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Q1. What is an oxygen concentrator? How does it work?
An oxygen concentrator is a medical device that delivers pure oxygen into the body of a patient by means of a nasal cannula or mask. It takes in air from the surroundings, compresses it, removes the nitrogen from it via a filter and sieve beds leaving 87-95% of oxygen in the air. This oxygen is then delivered to the patient.
Q2. What is a portable oxygen concentrator?
Portable oxygen concentrator is an oxygen therapy device that can easily be carried around. It offers therapy to those who are on the go and need more oxygen concentration than the ambient air level. It is small in size and lightweight. Portable oxygen concentrators can even be carried on-flight by air travellers.
Q3. What is the difference between portable and stationary oxygen concentrator?
Stationary oxygen concentrators are larger and heavier compared to portable oxygen concentrators. They also provide high flow rate and are recommended for patients who require substantial oxygen supply. Stationary oxygen concentrators deliver 3 to 10 liters of oxygen per minute while portable models supply 1 to 5 liters per minute.
Q4. How do portable oxygen concentrators work?
There are two types of portable oxygen concentrators - pulse dose and continuous flow. Pulse dose oxygen concentrator is ideal for use in the day time and delivers air through a nasal cannula only when the user inhales. This type is compact and has a greater battery life.
On the other hand, a continuous flow oxygen concentrator delivers constant air flow and is ideal for night-time use.
Q5. What is the advantage of an oxygen concentrator?
A home oxygen concentrator is safer and more cost-effective when compared to a traditional oxygen cylinder. Advantages of OC over cylinder is as follows:
i. Now there is no need to carry around heavy and unwieldy oxygen cylinders. No need for a family member to be engaged in Oxygen duty for the patient, daily.
ii. There is no Safety hazard with oxygen concentrators as they make ' oxygen on demand
iii. There is no storage of gas for a fire hazard as compared to Cylinders which are filled with liquid oxygen under high pressure.
iv. Oxygen is readily available with a concentrator and, unlike an oxygen tank, an oxygen concentrator allows unlimited supply of oxygen.
v. Patient can never run out of oxygen. There is no risk of leakage.
vi. Another major benefit is the ease with which one can carry it around, even when flying.
Q6. What is Pulse Flow and how is it different from Continuous Flow?
Pulse and continuous flow (or pulse dose and continuous flow dose) refer to how the oxygen is delivered to the patient. A pulse flow machine delivers oxygen only when the patient inhales and is triggered by inhaling. A continuous flow machine delivers a continuous flow of oxygen. Most continuous flow machines will deliver BOTH pulse and continuous flow.
Q7. Can I use a portable oxygen concentrator for my infant child?
Yes, you can use paediatric flow meters that can reduce the litre per minute flow for paediatric patients.
Q8. Can portable oxygen concentrators be used with CPAP or BiPAP devices?
Yes. Oxygen Concentrators that offer continuous flow can be used with sleep apnea devices.
Q9. What is the maximum concentration of oxygen that can be achieved with the Oxygen concentrator?
Up to 94% - 95%.
Q10. What kind of maintenance is required for the oxygen concentrator?
The device is as simple to manage as it looks.
i. All that is required is that the coarse filter has to be washed each day and replace the other filters as per instructions, which is usually at 1500 hours of use.
ii. The filters may also need to be changed according to local conditions (dust, humidity) and the amount of use of the concentrator.
iii. Skilled mechanical maintenance is needed only yearly.
iv. There is a fourth filter, the bacterial filter, located before the oxygen outlet of the concentrator.
v. Typically this must be changed every year, or more frequently, depending on the amount of use of the concentrator.
vi. The concentrator may work 24 hours a day, every day, with a rest of 30 mins after every 8 hours of continuous use
vii. Every concentrator has an hour meter The working hours should be written down in the service report.
viii. The humidity bottle must be cleaned every 2-3 days and distilled water should be filled to medium level.
ix. Nasal cannula should be changed every three months for hygiene purposes.
Q11. Are there any limitations of the oxygen concentrator?
In general oxygen concentrators have few problems during use but it is important to be aware of a few limitations.
i. Proper maintenance and running environment of the concentrator needs to be kept in check for trouble free experience.
ii. Manual of the machine should be read and understood, by the patient and the care giver, to ensure longevity of the machine and good health of the patient.
iii. Low voltage may pose a similar problem by overheating the machine due to inefficient running of the motor.
iv. A voltage regulator (UPS or Inverter) should be used in these circumstances. UPS or INTVERTER must be individually connected to the Concentrator.
v. Small concentrators are not intended or suitable for compressed gas anaesthesia (Boyle's) machines or ventilators.
vi. Power supply interruptions is a limitation to using an Oxygen Concentrators.
Q12. What are the precautions during usage of the oxygen concentrator?
