oxygen concentrators

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General Information

Home oxygen therapy can be accomplished in various ways. Your physician has determined the proper one for your condition.

Oxygen concentrators separate oxygen and nitrogen, the two main elements of room air. The machine discards the nitrogen, stores and concentrates the oxygen, and redelivers it at 90 to 95 percent purity. As in all home medical equipment, proper adjustment and operation are essential to achieve maximum benefit from the product. The individual who delivers the oxygen concentrator is experienced in setting it up, so be sure you understand its operation before he or she leaves the home.

Using the Oxygen Concentrator

Starting the Oxygen Flow

Plug the concentrator directly into a grounded electrical outlet and attach the tubing from the cannula to the oxygen output.Turn the switch on.
Adjust the oxygen flow meter to the prescribed flow rate.
Put on the cannula and adjust for comfort.

Note:

Do not use an extension cord with the concentrator machine.
See “Facts About the Nasal Cannula” in the Oxygen Therapy flyer.
If a humidifier is used, see “Facts About Humidifiers” in the Oxygen Therapy flyer.

Stopping the Oxygen Flow

1. Remove the nasal cannula and turn the concentrator power switch off.

Note:

You do not have to turn the flow control off once it has been set, but check it each time the concentrator is turned on and periodically during use.

First Health Medical Supply provides this product information for your benefit-Your Physician, Nurse, or Therapist can answer any specific questions you may have. Follow the instructions carefully.

General Troubleshooting

Oxygen concentrators are equipped with an alarm that sounds in the event of an equipment malfunction or power failure. Note the following if the alarm sounds:

Make sure that the power cord is still plugged in. If it is, check other electrical appliances in the home. The problem may be a power failure or a blown fuse or circuit breaker.
In the event of a power failure, turn the concentrator off to stop the alarm. Then, revert to your backup system.
Contact Yuma Regional First Health Medical Supplies office if electrical service is not promptly restored to get additional oxygen for the back-up system.

If the problem is not a power or circuit failure, the alarm indicates an equipment malfunction. In this event, do the following:

Turn off the concentrator and revert to your back-up system as above. Notify your First Health Medical Supply office of the malfunction immediately.

Note:

If you use your backup cylinder during several power failures, check the pressure gauge to ensure that you have sufficient back-up oxygen. The instructions provided with the backup system will help you determine the amount of oxygen remaining.

Cleaning and Maintaining the Equipment

Remove and clean the sponge-like air inlet filter twice a week by washing it under warm running water. Shake out the excess water and use a clean paper towel to squeeze it dry before replacing the filter. Do not use the concentrator machine without this filter in place. Periodically wipe off the outside of the concentrator with a damp cloth.

Other Important Reminders

Take note of the following when using the oxygen concentrator:

Carefully follow your physician’s instructions for the flow rate and duration of daily oxygen intake.
Oxygen concentrators do produce some heat; this is normal. Allow adequate space for air to circulate around the machine, and do not place it against a wall, curtains, etc.
Prominently display “No SMOKING” signs in all areas where oxygen is being used or stored. Follow all safety precautions outlined in the Oxygen Therapy filer.
Notify your power company that you have life-sustaining equipment in your home.
Oxygen concentrators do not reduce the amount of oxygen in a room.

If you have received instructions from your physician or therapist that differ in any way from the above information, follow those instructions explicitly. If you experience any functional problems with this product, discontinue use and call your First Health Medical Supply office for assistance.

Oxygen Therapy

General Information

All human beings need oxygen to live. Human cells, the basic unit of life, require energy to function, which they get from a combination of the food consumed and the oxygen gas breathed in. Cellular energy is achieved through the wondrous process of food being transformed into heat (energy) with the assistance of oxygen. Oxygen itself is colorless, odorless, and tasteless. The air we breathe is made up of approximately 78% nitrogen and 21% oxygen. When oxygen therapy is prescribed for certain conditions, it means that it is going to be supplied in concentrations higher than the 21% found in the air. Oxygen tanks of various sizes, an oxygen concentrator, or a liquid oxygen system may be utilized.Your physician has determined the one that is best for you.

