During our time in business we have learned that many of our clients are unfamiliar with sleep apnea and oxygen therapy and have questions about what to expect. For your convenience we have collected some of the questions we hear most often from our clients and provided the answers. Click on any of the listed headings to expand that section. Have a question that is not addressed here? Contact our office for more information.
Yes, oxygen may be used with CPAP, BiPAP, and AutoPAP if nocturnal (night time) oxygen is prescribed. Oxygen may also be used with a compressor while receiving aerosolized treatments as the nasal cannula can stay in place while using an aerosol mask. Oxygen is a drug and a valid medical order is required by a physician.
Oxygen is not toxic under usual conditions and is required to support life. Liquid oxygen or cold gas will freeze tissues leading to severe burns. Proper personal protective equipment should be used when necessary, and all safety protocols are to be followed. Some clients however, may suffer from hypoxic drive due to too much oxygen. Normally, our body tends to respond to high levels of carbon dioxide (CO²) in the blood by breathing. Excess CO² is then removed through exhalation. In other words, your body is usually stimulated to breathe when the levels of CO² increase or are too high. In some clients with chronic conditions such as Chronic Obstructive Pulmonary Disease (COPD), their body builds up a tolerance and no longer responds to the high blood carbon dioxide level. With this adjustment made by the body, it now uses low blood oxygen levels to help stimulate it to breathe instead of the high CO². Oxygen users who suffer from chronic CO² levels (CO² retention) may risk suffering from inadequate breathing patterns or rates (also known as oxygen-induced hypoventilation) caused by too much oxygen. Since the body no longer responds to high levels of CO² and prefers to be stimulated to breathe by lower oxygen levels, you won’t have the urge to breathe if you are receiving too much oxygen. Ideally, the PaO² or arterial blood oxygen levels should be 50-60mmHg (SaO² at 88-92%). These levels will allow for the maintenance of adequate tissue oxygenation while minimizing the chances of oxygen-induced hypoventilation. The most accurate method of determining if a client is retaining CO² is by obtaining arterial blood gases. Blood gases are generally drawn prior to initiation of oxygen therapy to determine if the client meets the Home Oxygen Program (HOP) criteria and qualifies for funding. Oxygen-induced hypoventilation may be monitored by routine oximetry testing during monthly or weekly visits. Further blood gases may be required to determine accurate levels of CO² and O².
Oxygen is not flammable, but supports combustion and can cause other materials that burn to ignite more easily and rapidly. Fire involving oxygen can appear explosive-like.
Breathe Easy forwards calls to an answering service which will dispatch ALL calls to On-Call personnel. Our answering service is NOT automated and you will speak to a live person. Breathe Easy staff are to immediately respond to all calls initially by phone as some problems may be verbally resolved with some assistance over the phone. Employees must physically respond to a call as soon as possible if not resolved by phone. If the client is residing at a facility, emergency and backup equipment will be available. Facility staff may be verbally directed over the phone or may refer to the P&P manual left at each facility.
Our Medical Service Driver will have a set schedule for deliveries. Convenient days and times for delivery will be discussed upon initiation of oxygen either in person or by phone. In some instances routine delivery may not be immediately set until the client’s portable needs are determined, or may be based on scheduled service to that particular area.
During routine scheduled visits, registered staff are to assess the client’s medical condition, address any questions or concerns they may have, change all necessary soft goods (cannula, tubing, etc.), check equipment, monitor hours used, clean or replace filters if required, provide extra supplies to the client and/or facility, and discuss any pertinent issues with the client, substitute decision makers, caregivers, or facility staff.
Clients in long term care homes including retirement residences are seen on a weekly basis with weekly progress documented in the resident’s chart after each visit. A separate chart is also kept on the client outside of the facility and in the care of Breathe Easy. Clients residing in private homes will be seen monthly or more frequently, and will have a chart kept in the care of Breathe Easy. Progress reports will be forwarded to the client’s physician each month or more frequently when required.
Oxygen must be ordered or prescribed by a physician, informed consent must be obtained from the client or their substitute decision maker, and the client must be properly identified prior to set-up. Depending on the blood gas results, Breathe Easy may inform the client that an immediate set-up is preferred to initiate oxygen therapy sooner than later, provided there is a valid medical order. Set-ups for clients in private homes are generally based on the client’s availability and at their convenience. Flow rates will be based on the valid medical orders from the prescribing physician. Registered staff may collaborate with the physician, facility staff and/or client or substitute decision maker, to discuss what is in the best interests of the client prior to initiation of therapy. A risk assessment will also be performed to ensure patient safety, with a follow-up visit scheduled within 7 days.
ADP has specific medical eligibility criteria to determine whether funding is available. ADP requires that the applicant’s medical status is stable, with optimization of their treatment regimen. Optimal treatment prior to the initiation of supplemental oxygen therapy includes smoking cessation.
Your family physician may send a referral to Breathe Easy in order to make arrangements for an oxygen assessment at our office or in your home. This assessment will determine if supplemental oxygen may be beneficial and if you meet the Home Oxygen Program’s (HOP) eligibility criteria for funding. Clients requiring End of Life Care may be eligible for 90 days of funding without testing.
During the assessment, oxygen levels will be checked on room air at rest, with exertion and/or at night. Depending on the outcome of the assessment, you may be further referred for Arterial Blood Gases or a Sleep Lab by your family physician. In the event that the ADP medical eligibility criteria are not met, alternative funding will be investigated. This may include private insurance, self-pay, WSIB, Veterans Affairs, etc.
Contact Breathe Easy at 519-439-1166 for more information, or visit the Ontario Ministry of Health and Long-Term Care website.
Home oxygen therapy is the process of administering supplemental oxygen through various oxygen supply systems in your place of residence. Oxygen is a drug and is usually prescribed by a physician or a nurse practitioner. Specific tests are conducted to determine if home oxygen therapy is appropriate for each individual client and if funding is available. Supplemental oxygen is prescribed for various chronic respiratory and cardiac conditions and for clients with terminal illnesses. The goal of this treatment is to not only improve blood oxygen levels, but to improve our clients’ overall quality of life. Other benefits may also include decreased stress on the cardiovascular system, decreased shortness of breath, decreased hospital visitations and increased mobility.