Oxygen Therapy and Smoking Does Not Mix

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Cigarettes on their own are the leading cause of house fires, but add to this the risk of oxygen being stored in the home and the danger dramatically increases.
Over the last few years there have been a staggering number of reports of people on home oxygen therapy being admitted to hospital with facial burns, eyebrows and hair burned off, death, smoke inhalation injuries and fire damage to their homes in the thousands of pounds. These occurred because they or a friend/family member were smoking whilst the patient’s oxygen equipment was in use.

However, do not interpret this to mean that oxygen therapy is something to be afraid of, it just needs to be respected.

General Advice when using oxygen equipment:

•    If you’re on oxygen, DO NOT smoke.
•    If you live with or visit someone on oxygen, DO NOT smoke around them.
•    Stay away from open flames, sparks, and gas (including gas stoves).
•    Turn the oxygen off while not in use.
•    Avoid petroleum-based products.
•    Do not use aerosol sprays nearby.
•    Comply with all safety instructions provided by your home medical equipment company.
•    Keep your oxygen concentrator in a well-ventilated area.
•    Never allow the tubing, cannula, or mask to be covered, as it can result in a build-up of concentrated oxygen.
•    Keep the name and number of your home medical equipment provider in a prominent spot for reference.
•    Post a sign stating ‘DANGER: No Smoking-Oxygen in Use’ for the benefit of engineers or visitors.

There are also health risks associated with smoking while on oxygen therapy. Smoking is the most common cause of many medical conditions associated with the requirement of oxygen therapy. Smoking got you here therefore it is highly recommended that you put as much effort as possible into trying to give up this harmful addiction, or to at least cut down. Smoking more will just continue to damage your lungs and increase the deterioration of your respiratory capability and make you increasingly more dependent upon supplemental oxygen. Using supplemental oxygen can improve your health and improve your medical condition but if you smoke you are hampering the possible medical benefits of the treatment.

There should be a respectful balance between your own lifestyle choices, your medical needs and the safety of yourself and others around you. Be aware of the dangers and make sure you take all possible safety precautions.

References: http://lambertshc.com and http://scienceblogs.com

Are There Side Effects To Oxygen Therapy?

Almost every medical treatment has risks and side effects to it, which vary in degree from person to person. The benefit of oxygen therapy is that it is not a foreign drug, we naturally use it everyday and therefore the only side effects will be due to the administration of it or because of the volume of oxygen being inhaled, which as a result dramatically reduces side effects when compared to other medical treatments. There is also the safety aspect of storing and using oxygen as it is highly combustable but as long as you follow the simple common sense safety advice from your provider you will be very safe.

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The side effects may include a dry or bloody nose, skin irritation from the nasal cannula or face mask, fatigue, tiredness and morning headaches. Some people only suffer side effects initially upon first use and then they disappear however if these problems persist then all you need to do is to inform your doctor and provider. Depending upon the problems all your doctor may need to do is to alter the oxygen flow rate or length of time you’re using the equipment.
If nose dryness is a problem then you may just require an additional nasal spray or to have a humidifier attached to your equipment to reduce the dryness effect of the oxygen.
If you experience irritation from the mask or cannula then your provider can try other devices that may fit you better and can recommend over-the-counter gels and devices designed to help lessen skin irritation.
If you use transtracheal oxygen therapy then complications can potentially be a bit more serious due to the more invasive way that the oxygen is delivered via a tube inserted into your windpipe a the front of your neck. You may develop mucus balls which can cause coughing and clog the windpipe, infection and injury to the windpipe. However as long as you follow the advice in the proper medical care and correct handling of the tube then this greatly reduces the risk of complications. Such as keeping it clean and to use suction to remove any build-up.
The majority of users find that they experience a little irritation and dryness which can be easily resolved. Their testimonials are clear in saying that the benefits of oxygen therapy such as improved quality of life, improved mobility and social interaction and longevity of life far outweigh the inconvenience of a few side effects.

References: http://www.nhlbi.nih.gov and http://www.livestrong.com

Breathing Extra Oxygen Can Help Fight Cancer

A study in mice has suggested that by doing something as simple as breathing in extra oxygen may provide our immune cells with an extra boost to fight cancer.

