HOME OXYGEN
CONTENT
Who goes home on oxygen
Safety and oxygen
Humidity
Supplies
24-hour schedule
Help
Visitors
Outing/travel
Doctor visits
CPR
Counting baby’s breathing
Call the doctor if…
Types of oxygen systems
· Nasal (nose) Cannula
· Cylinders (tanks)
· Concentrator
WHO GOES HOME ON OXYGEN
1. Babies who need oxygen for a long time, who are gaining weight on feedings and whose special care can be learned by parents may go home on oxygen.
2. Bronchopulmonary Dysplasia (BPD) is the most common reason a baby goes home on oxygen.
3. Babies with some birth defects or a tracheostomy may go home on oxygen.
4. Babies who need oxygen with feedings to avoid oxygen desaturation episodes.
SAFETY AND OXYGEN
1. NO smoking in a room with oxygen equipment!
2. Post “NO SMOKING” signs in your home and car.
3. NO open flames (heaters or fireplace) within 6-8 feet of your baby.
4. Keep oxygen tanks at least 5 feet away from any radiator or heater.
5. NO alcohol or spray cans should be used with a baby on oxygen.
6. NO Vaseline® or petroleum-based products should be used on the baby’s face.
7. If your baby’s nose is dry and irritated you may use Simply Saline®.
8. Keep the room open so air circulates and is not stuffy.
9. Tanks should be secure and maintained in an upright position, except the D-tank (small portable tank), which should lay flat at all time.
10. Oxygen tanks must be protected from being knocked over. They should be secure and upright, except the D-tank which should lay flat at all times.
a. If the tank is knocked over and makes a hissing noise, turn it off immediately
b. If the regulator is broken or you cannot safely turn the tank off, remove the tubing and take your baby from the room
c. Call the medical equipment supply company or the fire department for help.
HUMIDITY (MOISTURE IN THE AIR)
1. Oxygen is very drying to the baby’s air passages.
2. When your baby has a cold, you may be told to use a room humidifier in the home.
SUPPLIES AT HOME
1. The hospital will make arrangements with a company near where you live to provide all the home supplies you need.
2. The supply company will contact you before you take your baby home.
3. The supply company will tell you how and when to reorder supplies and give you their phone number. Call them if your equipment breaks or to reorder supplies.
24-HOUR SCHEDULE
1. You will be very busy at home. It helps to have a calendar with your day’s activities clearly marked.
2. Some things you will do several times a day. Some things you will do several times a week. Organization and a schedule are important.
Daily Things
a. Medications-as ordered
b. Chest physical therapy-usually twice a day, if recommended by your baby’s doctor
c. Feedings-every 3-4 hours
d. Check oxygen used and reorder as needed.
Weekly Things
a. Change cannula every 7 days (once a week)
b. Supplies are usually mailed to your home. Please be sure you do not run out
c. Oxygen tanks will be delivered directly to your home.
HELP
1. Taking care of a baby on home oxygen or with special needs can be very stressful. Most parents still prefer to have their baby at home. Contact with other parents who have gone through this experience can be helpful. Call the North Carolina Family Support Network (1-800-852-0042) for families or organizations near you.
2. Help from family members is also important. We suggest several family members or close friends learn how to care for your baby so everyone can get some rest and you can have a break and get out by yourself.
3. Some insurance companies approve home nursing care for a baby on home oxygen. We contact your insurance company to find out if they provide this service. Even if you have home nursing care, you must be able to do all of your baby’s care on your own. You will be the expert about your baby.
4. Home health agencies or public health services are used for short visits. These visits are an hour or less. The nurses answer questions, help with special treatments and help with medications. They may weigh your baby or watch a feeding.
5. Even though it is difficult to find people to baby-sit, it is important to teach other family members or close friends to care for your baby so you can get out.
VISITORS
1. Limit the number of people who handle your baby.
2. Handling your baby a lot may affect the baby’s feeding and sleeping.
3. Ask visitors to look but not to touch, wake, or handle the sleeping baby.
4. Ask friends and visitors with sickness in their families not to visit.
5. Ask friends and visitors handling your baby to wash their hands before doing so.
6. Say “Dr. ______said only a few people should handle the baby.” It helps you to not look overprotective or to feel badly about not having your wishes carried out.
OUTINGS/TRAVEL
1. Dress your baby based on the weather. Be careful not to overdress him. A good guide is to dress him the way you would feel comfortable.
2. Avoid direct sunlight.
3. Some babies do well enough to go out with you. Limit your trips to around your house or block, the porch, home of close friends and relatives and doctors’ visits. It may be easier for relatives, friends or baby-sitters to visit you.
4. Avoid places with large crowds (grocery stores, church, shopping malls) during the first 1-2 months you are home. It is difficult to control people who want to look, touch, and ask questions about your baby.
5. Limit outings when the weather is rainy, windy or cold.
6. You can get a sign from the local American Lung Association or Department of Motor Vehicles that lets you park in the space for handicapped people.
DOCTOR VISITS
1. Your baby will need to return to the Baby S.T.E.P.S Program; Pulmonary Clinic (Neonatal Follow-Up clinic) to check his breathing, oxygen needs as well as his growth.
a. Your first visit to the Baby S.T.E.P.S Program; Pulmonary Clinic is 2-6 weeks after your baby is discharged.
b. You will receive a letter at home telling you the date of your appointment at the Baby S.T.E.P.S Program; Pulmonary Clinic (Neonatal Follow-Up clinic.) Please follow the instructions in the letter and call to get your appointment time.
c. The baby’s doctor will receive a report about your clinic visits.
d. There is a charge for clinic visits. Your insurance will be billed for the visits. Other outside services (e.g. physical therapy, occupational therapy, speech therapy, etc) also have a charge.
