What is long term oxygen therapy (LTOT)?

Oxygen is an important gas in the air that we breathe. Our bodies need oxygen in order to function properly.

Some people with lung disease have low levels of oxygen in their blood as they cannot get enough oxygen from the air, therefore LTOT is needed.

Oxygen therapy increases the amount of oxygen that flows into the lungs and the blood stream.

You should use the oxygen for a minimum of 15 hours a day. However, your respiratory consultant or nurse may suggest that you use it for up to 24 hours a day.

The oxygen is administered via an oxygen concentrator installed in your house.

What are the benefits of having the treatment?

• Increased life expectancy.
• Improved sleep quality.
• Improved oxygen delivery to vital organs.

How long before I notice any benefits?

Many patients notice some benefit within a few weeks of starting regular LTOT, however, it usually takes several months before you notice a general improvement in your condition.

You should seek medical help if:

• you are far more tired than usual
• you start having headaches, particularly in the morning.

What is an oxygen concentrator?

An oxygen concentrator is a machine that works from your home electricity supply. Room air is drawn through a filter which concentrates the oxygen. The concentrated oxygen is then delivered to you through a nasal cannulae or mask.

An oxygen concentrator is about the size of a medium suitcase (approximately 60cm high x 40cm wide x 40cm deep). You will be advised on the best position to place the concentrator by the installing contractor.

Who will fit the machine?

• You will be contacted by an engineer from the oxygen supply company to arrange installation of the machine within three days of ordering it.
• It will set the flow rate and explain how to keep the filter clean. Once the flow rate is set it should not be altered unless instructed by the prescribing healthcare provider.
• You will be provided with tubing to enable you to move freely around your house.
• The engineer will leave you with a back-up oxygen cylinder and a 24-hour emergency contact number in the unlikely event the machine breaks down or there is a power cut.

What will happen after the machine is fitted?

• The engineer will contact you every six months to arrange a visit to service the machine and check the amount of oxygen you have used.
• The electricity costs for use will be reimbursed every three months. If you notify the oxygen company of the name of your electricity supplier the correct rate will be paid.

How to use your oxygen concentrator

• Your oxygen flow rate should be set at _____ litres per minute.
• You should use your oxygen for at least _____ hours each day, including when you are asleep at night.
• You can increase the number of hours you use the oxygen concentrator, but do not increase the flow rate – unless advised to do so by your respiratory nurse or doctor.

How to care for your equipment

• Check you nasal prongs daily to make sure the tips are not blocked.
• If required, wipe the nasal prongs with a damp cloth.
• Change your nasal prongs every four weeks (or more often if necessary). Your nasal prongs should feel comfortable enough for you to forget they are there.
• You can get nasal prongs and tubing from the oxygen supplier.
• If your nose gets sore, use a water-based lubricant such as KY jelly.
• Do not use petroleum-based creams such as Vaseline or decongestants such as VapoRub or Vicks, as this hardens the prongs and is a fire risk due to the grease component of the product.
• You can also be provided with small sponge tubes to ease any discomfort behind your ears, which may be caused by the nasal prongs.
• Each week, dust your oxygen concentrator cabinet with a damp cloth, making sure it is turned off at the on/off switch and the power cord is disconnected.
• The air filter at the back of the oxygen concentrator must be cleaned weekly. Remove the air filter from the concentrator and replace it with a spare from the wallet. Wash the filter you have removed in warm soapy water, rinse thoroughly and allow to dry naturally. Refer to the information book supplied by the home oxygen installation engineer for more details.

How to use your oxygen safely

• You must not smoke or use e-cigarettes while receiving oxygen therapy. Smoking reduces the benefits of the therapy and is a serious fire hazard. One You smokefree can help you quit, phone 0300 123 1220, text ‘quit’ to 87023 or visit kentcht.nhs.uk/oneyou
• It is important no one else smokes in the same room while you are using the concentrator.
• Do not use near a fire, a naked flame or a paraffin or gas heater.
• Do not use flammable products, such as aerosol sprays, oil-based lubricants or paint thinners near your oxygen concentrator.
• Warn visitors about the hazards of tripping over the oxygen tubing and take care not to trip yourself.
• You will be shown a video demonstrating the risks of smoking with oxygen and the potential hazards associated with oxygen use.

Do:

• inform your electricity supplier you are using an oxygen concentrator. It can put you on a priority list for reconnection of power if there is a power cut
• inform your home insurance company. This should not affect your premium but if you have any problems contact the 24/7 home oxygen supplier customer contact centre, which will help you
• have a smoke alarm in your home
• inform the local fire service oxygen equipment is being used in your home.

Do not:

• leave your concentrator running for long periods when it’s not in use
• leave your nasal prongs on the bed or chair with the oxygen running, as there may be a build-up of gas which could be dangerous.

For further safety tips please refer to the oxygen therapy booklet, supplied with your concentrator.

Supply and travel

• For information regarding supply, please contact the 24/7 home oxygen supplier customer contact centre.
• If you require oxygen away from home with the same equipment you have at home, you do not need to ask your prescriber for a new holiday order. Instead, you just need to call the home oxygen supplier customer contact centre and arrange your oxygen away from home supply at least three weeks before departure.
• If you need different equipment (for instance portable oxygen) to travel within the United Kingdom, please advise your prescriber who will order this for you. Please allow enough time for this process as the home oxygen supplier needs to receive the order from your healthcare professional at least three weeks before departure. For further information please call the 24/7 home oxygen supplier customer contact centre.