Mod 9 Home Oxygen Flashcards
What clinical assessments are evaluated for the screening process for patients with Chronic Lung Disease (CLD) for Home Oxygen Qualification?
- 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
What external factors determine if a patient qualifies for Home Oxygen that aren’t apart of the screening process?
- 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)
How long do Home Oxygen Qualifications last?
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
Why is MMRC considered for Oxygen Qualification?
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
What techniques can you coach Pts to manage their dyspnea?
Purse lip breathing, huff coughing, splinting position, huff coughs etc. etc.
- This card is not exhaustive, just keep in mind techniques to teach
What are huff coughs?
Coughs without closing the glottis
What are the Steps involved for Oxygen Qualification (generally)?
- Identity indications for oxygen/tests to confirm
- prescription for Oxygen therapy
- Pt informed of qualification results and chooses oxygen provider (usually before discharge)
- Oxygen provider is contacted/home oxygen setup
What tests are usually used to confirm a Pts need for Oxygen Therapy?
Qualification “testing” must be ordered by a physician. The tests would be:
- ABG
- Walk test w/pulse oximetry printout
What do prescriptions for oxygen therapy include?
- Type of therapy (continuous, nocturnal, exertional)
- A specific lpm, flow, or TDP (therapist driven prescription)
- Any other specific instruction (type of O2 therapy device)
How does oxygen setup differ if the start begins with the patient at the hospital vs home?
- In hospital, provider will provide tank/concentrator for trip home
- At home, company will arrange an appoint
What are Home Oxygen Qualification Categories?
- what is observed?
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?
What continuous breathing traits would qualify a patient for home oxygen?
PaO2 < 55mmHg or **PaO2 <60 (w/cor pulmonale)
- Evidence of heart failure
- Hematocrit >55 and documentation of pulmonary hypertension
How often are home care O2 treatments assessed after initial setup?
Typically at 3 months, than every 6 months, and prn.
- Tank deliveries
- Tech visits to test equipment function
Palliative Oxygen qualification?
SpO2 <92 at rest for 3 mins
Cardiac palliative oxygen qualification?
- EF <20%
- SOB at rest
- Stage 4 heart disease diagnosis
- Unresponsive angina
