Home Oxygen Therapy for Babies and Children - Air Liquide UK

Home Oxygen Therapyfor Babies & Childrenwww.uk.airliquide.com

Section 1: SafetySection 2: ConcentratorsSection 3: Medical Oxygen CylindersSection 4: Medical Liquid OxygenYou can contact the Customer Services Team on24/7 Customer Helpline 0808 143 9999 Freephone(Normal working hours are Monday to Friday 8:30am - 5:00pm)2

Before You StartBefore you use any of your oxygen equipment there are a few simple safety rulesthat you must follow. If you are unsure about them after reading this, please speakto your Homecare Technician or a Customer Services Representative who will beonly too pleased to explain these safety rules to you.GeneralInformation -Oxygen forMedical useOxygen is a colourless andodourless gas, so thenormal human sensescannot detect it if there ismore oxygen than normalin the surrounding air.Oxygen can build upunnoticed on your clothingand in your hair as youbreathe it, even while yousleep and use oxygen, yourbedding can becomesaturated. For this reason,home oxygen users arealways at risk from theirclothing, bedding, furnitureand their hair catching fireas a result of smoking orothers in close proximity tothem smoking.Higher OxygenConcentrationsMean GreaterRiskOxygen can build up andconcentrate in a closedroom or a confined space,but it can easily bedispersed in a wellventilated room.Oxygen makes up 21% ofthe air that we breathe,oxygen is an oxidizingagent which means that ithelps things burn moreeasily and more fiercely.Fire TriangleTo start a fire, three thingsare needed, something toburn (fuel), something to setit alight (heat or a spark)and oxygen to support thefire and keep it going.NEVER smoke or allowothers to smoke when yourbaby or child’s oxygen isbeing used.In oxygen enrichedatmospheres, fabrics,wood, paper and othermaterials, which normallydo not burn easily in airmay suddenly catch fire oncontact with a small spark,cigarette or naked flame.Fatty substances, oils andgreases may spontaneouslyignite in oxygen.Home Oxygen Users MUST NOTsmoke or allow others to smokewhere oxygen is being used.3

Section 2: ConcentratorsParts of theConcentratorMain Flow Control (lpm)Oxygen OutletPurity Warning LightHour MeterOn/Off SwitchUsing your Low Flow ConcentratorBefore you use your concentrator you should become familiarwith its parts. Refer to the following pages and ‘Your Guide toOxygen Concentrators’.ONFig. 2Fig. 1OFFAs your concentrator is being used for a baby or child with alow flow rate, a special flow meter has been attached (Refer toFig. 2).1. The flow rate will be set to the prescribed rate by yourHomecare Technician. Any further adjustments should onlybe made on the recommendation of your Doctor orHealthcare Professional.2. To turn your concentrator ON press the button up (I) (Referto Fig. 1).103. To Turn your concentrator OFF press the button down (O)(Refer to Fig. 1).

Section 2: Concentrators4. When your concentrator is turned on allow it to run for five(5) minutes to warm up, and the oxygen reaches the correctpurity for your child to breathe, check the ball in the flowmeter is centred on the line marking the prescribed flow(Refer to Fig. 2).5. Fit the cannula to your child.6. When not using your concentrator switch the power switchto the OFF (O) position (Refer to Fig. 1).7. In the event of a power failure, you have been provided witha back-up cylinder which should be used only for thispurpose. The back-up cylinder should not be used as amain medical oxygen supply for your child. How to use thiscylinder is dealt with in the next section on Medical OxygenCylinders.8. The flow of oxygen is very low. If at any time you areconcerned that the concentrator is not delivering anyoxygen, place the end of the supply hose, NOT the cannula,into a glass of water and check for bubbles.Test for Oxygen Flow11

