Home Oxygen Safety

Vol. 19 •Issue 6 • Page 9
Home Oxygen Safety

Ensure Patients Know the Do’s and Don’ts

I recently received an urgent call from a home care patient asking for help with a “family crisis.” It took me less than a second to say, “Well, if that is what the home health provider told you, that is what you need to do.” In truth, I was not going to take sides in this one.

Here is the deal: One elderly relative has a CPAP machine for sleep apnea and oxygen in his bedroom. Another relative (they never much liked each other anyway) is a chain smoker. So CPAP Cousin told Smoking Cousin he could not come in the house with a lit cigarette.

While it is easy for us to make fun of this situation, sadly some people with oxygen believe their house may spontaneously explode if they flick on a light switch too fast. Meanwhile, others chain smoke while heating coffee on the gas stove with their portable unit sitting right on the counter. We really should set the record straight.

Oxygen accelerates combustion. It does not spontaneously explode.

Now let me prepare all you new grads out there for reality. You are going to tell someone that bit of information, and they are going to come back with, “Oh yeah? What about the Challenger? Or that airplane in Florida that crashed?”

Some Teaching Moments

You need to tell them that while liquid oxygen was reportedly a factor in the rapid destruction of the aircraft, it was not the sole initiating cause. Chances are these patients are not going to query NASA for the final reports or want to debate the finer details. But you can use this as an opportunity to teach them safe handling techniques for their home oxygen.

Smoking near oxygen is a bad idea, and it actually is a good idea to post non-smoking signs and ask that visitors not smoke in a home where oxygen is in use. Oxygen users should likewise avoid being close to an open flame. This includes candles, fireplaces and gas stoves. It also includes open flames on chaffing dishes in restaurants.

Depending on the source, it is recommended that oxygen users stay five to 10 feet away from open flames. Oxygen cylinders and canisters should also be kept away from heat-producing appliances. Don’t tuck them away between the dryer and the hot water heater in the utility room or out of sight behind the chair next to the radiator.

Keeping these units 10 feet away from such heat sources is a good distance for safety. A well-ventilated area is, in fact, the best place for them. Make sure the oxygen unit—whether it is a cylinder, concentrator or liquid system—is secure at all times. It should not be left on an uneven rug or in an area where it could be easily knocked over and damaged.

If you have an oxygen concentrator, do not use an extension cord or—even worse—multiple extension cords to reach to another room. Certainly do not put the cords under rugs or furniture. Use only a grounded outlet for the equipment. A warning that I must admit even I had not thought of is to avoid using bedding or clothing made of wool, nylon or synthetic fabrics that may produce sparks from static electricity. Cotton material for bedding and clothes is a recommended alternative.

Some Problematic Products

Do not use petroleum-based products to clean the equipment. Some sources recommend avoiding petroleum-based products like petroleum jelly to moisturize lips and skin. While we are talking about personal hygiene products, remind your patients that hairspray, nail polish remover, aerosol deodorants and other grooming products may be flammable and should be used with care.

We have talked a lot about fires, but liquid oxygen patients also need to be careful to avoid cold burns too. Liquid oxygen is stored at approximately -297 degrees Fahrenheit. It can easily freeze skin and delicate tissue on direct contact. Patients and family members should be taught how to safely handle the equipment. Unprotected skin should never come in contact with frosted parts of liquid oxygen containers. Users should also be taught to step back to protect their eyes because the vapor can be very cold and damaging.

In addition to teaching the patients about home safety measures, at least one other care provider should be taught how safely to handle the equipment. Patients should also notify local authorities that they have oxygen equipment in their home. Regulations vary from state to state and even from city to city as to whom should be notified about the presence of oxygen equipment. If in doubt, call your local health department and fire department to find out what your locality requires.

The concept of notifying local officials has raised some confusion. Some say the company supplying the equipment has the responsibility for this; others say the patient does. It is probably safest if both notify the authorities. I would also recommend re-notifying them on a regular basis (annually or perhaps every two years) if oxygen has been in the home for some time. Some localities mandate this, others do not.

Most hospital-based practitioners (guilty as charged) are not familiar with the safety recommendations for home oxygen. But when a patient calls with a problem, do not take sides. Refer the caller to people who can help them.

Oxygen Safety Resources:

Cincinnati Children’s Hospital Medical Center: Home Oxygen Therapy for Premature Babies @ http://www.cincinnatichildrens.org/health/info/newborn-risk/home/home-oxygen-therapy.htm.

Oklahoma State University Environmental Health and Safety Dept.: Compressed Gas Cylinders @ http://www.pp.okstate.edu/ehs/links/gas.htm.

Seattle Fire Department: Home Oxygen Safety @ http://www.ci.seattle.wa.us/fire/FMO/firecode/infobulletins/2003-5.pdf.

Margaret Clark is a Georgia practitioner.

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