How We Breathe

Breathing is a much more complex process than inhaling and exhaling. Once we inhale air into our lungs our body’s real work begins. The oxygen enters the blood stream, which transports it to all the body’s cells. The cells then combine the oxygen with nutrients from the food to produce energy. Carbon dioxide, a by-product of this process, is absorbed by the blood and transported to the lungs where it is exhaled.

The condition hypoxemia and/or hypoxia develop when cells do not receive sufficient oxygen, causing shortness of breath, an elevated heart rate, and sometimes feelings of restlessness and confusion. This shortage of oxygen, and the subsequent need for oxygen therapy, is generally the result of one or more of the following:

The heart failing to pump an adequate amount of blood.
The blood failing to carry enough oxygen to the cells.
The lungs failing to provide enough oxygen to the blood.

Oxygen Therapy

Your condition requires that you breath a higher concentration of oxygen; and, since oxygen is a drug, it must be prescribed by a physician. Because it is a drug, use oxygen at exactly the flow rate, in liters per minute, and for the exact length of time that has been prescribed by your physician.

First Health Medical Supply provides this product information for your benefit-Your Physician, Nurse, or Therapist can answer any specific questions you may have. Follow the instructions carefully.

Safety Precautions

Medical oxygen is completely dry, and breathing it can sometimes cause discomfort, so a humidifier is often prescribed or recommended as part of oxygen therapy. A humidifier is little more than a container which, when filled with distilled water and attached to the oxygen system, moistens the oxygen before it is inhaled.

Because infection-causing bacteria grow readily in water and on wet surfaces, the humidifier must be kept clean and dry at all times when not in use.

Cleaning and Maintaining Humidifiers

Always wash your hands before handling/refilling the humidifier. Cleanliness in any medical treatment cannot be overstressed.

The cap must be screwed on to the bottle tightly enough to prevent leaks, and the humidifier fitting must be properly attached to the oxygen equipment.
Empty, rinse, and refill the humidifier every day. Do not overfill.
Thoroughly clean and sanitize the humidifier (see instructions below) at least once a week.
When not in use disconnect the tubing to the cannula (or mask) and unscrew the humidifier fitting. Disassemble the humidifier; there are only two parts: the bottle and the cap with stem attached.
Do not touch any of the internal parts of the humidifier with your hands or allow them to touch counter tops, sinks, etc., when refilling or cleaning.

Cleaning Instructions

Cleaning the humidifier requires mild dishwashing detergent, white vinegar, a bottlebrush, and two basins or buckets (plastic containers are ideal). Basin #1 will contain warm water and detergent. Basin #2 will contain a 1-to-2 vinegar-water solution (one cup of white vinegar to two cups of water). Increase the amount proportionately, if necessary, to cover the disassembled humidifier completely while soaking.

Wash the disassembled parts in the warm sudsy water. Use a brush to remove any residue.
Rinse the parts thoroughly under warm running water.
Soak all parts in the vinegar-water solution for 30 to 40 minutes. All parts must be completely submerged in the solution. Do not rinse after soaking.
Shake off excess solution, place parts on clean paper towels, over with another paper towel, and allow to air dry.
Store thoroughly dry humidifiers in clean plastic bags.

Note:

Do not touch the inside of the humidifier bottle.
Have two humidifiers: one to use while the other is being cleaned/sanitized.
Discard and replace the humidifier if the stem inside the container becomes discolored.
Discard the detergent solution after each cleaning.

Facts About Humidifiers

The nasal cannula is the flexible plastic nozzle with two short tips that are inserted into the nostrils and through which the oxygen flows.

Connect the humidifier, tubing, and cannula and set the oxygen flow rate at low to begin. Insert the tips of the cannula into the nostrils and slip the two smaller plastic tubes over the ears and under the chin. Adjust the plastic slide until the cannula fits snugly but comfortably, and then clip the tubing to the clothes. Allow enough slack in the tubing so your head can turn. Set the flow rate to that prescribed by your physician.

Note:

The flow rate prescribed by your physician has been set on the flow meter of the oxygen system. Do not change the flow rate for any reason without first consulting your physician.
Because of the continuous flow, oxygen will collect in the nose and throat, so it is not necessary always to breathe through the nose when using a nasal cannula.
The tips of the cannula must be curving toward you.
If wearing the nasal cannula causes irritation to your nose, consider using an only water-based lubricant inside your nostrils.Consult your physician or pharmacist. Do not use an oil-based product.
Rotating cannulas every month helps avoid possible contamination.
Replace the tubing connecting the humidifiers to the cannula every one to two months. If a humidifier is not being used, replace the tubing every four to six months.