Section 2: ConcentratorsFig. 3OFFAfter using your Concentrator1. When not using your concentrator flick the power switch tothe OFF (O) (Refer to Fig. 3) position.2. If you are not going to use your concentrator for an extendedperiod of time, you are advised to switch your unit off at themains socket.Looking after your ConcentratorBefore carrying out any of the following maintenance tasks onyour concentrator, PLEASE READ THE SAFETYINFORMATION IN SECTION 1 OF THIS GUIDE.1. Clean the cabinet occasionally with a damp cloth and thenwipe it dry. Avoid letting water into the internals of yourconcentrator. DO NOT use any detergents or abrasiveswhen cleaning the unit.2. Wash the filter from the unit at least once a week.● Remove the filter and replace it with the spare filter● Hand wash the filter in warm soapy water● Rinse it thoroughly and remove any excesswater with a clean absorbent towel● Allow the filter to dry naturally, and put it in a safe placeuntil you change the filter again3. If you have a humidifier fitted you must change the wateron a daily basis.4. Wash the humidifier bottle once a week.● Wash the bottle with warm soapy water● Rinse thoroughly with clean water● Dry the outside of the bottle with a clean absorbent cloth● Refill the bottle with distilled waterIf you run out of distilled water, use boiled water that has beenkept in a covered container and allowed to cool.12

Section 2: ConcentratorsServicingThe concentrator that you have been provided with will give youa constant supply of oxygen 24 hours per day every single dayof the year. Your Homecare Technician will visit every six (6)months to carry out maintenance on your concentrator.A member of our Customer Services Team will contact you inadvance to advise you when this routine maintenance will takeplace.During a maintenance visit the Homecare Technician will:– check that the tubing is in good condition,– check that your back-up cylinder(s) are full and workingproperly,– supply you with new cannulae and any other consumablesthat you may need.HumidificationFew home oxygen users require humidification. However, if ithas been prescribed for you, there are a few simple steps foryou to follow:1. Unscrew the top of your humidifier bottle and fill with distilledwater. NEVER fill the bottle above the line indicated.2. Screw the top of your humidifier bottle back on.3. On the top of the humidifier bottle you will see a threadednut. Screw the humidifier onto the concentrator and securetightly. Make sure you do not cross thread or over tightenyour humidifier bottle.4. Attach your short tube to the oxygen outlet on the humidifierbottle (Refer to Fig. 4). Attach the water trap to the other end(Refer to Fig. 5). Place it lower than the humidifier bottle.ConcentratorAttachmentFig. 4Oxygen OutletFig. 5 Attaching theWater Trap13

Section 2: ConcentratorsHourMeterElectricity RebatesWe will make a payment to you every three (3) months estimatingthe costs of running your concentrator according to theprescription supplied by your Doctor or Healthcare Professional.Every six (6) months during the routine maintenance visit, theHomecare Technician will take a reading and record the hoursthat your concentrator has been used. This reading will enableus to calculate the electricity that has been used to run yourconcentrator and we will send you a payment to cover thesecosts. We will take into account any under or over payment thathas been made to you as a result of the three monthly estimate.Payments are usually issued in the patient’s name, but we canchange this, especially when patients are babies or children. Youwill need to advise us by completing an Electricity ApplicationForm and return it to us in the Pre-Paid Envelope provided.If you are concerned about your electricity reading, you cantake a reading for yourself and call the Customer Helpline andspeak to our Accounts Team who will gladly discuss yourreading with you.The meter is located on the front of the concentrator, just belowthe serial number. (Refer to Fig. 6)To read your meter on the concentrator turn your head so that ittouches your left shoulder. You can now read the numbercorrectly: this number is the number of hours that yourconcentrator has been operating (32 hours shown in Fig. 6).On/OffSwitch14Fig. 6