The precautions to be observed are:
i. The concentrator should be placed as far away from the window as possible to avoid dust and moisture.
ii. Machine should be kept in a well ventilated room for optimal use or airconditioned room.
iii. Regular cleaning of filters and timely changing of HEPA filters should be practised.
iv. Always use a Stabilizer/UPS with the concentrator machine.
v. Keep a back up cylinder for unforeseen circumstances like power cuts.
vi. The concentrator should not be used to deliver oxygen through face mask but use cannula only.
vii. It should be kept far away from open flames.
viii. When a flow-splitter is being used, the total flow should not exceed more than 4 liters per minute or the concentration of oxygen will decrease.
ix. This happens because the canisters have a defined volume and can only separate a known volume of nitrogen at a given time. Therefore, concentrators must not be used at flows higher than those stated by the manufacturer.
Q13. Does the concentration of oxygen decrease over time?
The oxygen concentration is measured by an oxygen analyser which is available with all OXYMED service technicians. As the machine is used and the number of running hours increase and the machine comes to the end of its service life of 18k to 20k hours, the purity will also decrease. The machine is fitted with Purity Sensor and will sound an alarm if it goes below 83%.
Purity can also be greatly affected if the machine is not maintained properly or if the suggestions in the manual are not followed.
Q14. What are the common sources of Oxygen for therapy?
There are mainly 3 sources of Oxygen for therapy:
i. Oxygen Concentrators: Machines that concentrate Oxygen from room air. Just need a power source to work.
ii. Oxygen Cylinder: Compressed Oxygen in a cylinder-Conventional way of Oxygen therapy.
iii. Liquid Oxygen: Usually used in central supplies of hospitals. Liquid oxygen is stored in freezing cold tanks.
Q15. Does the oxygen concentrator have an oxygen sensing device?
All OXYMED machine are fitted with Oxygen sensors which are calibrated to sound an alarm if the oxygen purity goes below 83%. If such a problem occurs, please see the manual for troubleshooting.
Q16. Should I use a nasal cannula or a mask?
Most people prefer nasal cannula as it doesn’t look medical but most cannulas have a limitation that they are effective for flows up to 6 Litres Per Minute (LPM). There are special cannulas for higher flow (you may check with your equipment provider).
However, if you get rashes in your nostrils by use of cannula or if your flow requirement is above 6 LPM then a simple face mask is used by most people.
Q17. What kind of water should I use in humidifier? How often should I clean it?
It is recommended to use clean drinking water (distilled water) for humidifier as after all you are going to breathe through it.
There is no hard and fast rule for cleaning but there is no harm in having good daily cleaning practices just by rinsing through fresh water and replacing the water in the bottle.
Q18. When do I need to use a humidifier bottle?
The purpose of humidification is to provide moisture which makes Oxygen therapy comfortable; if not used, can cause dryness in airways of nose and throat. Usually, use of humidifier is recommended in continuous flow of more than 3 LPM
For patient comfort, please use the humidifier bottle with water up to mid level of bottle.
Q19. I feel that Oxygen coming out of the Oxygen machine is not as effective as that from a cylinder. What should I do?
You feel this because the temperature of Oxygen coming out of the machine is exactly the same as room temperature.
However, this is proven that effectiveness of Oxygen from both the sources is virtually the same.
What you need to see is the Oxygen saturation in your blood and you can check this using an Oximeter.
Please consult your physician immediately.
Q20. How much Oxygen is ideal for me?
The ideal amount of Oxygen is decided by your physician; he does it by carefully analysing your ABGs.
In most cases, the goal is to keep your Oxygen levels above 88% which after prescription is monitored using Oximetry.
In healthy individuals, ideal saturation of Oxygen in blood is 95-99%.
Q21. Is it alright if I use less than prescribed Oxygen?
No, you should use Oxygen exactly as prescribed by the physician. Using less than prescribed Oxygen can cause low levels of Oxygen in blood which can further cause poor memory, irritable mood, poor cognition, shortness of breath, headaches and much more.
Using less than prescribed oxygen for longer periods of time also deteriorates lung's health and causes the disease to grow.
Q22. Can I use more Oxygen than prescribed?
No, using more than prescribed oxygen can cause Oxygen toxicity/Oxygen poisoning in the body which has many harmful effects like damage to eyes, acute respiratory distress syndrome (ARDS), alveolar damage, destruction of neurons , etc.
Q23. Will my body get dependent on Oxygen if I use it continuously?
No, Oxygen is not addictive at all. A large number of patients express their concern regarding this and try to decrease the time they are on Oxygen or totally avoid it. Supplemental Oxygen is prescribed because the lungs have become weak due to condition like COPD and the 21% Oxygen of air is now not sufficient for lungs which results in low level of O2 in blood.
In order to make lungs feel like as if they are exactly in a normal healthy environment, they need some extra Oxygen so that the Oxygen exchange with blood is exactly same as it would have been with normal healthy lungs.