Traveling/Transporting Oxygen

Keep all oxygen systems in an upright position when handling and transporting. Carry oxygen in the back seat of your car, not in the trunk, secured in a stable, upright position. Open the widow as much as weather conditions will permit.

Contact your First Health Medical Supply office well in advance if you plan to travel outside our service area.

Safety Precautions

As in all home medical equipment, proper adjustment and operation are essential to achieve maximum benefit from the product.The individual who delivers the oxygen equipment is experienced in setting it up, so be sure you understand its operation before he or she leaves the home.

Oxygen itself is a stable and relatively harmless element. It will not explode and it will not burn. However, an oxygen-enriched atmosphere can cause a fire to burn faster and hotter. Read the following precautions carefully in order to benefit completely from the use of oxygen in the home and avoid the chance of fire and other hazards.

DO NOT

Do not allow open flames or smoking in a room where oxygen is used or stored.
Do not use any electrical appliances (e.g., electric blankets, electric heating pads, fans, etc.) near where oxygen is being used.
Do not leave oxygen turned on when not in use.
Do not abuse or handle oxygen containers roughly.
Do not store oxygen in an unventilated area.
Do not use friction or other spark-inducing devices where oxygen is being used or stored.
Do not use petroleum products such as Vaseline, lotions, creams, etc., while receiving oxygen, and do not handle or allow others to handle oxygen equipment with these substances on the hands.
Do not use aerosol sprays while oxygen is in use.
Do not use alcohol, alcohol-based products, or products containing either or other flammable products in an oxygen-enriched room.
Do not oil or grease oxygen equipment.
Do not cover oxygen tubing with bedding or any other objects. Do not place long oxygen supply tubing under carpet or furniture.
Do not allow untrained persons to use, adjust, modify, or repair oxygen equipment.
Do not place oxygen containers near heat sources such as fireplaces, radiators, heat ducts, etc.
Do not touch “frosted” fittings or piping on liquid oxygen systems with bare hands.
Do not open cylinder valves quickly.
Do not transport oxygen in the trunk of a car.

DO:

Do use a stand to keep oxygen cylinders upright, or secure them with a strap, chain, or rope.
Do use all-cotton clothing and bedding to avoid sparks from static electricity.
Do keep oxygen equipment out of reach of children.
Do keep oxygen equipment clean and dusted. Wipe it off periodically with a damp cloth and clean with a mild household detergent when necessary. Oxygen Therapy-4

Other Important Information

Remember: follow precisely your physician’s orders for the amount and duration of daily oxygen. Take all medications at the proper times and in the correct dosage.
Keep all appointments with your physician, therapist, and other healthcare providers, and continue to practice the breathing training and physical conditioning they have recommended.
Do not stop exercising unless instructed by your physician. Within the prescribed limits, try to increase your level of activity while taking oxygen.
Contact your physician immediately if you sense any changes in your overall health.

First Health Medical Supply

Large Cylinder O2 Equipment

General Information

Home oxygen therapy can be accomplished in various ways. Your physician has determined the proper one for your condition. If the oxygen for your therapy is supplied from a cylinder or tank, secure it with a strap, chain, or rope so it cannot be upset. A stand has been provided for this purpose. Keep all cylinders, empty or full ones, secured. (Cylinders in storage may be stored lying down.) All large cylinders, whether full or empty, must have the protective cap securely on when not in use. Keep all cylinders away from radiators, heat ducts, fireplaces, or any other sources of heat.

Using The Oxygen Cylinder

As in all home medical equipment, proper adjustment and operation are essential to achieve maximum benefit. The individual who delivers the oxygen cylinder is experienced in setting it up; be sure you understand its operation before he or she leaves the home.

Starting The Oxygen Flow

1. Turn the flow adjustment knob completely off, finger tight only-do not over tighten.

2. Open the cylinder valve slowly, all the way, so that the pressure gauge indicates the amount of oxygen in the tank.

3. Turn the flow adjustment knob on until the flow meter gauge registers the flow rate prescribed by your physician.

Your physician has prescribed a flow rate of __________ liters per minute.

