Safety Measures and Patient Education for Supplemental Oxygen Use

  1. Instruct all oxygen dependent patients and caregivers on safety measures and precautions to be observed with oxygen use.
  2. Reinforce strict instructions regarding “no smoking” in the room, irrespective to oxygen use. Oxygen can get trapped in the bedsheets and curtains for long periods of time and can be a potential source of fire accident. Educate the patient and family on posting “no smoking” and “oxygen in use” labels visibly in the patient’s room, to keep any visitors from smoking.
  3. Make sure the patients do not drape any clothing around the oxygen tanks, as it can lead to undue heating of the tank. Gas can expand at higher temperatures resulting in increased pressure inside the tank, causing it to explode.
  4. Make sure the tank in use and the back-up are situated far away from any potential source of heat and flame. Sources of heat and flame can include but are not limited to stove, oven, fireplace, heater, toaster, barbeque, hair dryers, and lighted candles etc. This can help prevent any accidental explosion and undue fire accidents.
  5. Check with the patient or caregiver regarding availability of oxygen back-up and proper storage of the tanks. Reinforce instructions on storing the back-up tank in a well-ventilated place, such as, a living room and maintained at normal room temperature. Instruct the patient and caregivers on not storing the oxygen tank in a closed space like garage, closet, attic, basement, where the temperatures are likely to shoot up in no time.
  6. Instruct the patient on initiating the oxygen flow, adjusting the rate of oxygen delivery as needed, and turning the oxygen flow off when not in use, especially if oxygen is newly prescribed. This forms an important piece of patient education information, as the need for oxygen use can be felt at random and at times when caregivers are not around to assist.
  7. Instruct the patient on how to periodically check for amount of oxygen still available in the tank, which can help order a timely refill.
  8. Make sure the oxygen tanks are safely situated in a stand or cart to avoid any accidental tipping and fall.  Accidental fall of the tank can be hazardous, as the tank can break with rapid escape of the pressurized gas, resulting in a dangerous explosion. While in the house, tanks can be left stable, lying flat on the floor, to avoid any accidental tipping.
  9. If an oxygen tank were to be transported, do not leave the tank in the car trunk, as it can roll around, leading to escape of the gas and explosion. Also, a car trunk can get unduly hot that oxygen in the tank can expand resulting in increased pressure inside the tank, causing it to explode. While transporting in the car, leave the standing upright in the cart and leave the car window partially open to allow some ventilation. Instructions for no smoking inside the car continue to apply.
  10. Instruct your oxygen dependent patients to avoid using alcohol and petroleum-based household, cosmetic, and therapeutic products. This list can include products such as, aerosol sprays, deodorants, perfumes, face creams, body lotions, moisturizers, lip balms, therapeutic oils, and so on. These products are combustible and upon contact with oxygen can result in serious burn injuries for the patient. Encourage your patients to use only water-based products to avoid risk of suffering burn injuries.
  11. Check with the patient for properly functioning smoke detectors. Instruct the patient and caregivers to inspect the smoke detectors periodically and change batteries as needed. Also encourage the patient and family to carry a fire extinguisher to help in emergency, if an accident were to happen.
  12. Do not forget to check the oxygen tubing for cracks and leaks. Damage to the tubing can result in escape of the gas compromising the therapeutic benefit to the patient. Also, check the oxygen tubing for any kinks, which can result in obstruction of gas flow to the individual. Instruct the patient or caregiver to change the oxygen tubing periodically or if it is damaged or soiled. The general recommendation is to change the tubing every 2 months.
  13. Too long tubing can contribute to patient tripping on it and is a significant fall risk. Also, oxygen tubing plain white in color is barely discernible, especially during the night leading to eventful falls. Oxygen tubing can come in bright and fluorescent colors for better contrast and visibility.
  14. Ensure proper placement of nasal prongs in the patient’s nares, especially if one is new to oxygen use. Nasal prongs should always point backward and downward, which can help proper delivery of oxygen. Instruct on checking the nasal prongs every day for any block. Educate the patient on cleaning the nasal prongs every week or if soiled, with water-based soap and warm water, rinse thoroughly, and let air dry before used again.
  15. Check with the oxygen dependent patient on every visit for any irritation and dryness of nasal passages, oral cavity, and throat. Oxygen dries out the mucus membranes causing irritation and breakdown, resulting in nasal bleeds and oral ulcers.
  16. Instruct the patient on measures such as compliance with fluid intake & hydration recommendations, use of water-based moisturizers, use of a humidifier along with the oxygen delivery system, to help prevent the mucus membranes from drying out.
  17. Check for skin integrity on every visit on the back of the ears where the oxygen tubing goes around. Prolonged wearing of oxygen tubing can result in friction against the skin surface on the back of ears and risk for skin integrity. Wearing eyeglasses with the temples of glasses located in this portion of the skin can add to the possibility of risk for skin integrity. Educate and encourage your patient and caregiver regarding regular application of water-based moisturizer to protect skin integrity.