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The immune system often can spot and destroy abnormal cells before they grow into cancer. Normally cancer tumour cells put up defences in order to block our immune system from attacking them. One way they do this is because tumours can grow so rapidly that they outpace their blood supply, creating a low-oxygen environment. By maintaining low oxygen levels inside the tumour, this can increase the production of a molecule that blocks the tumour fighters that our immune system produces, called T cells. Lots of research is under way to develop drugs that could block the production of this molecule adenosine, but researchers at North Eastern University wondered whether adding oxygen to tumours could strip away that defence. So they put mice with lung tumours into chambers that let them breathe oxygen doses mimicking supplemental oxygen therapy doses.

The results showed that tumours shrank more in the high-oxygen group, and even more so when researchers also injected the mice with doses of extra T cells. With the extra oxygen, “you remove the brake pedal” that cancer can put on tumour-fighting immune cells, said Michail Sitkovsky, director of the New England Inflammation and Tissue Protection Institute at North Eastern University, who led the work. The extra oxygen changed the tumour’s environment so that immune cells could get inside and do their jobs.

The study has exciting potential but obviously it must be tested in people first. If it works then this supplemental oxygen approach could be utilised to work in conjunction with other cancer therapies to aid in the battle against cancer.

References: http://www.usnews.com and http://blackburnnews.com

How Do Different Devices Provide My Oxygen?

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Oxygen therapy is administered in a variety of ways depending upon the circumstance, the patient’s requirements and the devices used. It is required in order to provide additional oxygen to the patient and to increase the level of oxygen in the body needed by your body to function.
In most cases the oxygen first passes through a pressure regulator which controls the oxygen pressure as it passes from an oxygen cylinder to the device which is at a lower pressure. Once the oxygen is at this lower pressure, the flow of the oxygen can be controlled by a flow-meter and is measured in litres of oxygen per minute (lpm). The usual flow rate for most devices is between 0 and 15 lpm but can be as high as 25 lpm in some units. Many flow-meters are based on a ‘Thorpe tube’ design which can be set to ‘flush’ which is useful in an emergency situation.
In room air the content of oxygen is only 21%, which although is adequate for healthy individuals, needs to be increased to help those with certain diseases or medical conditions in order to increase the oxygen that manages to get through to their blood stream. Usually increasing the oxygen to 30-35% is enough to make a significant difference and this can be achieved using a nasal cannula, a thin tube with an individual tube for each nostril. This can provide the oxygen at a low flow rate (0.25 to 6 lpm) to achieve an oxygen level of 24-40%.
To achieve higher oxygen concentrations various face masks can be used including a simple face mask, which can deliver oxygen at 5-15 lpm to achieve 28-50% oxygen levels. The Venturi mask can provide oxygen up to 40% and a partial re-breathing mask, which includes a reservoir bag attached to it can provide oxygen at between 40% and 70% concentration.
For patients requiring 100% oxygen the most common device is the non-breather or reservoir mask. This is similar to the re-breathing mask but has a number of valves to stop air that has been exhaled from the lungs from returning to the bag. At a flow rate of 10 lpm up to 80% oxygen levels can be achieved.
For patients requiring the therapy on a constant long-term basis, the oxygen can be warmed and humidified before administration through the nasal cannula to prevent irritation and dryness.
If a patient cannot breathe independently then positive pressure may be needed to force air into the lungs, which is provided by complex artificial respirator machines such as ventilators or a continuous positive airway pressure machine.

References: http://www.news-medical.net and http://www.nhs.uk/conditions/home-oxygen

How Does My Oxygen Concentrator Work?

Oxygen concentrators work on the principle of ‘rapid pressure swing adsorption’ which is where the Nitrogen is removed from the air using zeolite minerals which adsorb the Nitrogen, leaving the other gases to pass through and leaving oxygen as the primary gas. Once the oxygen is collected the pressure then drops which allows Nitrogen to desorb and be expelled back into the air.