4. Attach the tubing from the cannula to the outlet nipple (or the humidifier output if a humidifier is being used).

5. Put on the cannula and adjust for comfort.

Note:

A full tank registers about 2,000 PSI, a half tank 1,000 PSI, etc.
Refer to “Facts About the Nasal Cannula” in the Oxygen Therapy flyer.
If a humidifier is being used it should bubble when the oxygen is turned on if it has been properly filled with water, and all connections are tight. Refer to “Facts About Your Humidifier” in the Oxygen Therapy flier.

First Health Medical Supply provides this product information for your benefit- Your Physician, Nurse, or Therapist can answer any specific questions you may have. Follow the instructions carefully.

Stopping The Oxygen Flow

1. Turn the cylinder valve completely off. As oxygen flows from the regulator, the pressure gauge and flow meter will gradually drop to zero.

2. When both gauges register zero, turn the flow adjustment knob off, finger tight only-do not over tighten.

Maintaining A Supply of Oxygen

Check the pressure gauge regularly to avoid running out of oxygen. Your First Health Medical Supply representative will do as much as possible to assist you, but he or she cannot monitor your oxygen supply as effectively as your can. The following information will help you determine when to order more oxygen.

Note:

A full 244 cubic foot tank contains 6900 liters (2,000 PSI) of oxygen. At a flow rate of 2 liters per minute it will produce for approximately 56 hours, at 3 liters per minute it will produce for approximately 38 hours, etc.
The pressure should be watched carefully beginning at 500 PSI, as flow meter accuracy decreases rapidly at lower weights.Change tanks before the pressure drops below 200 PSI.

Other Important Reminders

The cylinder valve must be on in order to read the pressure.
Keep sufficient spare oxygen to last overnight and during weekends and holidays. If you need help deciding how long your tank will last, please call our office.

Display NO SMOKING signs prominently in all areas where oxygen is being used or stored.

Portable Oxygen Cylinder

General Information

Home oxygen therapy can be accomplished in various ways. Your physician has determined the proper one for your condition. If the oxygen for your therapy is supplied from a cylinder or tank, secure it with a strap, chains, or ropes so it cannot be upset. A stand has been provided for this purpose. Keep all cylinders, empty as well as full ones, also secured. (Cylinders in storage may be stored lying down.) All cylinders, whether full or empty, must have the protective cap on tightly when not in use. Keep all cylinders away from radiators, heat ducts, fireplaces, or any other source of heat.

Using the Portable Cylinder

As in all home medical equipment, proper adjustment and operation are essential to achieve maximum benefit. The individual who delivers the oxygen system is experienced in setting it up. Be sure you understand its operation before he or she leaves the home.

Review the other safety precautions in the general information Oxygen Therapy flyer that was provided with these instructions.

Attaching the Regulator to Small Cylinders

Your portable oxygen cylinder may require a washer between the regulator and the post valve of the cylinder to prevent leaking.If the cylinder you use does not require this washer, ignore those references below.

1. Discard the old washer inside the regulator yoke.

2. Remove the seal from the post valve of the full cylinder, remove the washer inside and place it on the largest peg inside the yoke of the regulator.

3. Slide the regulator yoke down over the post valve of the cylinder and align the pegs inside the yoke with the holes in the post valve on the cylinder.

4. Tighten the T-handle snugly.

Note:

When the valve is turned on the cylinder will make a loud hissing sound (indicating oxygen is escaping) if the T-bolt is not secure or if the washer is not in place. Do not be alarmed. Turn the cylinder valve off, make sure the washer is in place, and check the alignment of the regulator on the cylinder. Retighten the T-handle firmly.

First Health Medical Supply provides this product information for your benefit- Your Physician, Nurse, or Therapist can answer any specific questions you may have. Follow the instructions carefully.

Starting the Oxygen Flow

1. Turn the flow adjustment knob completely off. Finger tighten only-do not over tighten.

2. Turn the cylinder valve slowly one full turn to the on position using the small cylinder wrench (or the handle on cylinders so equipped).

3. Turn the flow adjustment knob on until the gauge registers a flow rate of __________ liters per minute, the rate prescribed by your physician.

