Mod 9 Home Oxygen

Question 1

What clinical assessments are evaluated for the screening process for patients with Chronic Lung Disease (CLD) for Home Oxygen Qualification?

Answer 1

• Assess SpO2 at rest
• Assess SpO2 on exertion
• MMRC (dyspnea chart) -> Consider Pt education in dyspnea management if Pt does not qualify for home oxygen

Question 2

What external factors determine if a patient qualifies for Home Oxygen that aren’t apart of the screening process?

Answer 2

• Discharge planning, is the only reason they can’t be discharged is bc they need oxygen?
• Eligibility and guidelines differ by province, but AADL (provincial guideline for canada)

Question 3

How long do Home Oxygen Qualifications last?

Answer 3

Generally only up to 3 months while they recover from an event, than you usually won’t need it.

• sometimes, it may also only be for 24hs.
• If they need to stay or get an ABG draw for whatever reason, they need to be reassessed for qualification

Question 4

Why is MMRC considered for Oxygen Qualification?

Answer 4

The key thing to teach Pts with dyspnea is how to cope with it (they may not qualify and live with O2)

• AKA how to teach Pts to preserve their energy and prevent muscle dystrophy and exhaustion

Question 5

What techniques can you coach Pts to manage their dyspnea?

Answer 5

Purse lip breathing, huff coughing, splinting position, huff coughs etc. etc.

• This card is not exhaustive, just keep in mind techniques to teach

Question 6

What are huff coughs?

Answer 6

Coughs without closing the glottis

Question 7

What are the Steps involved for Oxygen Qualification (generally)?

Answer 7

1. Identity indications for oxygen/tests to confirm
2. prescription for Oxygen therapy
3. Pt informed of qualification results and chooses oxygen provider (usually before discharge)
4. Oxygen provider is contacted/home oxygen setup

Question 8

What tests are usually used to confirm a Pts need for Oxygen Therapy?

Answer 8

Qualification “testing” must be ordered by a physician. The tests would be:

• ABG
• Walk test w/pulse oximetry printout

Question 9

What do prescriptions for oxygen therapy include?

Answer 9

• Type of therapy (continuous, nocturnal, exertional)
• A specific lpm, flow, or TDP (therapist driven prescription)
• Any other specific instruction (type of O2 therapy device)

Question 10

How does oxygen setup differ if the start begins with the patient at the hospital vs home?

Answer 10

• In hospital, provider will provide tank/concentrator for trip home
• At home, company will arrange an appoint

Question 11

What are Home Oxygen Qualification Categories?

• what is observed?

Answer 11

How does Breathing affect SpO2? what level of breathing performed, age group, funding, and status of the patient The following are assessed:

• Continuous breathing (at rest)
• Exertional breathing
• Nocturnal breathing
• Palliative
• Cardiac pallative
• Neonatal/pediatric
• Exceptional oxygenation funding
• private health care?

Question 12

What continuous breathing traits would qualify a patient for home oxygen?

Answer 12

PaO2 < 55mmHg or **PaO2 <60 (w/cor pulmonale)

• Evidence of heart failure
• Hematocrit >55 and documentation of pulmonary hypertension

Question 13

How often are home care O2 treatments assessed after initial setup?

Answer 13

Typically at 3 months, than every 6 months, and prn.

• Tank deliveries
• Tech visits to test equipment function