2. You will take your baby to a local baby doctor for routine baby care and shots (immunizations.) An appointment to see your baby’s doctor the first week you are at home will be given to you at the time your baby is discharged.
3. If you see other doctors (eye, surgery, breathing, x-ray, lab and developmental), check to see if the appointments can be made for the same day.
4. At first it seems you spend most of your time going to the doctor.
5. As your baby’s health gets better the doctor visits become less often.
COUNTING YOUR BABY’S BREATHING
1. Become familiar with your baby’s usual breathing pattern. You may want to count your baby’s breathing rate once or twice a day when your baby is quiet or asleep. You can write the number in a record book to bring with you to the doctor visits.
2. A breath in and out is one count. Sometimes your baby will hold his breath briefly, breathe fast then slow, stretch or move. Count the breathing as best you can.
3. Make sure your baby is not too warm or does not have mucus in his nose if his breathing rate is 15-20 counts higher than his normal rate.
CALL THE DOCTOR IF….
1. Your baby’s breathing becomes harder or consistently faster than usual.
2. Your baby eats poorly two feedings in a row.
3. Your baby’s color is unusually pale or blue.
4. Your baby vomits more than usual.
5. Your baby has a temperature over 99.0 F (37.2 0 C) [axillary] or 100.0 F (37.8 0 C) [rectally].
6. Your baby is too quiet or too fussy (different from his usual behavior).
Congratulations on having your baby go home!!!!! We are here to help, as you need.
TYPES OF OXYGEN SYSTEMS
1. Two types of oxygen equipment are used at home. The insurance company or Medicaid often determines the type your baby uses.
2. We check with your insurance company or Medicaid office for you and arrange for your equipment.
3. The medical equipment company will help you to figure out how long the oxygen will last. They will tell you when to reorder supplies.
A. NASAL (NOSE) CANNULA
1. A small tube (cannula) is used to give your baby oxygen. It fits under baby’s nose and around his head.
2. The tube has two prongs. These prongs should be just inside your baby’s nostrils.
3. The cannula is kept in place with pink tape.
4. Change the cannula every 7 days, if it gets mucus or formula in it or according to directions from the equipment company.
5. The size of the cannula depends on the size of your baby.
6. Use lotion or a moist cloth to help remove the tape or adhesive from your baby’s face. Be careful not to hurt your baby’s skin when changing the cannula.
7. To clean the cannula:
a. Run warm water onto the prongs to remove formula or mucus
b. Shake excess water out of the prongs
c. Dry off the outside of the cannula with a paper towel.
8. The equipment company will teach you about cleaning equipment and supplies.
B. OXYGEN (O2) TANKS OR CYLINDERS
1. The length of time before a tank needs to be replaced depends on how much O2 your baby is on. Your equipment supply company will show you how to read a gauge and figure out when to call for more oxygen. This is usually at 500 psi (pounds per square inch) or just before the red area on the gauge.
2. The supply company will help you decide when to reorder supplies. Call them if your equipment breaks or you need to reorder supplies. PLEASE CALL YOUR EQUIPMENT SUPPLY COMPANY 24 HOURS IN ADVANCE.
3. The oxygen company will pick up the empty tank and leave you a filled tank. This is called a refill.
4. O2 tanks (M cylinders) are 4-5 feet tall and weigh about 150 pounds. They sit in a metal stand so they do not fall over. They must remain where they are placed. They are always green.
5. A smaller tank (D or E cylinder) on rollers or carried in a pouch over your shoulder is used for travel to the doctor or short trips. The weigh about 15 pounds.
6. Portable tanks used in a car should remain on the seat and never be placed in the trunk. They must be secured well for travel (may be seat belted). Do not leave the tanks in a hot car. If the tanks are left in the car for short periods of time make sure you leave a window cracked or a vent open.
SAFETY: See page 1
C. OXYGEN CONCENTRATORS
1. The concentrator is a 28-pound machine that takes oxygen from the room air and gives it to your baby.
2. The concentrator runs on electricity.
3. The concentrator can be used with babies on flow rates between ¼ lpm and 5 lpm.
Safety: See page 1
1. Plug your concentrator into a separate circuit from other appliances.
2. Do not use extension cords on concentrators.
3. Keep the filter clean.
Operating Your Concentrator
1. Plug the cord into a grounded outlet (three holes). No other appliances should use this circuit.
2. Connect the oxygen tubing to the concentrator.
3. Turn the power switch ‘ON’.
Cleaning
1. Wipe the concentrator with a damp cloth. Do not use furniture wax or spray.
2. Wash the filter under running water once a week. Dry with a towel or air dry. Return the filter to the concentrator.
Problems
1. Concentrator does not work.
a. Check if plug is in outlet
b. Check house fuse or circuit breaker
c. Check circuit breaker on concentrator.
2. No oxygen flow.
a. Make sure oxygen tubing is not kinked, clogged or disconnected
b. Check concentrator filter for dust.
3. Call the equipment supply company if you are unable to solve the problem. (Connect the child to portable or back-up oxygen tank while problem-solving).
Hours of Oxygen
Liters Per Minute (lpm)Tank Size / 1 / ¾ / ½ / ¼ / 1/8
D
/ 5.8 hrs / 8.7 hrs / 11.6 hrs / 23.2 hrs / 46.4 hrsE
/ 10.2 hrs / 15.3 hrs / 20.4 hrs / 40.8 hrs / 81.6 hrsMy _____ cylinder at ______lpm will last ______hours of continuous use.
My _____ cylinder at ______lpm will last ______hours of continuous use.
My Equipment Supply Company is:
Name:
Address:
Telephone:
Reviewed/Revised: 04/98…..06/13
Home Oxygen 10