4. Attach the tubing from the cannula to the outlet nipple adapter on the regulator.

5. Put on the cannula and adjust for comfort.

Note:

The pressure gauge indicates the amount of oxygen in the tank. A full tank registers about 2,000 PSI, a half tank 1,000 PSI, and so forth.
Refer to “Facts About the Nasal Cannula” in the Oxygen Therapy flyer.

Stopping the Oxygen Flow

1. Turn the cylinder valve completely off using the small-cylinder wrench or handle. As oxygen flows from the regulator, the pressure gauge and flow meter should slowly drop to zero.

2. When both gauges register zero, turn the flow adjustment knob off. Finger tighten only-do not over tighten.

Note:

To remove the regulator, turn the oxygen off as described, loosen the T-bolt, disengage the pegs in the regulator yoke, and lift off the regulator.

Ordering More Oxygen

Check the pressure gauge frequently to avoid running out of oxygen. Your First Health Medical Supply representative will assist you as much as possible, but you should closely monitor your oxygen supply. Use the following charts to determine when to order more oxygen for “E” and “D” type tanks:

FLOW IN LITERS PER MINUTE E-TANK
APPROPRIATE DURATION
Pressure Gauge Reading	HOURS	HOURS	HOURS	HOURS	HOURS
2,000 PSI	8	4.25	2.75	2	1.25
1,500 PSI	5.5	3	2	1.5	…..
1,000 PSI	3	2	1.5	< 1	…..
500 PSI	1.5	<1	0.75	…..	…..

FLOW IN LITERS PER MINUTE D-TANK
APPROPRIATE DURATION
Pressure Gauge Reading	HOURS	HOURS	HOURS	HOURS	HOURS
2,000 PSI	4.5	2	1	…..	…..
1,500 PSI	3.5	1.5	< 1	…..	…..
1,000 PSI	2	1	…..	…..	…..
500 PSI	< 1	…..	…..	…..	…..

Note:

The pressure should be watched carefully below 500 PSI. Flow meter accuracy decreases rapidly when gas pressure is less than 200 PSI. Change tanks before the pressure drops below 200 PSI.

Other Important Information

The cylinder valve must be on in order to read the pressure.
Always keep sufficient spare oxygen to last overnight and during weekends and holidays. If you need help deciding how long your tank will last, please call your First Health Medical Supply office.
Prominently display “NO SMOKING” signs in all areas where oxygen is being used or stored.

Liquid Oxygen System

General Information

Home oxygen therapy can be accomplished in various ways. Your physician has determined the proper one for your condition.Liquid oxygen systems are commonly prescribed for individuals whose bodies fail to take in adequate oxygen but who are otherwise mobile and active. Oxygen takes up less space and can be stored at much lower pressures in its liquid state. Hence, sufficient oxygen can be carried in the lighter weight portable liquid unit than an oxygen gas cylinder.

Oxygen must be stored at approximately minus -300 degrees Fahrenheit to remain in a liquid state. For this reason the reservoir and portable unit act much like large “thermos” containers. When the oxygen is turned on, the liquid warms as it leaves the container, changes to a gas, and is furnished at room temperature.

Liquid oxygen systems consist of two principal elements: the stationary unit (or reservoir) that stores a large volume of liquid oxygen, and a portable unit that is refilled from the reservoir. The stationary unit serves as the primary source of oxygen while at home, and the portable unit is used for exercise or other activities outside the home (or within the home when out of reach of the stationary reservoir).

The Stationary Unit (Reservoir)

The reservoir is comprised of four parts: (1) a contents indicator that registers the amount of oxygen in the tank, (2) a flow selector for controlling the oxygen flow rate, (3) an oxygen outlet, and (4) a fill port that connects to a matching connector on the portable unit.

Observe the following in regard to the reservoir:

Select a location for the reservoir that is cool, dry, well ventilated, and with a level surface.
Attach the humidifier (if being used) to the oxygen outlet. (See “Facts About Humidifiers” in the Oxygen Therapy flyer.) Then, connect the tubing from the cannula to the humidifier output.
Make sure the tubing is not twisted, crimped, or bent, it must be open at all times.

Keep the reservoir upright at all times. If it is ever upset, place it upright immediately and notify your all-med healthcare, inc. office.

Starting The Oxygen Flow

1. Adjust the flow selector to the prescribed flow rate.

Your physician has prescribed a flow rate of __________ liters per minute.