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An oxygen concentrator has an air compressor, two cylinders filled with zeolite pellets, a pressure equalizing reservoir and valves and tubes. During the first half-cycle the first cylinder receives air from the compressor, which lasts about 3 seconds. During that time the pressure in the first cylinder rises from atmospheric to a few times normal atmospheric pressure (about 20 psi) and the zeolite becomes saturated with nitrogen. As the first cylinder reaches near pure oxygen (there are small amounts of argon, CO2, water vapour, radon and other minor atmospheric components) a valve opens and the oxygen enriched gas flows to the pressure equalizing reservoir, which connects to the patient’s oxygen hose. At the end of the first half of the cycle, the air from the compressor is directed to the 2nd cylinder. Pressure in the first cylinder drops as the enriched oxygen moves into the reservoir, allowing the nitrogen to be desorbed back into gas. Part way through the second half of the cycle there is another valve position change to vent the gas in the first cylinder back into the ambient atmosphere, keeping the concentration of oxygen in the pressure equalizing reservoir from falling below about 90%. The pressure in the hose delivering oxygen from the equalizing reservoir is kept steady by a pressure reducing valve.
Portable oxygen concentrators
These have been around for decades, but older models were bulky, unreliable, and were not allowed on airplanes. Since 2000, manufacturers have improved their reliability and size and they now produce 1-6 lpm of oxygen. The portable concentrators plug directly into a regular house outlet for charging at home or hotel, but they came with a power adapter that can usually be plugged into a vehicle DC adapter. They are able to operate from the battery power as well for either ambulatory use, or away from a power source, or on an airplane.

Portable oxygen concentrators operate on the same principle as a home domestic concentrator, operating through a series of cycles. Air passes from the miniaturised air compressor and through the molecular sieve of zeolite granules, which adsorb the nitrogen. Some of the oxygen produced is delivered to the patient and some is fed back into the sieves to clear them of the accumulated nitrogen, preparing them for the next cycle. Through this process, the system is capable of producing oxygen of up to 90% consistently. The latest models can be powered from mains electricity supply, 12v DC (car/boat etc.), and battery packs making the patient free from relying on using cylinders & other current solutions that put a restriction on their activities and mobility due to  time, weight, and size.
Most of the current portable oxygen concentrator systems provide oxygen on a pulse (on-demand) delivery in order to maximise the purity of the oxygen. The system supplies a high concentration of oxygen and is used with a nasal cannula to channel oxygen from the concentrator to the patient.

References: http://en.wikipedia.org and http://www.inogen.com and http://hme-business.com

The Difference Between Pulse And Continuous Flow

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Companies have been producing portable oxygen concentrators since 2000 and can provide oxygen via continuous flow, pulse flow or a combination of the two.

Continuous flow machines supply the patient with a continuous supply of oxygen, preferred by some patients who have very poor respiratory effort and a low oxygen level although some oxygen is wasted while the patient is exhaling and the supply can be used up quickly but do offer the patient mobility and freedom.

On-demand (also called intermittent-flow or pulse-dose) portable oxygen concentrators (POCs) are the smallest, often the size of a briefcase or picnic cooler and weigh about 2kg. They can deliver oxygen only when patients inhale which avoids any waste of oxygen when the patient exhales. Their ability to conserve oxygen and not waste it is key to keeping the units so compact as the oxygen supply will last longer. Their size allows them to be sleek and come with easy to carry bags allowing the flexibility to take these units almost anywhere, even to high altitudes, as long as there’s sufficient battery run time until the next opportunity to recharge it.

Another type of POC combines pulse and continuous-flow to meet a wider range of patient needs. These dual-supply concentrators can provide a larger volume of oxygen than smaller pulse units, however they need bigger, heavier battery supplies (otherwise the battery run time is reduced) and they are heavier, between 5 and 10kg. These dual-system converters often come with built-in wheels or a cart to make them easier to carry and move around without compromising the patient’s mobility.

There are different brands with slightly different characteristics, but the most important thing for the patient to consider when choosing which type of POC to have is their medical needs around the supply of oxygen they need.

With continuous-flow, oxygen delivery is measured in LPM (litres per minute). With pulse-flow delivery is measured by the size (in millilitres) of the ‘bolus’ of oxygen per breath, referring to the burst of oxygen released when you inhale. Other important considerations include the maximum oxygen percentage it can achieve, the number and increment of settings for adjusting oxygen flow, battery capacity and power cord options for recharging.

