oxygen guidelines (NHSG)


general points

  • Refer for home Oxygen only if your patient is hypoxic (this may sound obvious but you'd be surprised!).

  • Oxygen is a drug which requires a prescription (SHOOF).

  • Oxygen is a treatment for hypoxaemia, not breathlessness.

  • Oxygen has no impact on the sensation of breathlessness in non-hypoxaemic patients - patients may benefit from airflow across their face e.g. fan.

HOW TO CONTACT THE OXYGEN TEAM

  • gram.oxygen@nhs.scot

  • Telephone - 01224555796 / 01224559569

how to refer for home oxygen

  • For routine referrals please refer via SCI Gateway.

  • For an urgent request click on the blue link below (or if problems contact us as above on email or phone).

  • If you are referring a patient for Home Oxygen on discharge from hospital additional information will be required including discharge plan and contact details of the keyholder for installation.

oxygen contractor details

Arrange direct home deliveries of equipment and supplies.

Offer access to help and support for patients through a 24 hour helpline if there is equipment failure

A single point of contact

Holiday loans and advice available

different types of oxygen delivery

Long term oxygen therapy (LTOT)

  • Defined as oxygen used for at least 15 h per day in chronically hypoxaemic patients (often COPD).

  • Chronic hypoxaemia is defined as a PaO2 ≤7.3 kPa or, in certain clinical situations, PaO2 ≤8.0 kPa.

  • Refer for arterial blood gas if saturations < 92% with date of last exacerbation

  • LTOT is delivered via an oxygen concentrator and should be differentiated from the use of oxygen as a palliative measure for symptomatic relief in hypoxic breathless patients.

AMBULATORY oxygen therapy (AOT)

  • Defined as the use of supplemental oxygen during exercise and activities of daily living.

  • AOT should be limited to patients where oxygen improves exercise tolerance. Assess for desaturation below 88-90%

  • Significant exercise desaturation commonly found in patients with interstitial lung diseases and cystic fibrosis.

  • In cystic fibrosis, AOT may be used to enable effective airway clearance.

  • Minimal evidence of benefit to COPD patients

PALLIATIVE oxygen therapy (pOT)

  • POT should not be supplied if the patient is not hypoxaemic or have mild levels of hypoxaemia above current LTOT threshold levels of 92% (Grade A)

  • All patients experiencing intractable breathlessness should have a trial of opiates (Grade A)

  • All patients should receive assessment for a trial of non-pharmacological treatment e.g. fan therapy.

short burst oxygen therapy (sbOT)

  • Should not be ordered for use prior to or after exercise in hypoxaemic or normoxic patients with COPD (Grade A)

  • Prescribed by Neurology for cluster headaches

how to prescribe oxygen safely

  • Significant risks of fire and personal injury associated with smoking or vaping and the use of home oxygen therapy, patients who are found to be smoking/vaping may have oxygen uplifted.

  • Clinician’s assessment of smoking status relies mainly on patients’ testimony and evidence has shown that this can be inaccurate

  • Dolby Vivisol carries out a Risk Assessment including a range of factors such as smoking/vaping, use of gas appliances, open fires and woodburners.

  • Trips or falls may result from mobility or sight impairment as a result of equipment and tubing.

  • We share information with Scottish Fire and Rescue Service with verbal consent from patient or relative living in the house.

  • The Scottish Fire and Rescue Service will offer a Home Fire Safety Visit (HFSV) to all patients with a new prescription or where concerns have been highlighted.