Section 2: ConcentratorsMinor Troubleshooting Guide for ConcentratorsThe following guide will assist you to correct any minor problems that you may experience with yourchild’s equipment.You may also wish to refer to your individual guide book that was provided by your HomecareTechnician, these booklets will give you further advice on basic troubleshooting.If after carrying out any of the following steps you find that your child’s equipment is still not workingthen please call theCustomer Services Team on24/7 Customer Helpline 0808 143 9999 Freephone(Normal working hours are Monday to Friday 8:30am - 5:00pm)PROBLEM PROBABLE CAUSE SOLUTIONBack-up cylinder is on but oxygendoes not flow.Tubing trapped.Blocked cannula.Cylinder is empty.Check that the tubing has notbecome trapped by a cot frame,chair, door or furniture standingon it.Replace the cannula with a newone as the old one may havesecretions in the fine tubing.Check the contents indicatorgauge and replace if needed.Compressor does not run.Constant audio alarm with powerswitch in the On position.Compressor shuts downintermittently.No power to the unit.Restricted airflow through unit.Unit overheating due to improperlocation.Check wall outlet for power.Clean the inlet filter or removethe obstruction.Relocate unit away from heatingsource, provide adequateventilation on all sides.Alarm does not sound. Dead battery. Call Customer Services.Limited or low flow.Low oxygen concentration/low purity.Restriction in tubing or humidifierif fitted.Blocked internal air filter.Replace tubing or humidifier.Check the filter.Call Customer Services toarrange replacement filter.15

Section 3: Medical Oxygen CylindersF Flow Rate IndicatorB Oxygen OutletUsing a Cylinder with a Micro Flow/LowFlow MeterPortable oxygen cylinders are filled with medical oxygen and willhelp your baby or child go out and do everyday things.To reduce the flow of medical oxygen from the cylinder so thatthe pressure and flow are not too high for your child, you havebeen supplied a micro flow or low flow meter (Refer to Fig. 7)depending upon the prescribed flow rate your Doctor requested.1. Check that the flow meter is plugged into the outlet socket(A) of the main cylinder valve. Once you have pushed it intoplace, gently tug on the device to make sure it does notcome away (Refer to Fig. 8).E Flow Rate SelectorFig. 7BAC15 metresmax.Connecting your TubingFig. 8Connecting your tubing to a oxygen supply system is easy andvery simple.Tubing over 15 metres long MUST NOT be used as this willreduce the flow. Take care with any tubing laying on the floorand ensure that it is not trapped under doors, chairs, or heavyitems of furniture, and that it is not allowed to kink.2. Attach the medical oxygen supply tube to the outlet (B)making sure that the tube is not trapped or kinked in anyway as this could restrict or stop the flow.16

Section 3: Medical Oxygen Cylinders3. Turn the ON/OFF valve (C) on your cylinder anti-clockwise tothe ‘ON’ position.4. Turn the low/micro flow meter ON by slowly turning the valve(E) anti-clockwise. Make sure that it is set to the prescribedflow rate number. It is important that the number is in themiddle of the viewing window (F) (Refer to Fig. 7).5. Check to see if there is a flow through the tubing andcannula.The flow of medical oxygen is very low. If at any time youare concerned that the equipment is not delivering anymedical oxygen, place the end of the supply hose, NOTthe cannula, into a glass of water and check for bubbles.6. When you are satisfied that there is a medical oxygen flowput the cannula or mask on your child.Test for Oxygen Flow7. To turn the low flow/micro flow meter OFF turn the valve (E)clockwise until you see 0 in the viewing window. Then turnoff the cylinder by turning the ON/OFF valve (C) clockwise tothe OFF position.8. After use, check the remaining medical oxygen in thecylinder by looking at the contents gauge (D). If it is in thered zone it is time to re-order (Refer to Fig. 9).CDRe-ordering Cylinders:When your child starts using his/her last cylinderREMEMBER to order a new supply and to allowthree (3) working days for a normal delivery. Call0808 143 9999 between 8:30am and 5:00pmMonday to Friday for normal deliveries. Thisnumber is available outside of normal workinghours for EMERGENCIES ONLY.Fig. 9CYLINDER INFORMATION:Weight Full2.9 kgHeight405 mmDiameter340 mmCapacity690 LitresAccessoriesBAG17