Your oxygen requirements during sleep is another variable. Usually pulse-flow oxygen concentrators are not used by patients while they sleep, as sometimes the machine is not able to detect when the patient is inhaling, as night-time breathing is low and shallow. Sleep apnoea patients are specifically not advised to use Pulse-flow units as they usually require a CPAP (Continuous Positive Airway Pressure) mask. For patients without apnoea, the use of portable concentrators during sleep is increasing as their preferred choice, especially with the addition of alarms and technology that detects a patient’s slower breathing during sleep and the machine will then adjusts the flow or bolus size accordingly. Continuous-flow mode is considered safer for night use when used with a CPAP machine. Some larger portable oxygen concentrators are designed to operate in both continuous-flow mode and pulse-flow mode.

References: http://en.wikipedia.org and http://hme-business.com

Misdiagnosis of COPD is Common and Dangerous

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There are many stories of patients being misdiagnosed and given treatment for asthma when in fact years later the patient is then diagnosed with COPD.
Pat Crowe was a healthy, active 39 year old but was told he had developed asthma and was given an inhaler. Over the next few years his health deteriorated, he grew dependent upon and overused his inhaler, suffered from side effects and eventually the inhaler wasn’t enough. Being so breathless meant his confidence plummeted, making him almost housebound.
‘I panicked about going outside and crossing busy roads because I was having trouble breathing and couldn’t move quickly.’
During bad spells and prolonged attacks he was also prescribed strong steroid pills, which caused side-effects, including a swollen face and hunger.
‘My wife became my carer, and my family were very scared watching me struggle to breathe,’ he says. ‘I didn’t even want to get out of bed and go down stairs because I was worried about getting back up. My life changed completely.’
It was only then that Pat’s consultant performed a spirometer test which confirmed that he didn’t have asthma after all but suffered from COPD, which explained why he’d found the condition impossible to control.
COPD is incurable and affects 900,000 people in the UK, usually above the age of 35, and an estimated 30,000 people die from it each year. Experts believe there are also more than two million undiagnosed cases.
Specialist advice is crucial when it comes to achieving an accurate diagnosis says Dr Kurukulaaratchy: ‘GPs need better awareness of these conditions. They both rank highly in hospital admissions, but if management is right early on, you can improve quality of life and possibly even life expectancy.’
Nick Hopkinson, honorary chest physician at the Royal Brompton Hospital, London, adds: ‘Asthma patients usually have normal lung function, but when they experience asthma symptoms or an attack their airways go into spasm, becoming narrow and inflamed. Then, after taking medication – usually an inhaler – their lungs return to normal. However, COPD patients have relatively fixed lung disease, so even on a good day they still have symptoms. Most of the damage isn’t reversible and progressively worsens.’
One major consequence of misdiagnosis is that patients could be given the wrong medication.
COPD patients usually start with bronchodilator inhalers to relieve narrowing of the airways and then go through a variety of drugs, starting with shorter-acting medications and moving to longer-acting ones, as the disease worsens, says Dr Kurukulaaratchy.
‘Research has shown steroids can lead to an increased risk of pneumonia (inflammation of lung tissue) in COPD patients, so this is a risk if they are wrongly labelled as having asthma.’
If the condition doesn’t improve, they can end up using a lot of steroids, which have side-effects such as weight gain, mood changes and osteoporosis.
‘If patients are told they have COPD but it’s asthma and they don’t have inhaled steroids, they won’t be able to control the disease – leaving them prone to worsening symptoms and even death from an asthma attack,’ says Dr Hopkinson. ‘We see 1,100 asthma deaths a year in the UK, often because they weren’t on preventer treatments.’
Also oxygen therapy treatment is a major component of COPD treatment which is prescribed by your doctor, so if you are misdiagnosed then you may not be prescribed oxygen as early as you should have been which can affect your health and long-term diagnosis as COPD damage to the lungs is irreversible.
If you have any doubts about your diagnosis then speak to your doctor or get a second opinion, just to be sure as your health is the most important thing.

References: http://www.dailymail.co.uk