlying medical condition, some airlines require you to provide a statement from your healthcare team proving you are “fit-to-fly”. In addition to the information in your medical record and your shared travel plans, your healthcare team may perform a number of different assessments before issuing a letter to the airline.

One simple test you may need to perform is called a walking test. In this test, you’ll be asked to walk 50 metres (55 yards) or climb one flight of stairs. If you’re unable to complete the task due to breathlessness or any other respiratory symptoms, the healthcare team will probably recommend the use of in-flight oxygen.

There are also several other tests that your healthcare team may use to assess your fitness to travel.

Quick Tip

Many people still manage to do lots of travelling, even if they receive oxygen therapy. If you are involved in a support group, ask others in the group if they have travelled while using oxygen therapy to share hints and tips.