Section 3: Medical Oxygen CylindersCalculating the Duration of your CylinderThe following tables will show you how long your child’s cylinder will last based on the flow rate andtype of flow meter supplied.Cylinder Type: Paediatric 2 Litre 300 BARThis is a high capacity filled cylinder which allows you to fit the micro or low flow device selected foryou child’s prescription.816 MICRO FLOW METER:Flow Rate Duration Duration(LPM) (HOURS) (DAYS)0.01 1150 48.950.02 575 23.950.03 383 15.950.04 287 11.950.05 230 9.580.06 191 7.950.07 164 6.830.08 143 5.950.09 127 5.290.1 115 4.79817 LOW FLOW METER:Flow Rate Duration Duration(LPM) (HOURS) (DAYS)0.1 115.0 4.790.2 57.5 2.390.3 38.3 1.590.4 28.7 1.190.5 23.0 N/A0.6 19.1 N/A0.7 16.4 N/A0.8 14.3 N/A0.9 12.7 N/A1.0 11.5 N/A1.5 7.6 N/AAll of the above figures are based on a 24 hours continual use. For flow rates above those givenabove please contact your Homecare Customer Services Representative on:0808 143 9999 Freephone18

Section 4: Medical Liquid OxygenHow to use your Medical Liquid OxygenSystem:If your child’s doctor has requested medical liquid oxygen youwill be supplied with a base unit from which you will be able tofill your portable unit (Refer to Fig. 10).Medical liquid oxygen is stored in a base unit, which is aninsulated stainless steel container, and is similar to a thermosflask. The medical liquid oxygen is stored at a very lowtemperature, and its quantity amounts to the equivalent of35,260 litres of oxygen gas.7. ALWAYS store your base unit and portable unit in an uprightposition. Both units will continue to produce medical oxygengas even if they are not being used.8. NEVER cover your base unit or portable unit with clothing orany other items and never carry your portable unit underyour coat.Keepequipmentupright19

Section 4: Medical Liquid OxygenUseful Information:● 1 litre of medical liquid oxygen will ‘evaporate’ as it warmsup to provide 860 litres of oxygen gas.● A typical portable 0.6 litre paediatric medical oxygen unitcontains about 516 litres of oxygen gas.● A typical base unit will hold approximately 25,800 litres ofoxygen gas. That is the equivalent of having 52 portablecylinders ‘on tap’. Lighter medical liquid oxygen portableunits provide you with excellent mobility.● A medical liquid oxygen base unit takes up less floor spacethan 4 standard 10 litre medical oxygen cylinders. Thismakes it a highly efficient method of storage and supply.● Home oxygen users / their carers may refill the portable unitsdirectly from the base unit as and when required.● Portable medical liquid oxygen units may be carried over theshoulder or worn across the chest using the strap provided.IMPORTANT!Safety information for medical liquid oxygenIn the unlikely event of a leak from the base unit, wheel thebase unit outside. If possible, open the doors and windowsfor ventilation and allow the oxygen to disperse.In the event of accidental contact with the skin● DO NOT rub● Remove any clothing if necessary and gently applyslightly warm water for at least 15 minutes● Call your Doctor20

Section 4: Medical Liquid OxygenWhat is Medical Liquid Oxygen?Medical liquid oxygen is stored in an insulated stainless steelcontainer similar to a thermos flask. These storage containersare referred to as base units and they hold the medical liquidoxygen at an extremely low temperature.Medical liquid oxygen base units are low pressure storagecontainers designed to safely store more oxygen than gascylinders can.The temperature of liquid oxygen is -183°C and can causeserious ‘cold’ burns if it should ever come into contact withyour skin.A medical liquid oxygen system that is installed in your homewill generally consist of a base unit mounted on a roller basewith a separate portable unit similar to the ones shown (Refer toFig. 10).Medical liquid oxygen systems are installed to meet portableoxygen requirements outside the home. If you have beensupplied with an oxygen concentrator for use in the home, youMUST NOT use your medical liquid oxygen system for thispurpose.In the event of a power or concentrator failure, the medical liquidoxygen base unit, in conjunction with the portable unit, may beused as a temporary back-up supply until the concentrator orelectricity supply has been repaired or restored.Fig. 1021