2. Put on the cannula and adjust for comfort.

Stopping The Oxygen Flow

1. Remove the nasal cannula.

2. Turn the flow selector off.

Note:

If humidifier is filled with water and all connections are tight, it will begin to bubble when the flow is started.
Refer to “Facts About the Nasal Cannula” in the Oxygen Therapy flyer.

Ordering Additional Oxygen

Check the reservoir contents gauge regularly to avoid running out of oxygen. Everything possible will be done to schedule delivery to prevent this from occurring, but you must monitor your oxygen supply closely.

Notify your First Health Medical Supply office when your reservoir contents indicator registers __________.

The Portable Unit

The portable unit is comprised of five parts: (1) an oxygen outlet to attach the tubing from the cannula, (2) a flow rate selector for controlling the oxygen flow rate, (3) a contents indicator that registers the amount of oxygen in the unit, (4) a fill port that connects to a matching connector on the reservoir for refilling, and (5) a carrying strap.

Filling The Portable Unit

Check the level of oxygen in the reservoir before attempting to fill the portable. Do not try to refill the portable if the reservoir contents indicator registers below__________. Contact your First Health Medical Supply office to make arrangements for refilling the reservoir.

Observe the following procedure for filling the unit:

1. Clean and thoroughly dry the fill ports on both the reservoir and the portable unit.

2. Set the flow selector off on both units.

3. With the portable unit in a stable upright position, align and connect the port coupling on the portable to the one on the reservoir.

4. Open the vent valve on the portable. You should detect a hissing sound when the gas remaining in the portable is forced out by the incoming liquid oxygen. When the portable is full a continuous stream of white vapor will escape from the vent port.

5. As soon as this liquid venting occurs, quickly close the vent valve.

6. Allow the pressure in both containers to equalize by leaving the two units connected for at least 30 seconds after closing the vent valve.

7. Adjust the flow selector on the reservoir to your prescribed flow rate, put on the cannula, and resume receiving oxygen from the reservoir. Disconnect the portable as described blow.

Note:

Any moisture on the couplings during the filling process can cause temporary freezing.
Filling the portable unit only takes 1 to 2 minutes. Do not leave the units unattended during the filling process.
If venting continues when the valve is closed, reopen and close the vent valve quickly to help seal the valve. Do not force the valve closed.

Disconnecting The Portable

1. When the pressure has stabilized, disengage the couplings between the units.

2. After separating the units, check both for leakage. If any leakage persists, leave the units connected and call First Health Medical Supply office.

3. Wipe off any moisture that may have collected on both units.

Note:

Difficulty in disengaging means the connection may be temporarily frozen. Do not force the units apart and do not touch any frosted parts of the units. Be sure that the vent valve is closed and allow the connectors to warm to room temperature. The couplings will disengage easily after a few minutes.
In the event of a malfunction or severe leakage, move well away from the equipment and call your First Health Medical Supply office immediately. Avoid skin contact with the liquid as severe burns can result.

Starting The (Portable) Oxygen Flow

1. Attach the tubing from the cannula to the outlet on the portable.

2. Adjust the flow rate to __________ liters per minute, the flow rate prescribed by your physician.

3. Put on the cannula and adjust for comfort. See “Facts About the Nasal Cannula” in the Oxygen Therapy flyer.

Stopping The (Portable) Flow of Oxygen

1. Remove the cannula.

2. Turn the flow selector off.

Note:

Keep the portable unit upright at all times.
Always store the portable unit and the reservoir in an open, well-ventilated area.

Cleaning And Maintenance

Clean the liquid oxygen system periodically with a soft, damp, lint-free cloth. If necessary, a mild household detergent may be used, but do not use abrasive cleaners. If a humidifier is being used, refer to “Facts About Humidifiers” in the Oxygen Therapy flyer for the proper procedure for cleaning your humidifier.

Other Important Information

Follow your physician’s orders exactly for the flow rate and duration of daily oxygen therapy.
Prominently display NO SMOKING signs in all areas where oxygen is being used or stored. Follow all of the safety precautions outlined in the Oxygen Therapy flyer.
Do not attempt to fill the portable unit partially full; fill it completely each time. If you used the portable unit away from home for only a short time, continue to use it after returning home until it is empty, and then refill it from the reservoir.