This document provides information about oxygen therapy, including what it is, reasons for its use, who needs it, different delivery systems and devices, safety measures, risks, and ongoing care. Oxygen therapy provides extra oxygen to those whose lungs do not absorb enough from the air due to conditions like COPD or sleep apnea. It must be prescribed and involves either portable compressed gas tanks, liquid oxygen, or concentrated oxygen systems with nasal cannulas or masks. Safety is important when using supplemental oxygen due to fire risks.

1. Welcome to
Pulmonary Rehab
Oxygen Therapy
Babette Parthum, RRT
Clinical Coordinator
Respiratory Therapy

2. What is Oxygen Therapy?
● A treatment that provides you with extra oxygen.
● Normally your lungs absorb oxygen from the air.
● Some diseases and conditions prevent you from getting
enough oxygen.
● Your doctor and respiratory therapist will determine
whether you need oxygen at home based on arterial
blood gas testing and/or pulse oximetry.
● Oxygen therapy is considered a medicine, therefore it
must be prescribed by your doctor.

3. Reasons for Oxygen Therapy
● Decreases shortness of breath and fatigue
● Improves sleep in people with sleep-related breathing
disorders
● Increases the lifespan of some people with COPD
● Decreases the work of the heart

4. Who Needs Oxygen Therapy
● Somebody who has low blood oxygen levels
● Certain conditions that admit you to the hospital
o Acute conditions
 Pneumonia
 Asthma attack or Reactive Airway Disease
 RDS
o Chronic conditions
 COPD
 Heart failure
 Cystic Fibrosis
 Sleep Apnea

5. Oxygen Therapy Systems
● Compressed Gas
o Stored under pressure in
metal cylinders
o Cylinders come in many
sizes
o Can be placed in a small
wheeled cart or a shoulder bag

6. ● Liquid
o Very cold
o When released from its container, it becomes a gas
o Evaporates easily

7. ● Concentrated Form
o Cost less because they do not require oxygen refills
o Filter out the gases in the air and only store oxygen
o Powered by electricity

8. Oxygen Delivery Devices
Nasal Cannula - small flexible
plastic tubes that direct oxygen
into each nostril
● Can be delivered from 1-6 liters
Giving a range of 24-44%
● Patients with COPD should not
exceed 3 liters. If more is
required, need to seek medical
attention.

9. Venturi Mask - mixes oxygen
with room air, provides an
accurate and constant oxygen
delivery.
● Delivers an oxygen range of
24-50% with 4-15 liters of
oxygen.
● Used on COPD patients who
require > 3 liters on a nasal
cannula or patients with an
increased work of breathing.

10. CPAP - Used as a treatment for
obstructive sleep apnea
● Provides a constant pressure (set
by your physician according to
the results of a sleep study) in
your lungs on exhalation to
prevent airway collapse.
● Nasal mask that fits over your
nose
● Full face mask that fits over nose
and mouth
● Nasal pillows that fit in both
nostrils

11. BiPAP- bilevel positive airway
pressure, non-invasive ventilation
● Provides a constant pressure on
inhalation and exhalation to keep
the upper airways open.
● A higher pressure (IPAP) is used
to breathe in and a lower pressure
(EPAP) is used when breathing
out.
● BiPAP is used to increase oxygen
and decrease CO2 levels.
● Utilizes the same types of masks
and nasal pillows as the CPAP

13. Safety Measures for Oxygen Use
Three elements are needed to start a fire
● A fuel source
● Oxygen
● Heat source

14. Safety Measures for Oxygen Use
Therefore if you are wearing oxygen, you should
never:
o Smoke or be around people who are smoking
o Use paint thinners, cleaning fluids, gasoline,
aerosol sprays, and other flammable materials
o You should stay at least 5 feet away from gas
stoves, cleaning fluids, gasoline, aerosol
sprays, and other flammable materials

17. Risks of Oxygen Therapy
● Dry or bloody nose - ask your provider if a
humidifier can be added to your device; use a
saline nasal spray
● Skin irritation from the nasal cannula or face
mask - ask if there is an alternate device that
will fit better or ask for a gel or device that is
designed to lessen skin irritation

18. Risks of Oxygen Therapy
● Risk of fire - Oxygen by itself is not explosive,
but it can worsen a fire.
o Compressed oxygen gas cylinders can
explode if exposed to heat
o The presence of oxygen can cause a small
fire to quickly get out of control

19. Picture courtesy of republicanherald.com

20. Living with Oxygen Therapy
● Portable oxygen units make it easier for you to move
around and enjoy many of your daily activities.
● Portable oxygen units make it easier for you to travel.
o You will need to plan ahead
o Contact your transportation carrier to find out their
specific rules.
o Talk with your doctor and home equipment provider.
They can help you plan for your oxygen needs, ensure
you have enough oxygen to last throughout your trip,
and fill out any required medical forms.

21. Ongoing Care
● Visit your doctor regularly
● Your doctor can adjust your oxygen therapy as
needed
● Never adjust the amount of oxygen you are
taking or adjust the flow rate of your oxygen on
your own
● Discuss any problems or side effects with your
doctor

22. Ongoing Care
● Know when to contact your doctor or seek emergency
care
o Increased shortness of breath, wheezing, or other
changes from your usual breathing
o Fever, increased mucus production, or other
symptoms of an infection
o A blue tint to your lips or fingernails. This is a sign
that your body is not getting enough oxygen
o Confusion, restlessness, or more anxiety than usual

23. Conclusion
● Understand that a chronic condition (ie COPD, Asthma)
that does not require home oxygen may become acute
(exacerbation of COPD, severe asthma attack) and
require temporary hospitalization with oxygen
● Understand the need for BiPAP during hospitalization
● Understand that too much oxygen for a patient with
COPD can be just as dangerous as not enough oxygen
● Know the safety measures and risks of home oxygen
therapy

24. References
● American Cancer Society
● American Thoracic Society
● COPD foundation
● NIH: National Heart, Lung, and Blood
Institute