Section 4: Medical Liquid OxygenHow to use your Medical Liquid OxygenYour portable medical liquid oxygen unit should only be usedfor active use and not for storage. You should fill the portableunit about 15 minutes before you intend to use it, this willmaximise the time available when you do go out.1. Wash your hands before handling any medical oxygenequipment.2. Wipe both blue filling connections with a dry lint free cloth.The blue connections are located as follows, one on top ofthe base unit and the other on the base of your portableunit. These two connections must be clean and dry toprevent ice formation during filling.3. NEVER try to fill your portable unit if your base unit isempty.4. Turn the flow rate selector to (0).5a5c5e5b5d5f5a. Hold the portable unit in both hands.5b. Position the two blue quick release connectors together,one is on the base unit and the other is on the bottom ofthe portable and press down firmly with two hands.5c. Begin filling the portable unit by simply pulling the blackvent valve handle into the open position while continuing toapply downward pressure on the portable unit to maintaina connection.5d. When the portable unit starts to let out vapour, it is full andyou should close the vent valve immediately.5e. When disconnecting the portable unit, simply depress orpush the grey disconnect plunger on the liberator base unit,this will disengage your portable unit from the base unit.5f. If the portable unit freezes to the liberator base unit,simply close the vent valve handle and leave it attached.Once the connections have thawed out in about 10–15minutes the units can be easily disengaged.22

Section 4: Medical Liquid Oxygen6. Never touch the blue quick release connectors after filling,as they are very cold and will cause freeze burns.7. Connect the cannula to the medical oxygen outlet.8. Using the flow rate selector (red knob) on the top of theportable unit set this to your prescribed number (litres perminute). This is the flow rate prescribed by your HealthcareProfessional.Take care that the flow rate selector has been set properlyand is not set in between two correct settings, if this is thecase then your medical oxygen will not be able to flow.The above filling guide is only a quick reference guide, forfurther information regarding your particular medical liquidoxygen system, please refer to the ‘Manufacturers PatientHandbook’ that your Homecare Technician has providedyou with.Taking care of your child’s mask orcannulaYour child’s oxygen cannula or mask are important pieces ofequipment.A cannula can easily become blocked by nasal secretion andmucus. Both cannula and masks should therefore be kept asclean as possible.You should also check the oxygen tubing daily for any obvioussigns of damage such as kinking, flattening or splitting. If younotice any damage you must replace the tubing immediately.It is important that you keep a spare cannula or mask to handat all times.CAUTION:Take care that tubing does not become trapped in itemssuch as furniture, doors, babies’ cots, infants’ high chairs etc;as this will restrict or even stop the flow of medical oxygen.23

Important InformationElectricity CompanyWe recommend that you inform your electricityprovider that you are using an oxygenconcentrator for medical purposes so that inthe event of a power supply failure they areaware of your special needs.Insurance CompanyWhilst it should not affect your insurancepremium, it is advisable that you inform yourHome Insurance company to ensure that youare fully covered should you ever have the needto make a claim.Moving House/Changing TelephoneNumbersPlease remember to inform us if you aremoving house or if you have changed yourtelephone number. It is very important that youtell us this information so that we can maintaina regular medical oxygen supply to you.ContactsGeneral enquiries:Customer Services Department8:30am - 5:00pm Monday to Friday0808 143 9999For emergencies:Outside of normal working hours, 24/70808 143 9999Data ProtectionFor us to supply you with all of your oxygenrequirements and reimburse you for electricitypayments, it is important that we keep personaldata about your oxygen needs.This information will be kept securely within ourdatabase and we will only disclose thisinformation to those Healthcare Professionalswho are directly involved in your care or in theadministration of your care.You have the right under the Data ProtectionAct to see the personal data that we hold andprocess. If you wish a copy of this information,an application must be made in writing andsent to:The Business Manager,Air Liquide Limited,Unit 2, Tyne Dock - East Side,South Shields,Tyne and Wear,NE33 5SPUseful NumbersBritish Lung FoundationHelpline: 08458 50 50 20Email: enquiries@blf-uk.orgWebsite: www.lunguk.orgwww.uk.airliquide.comAir Liquide Limited. Unit 2, Tyne Dock - East Side, South Shields, Tyne and Wear, NE33 5SP.South West - Version 1 Dec 08