BREATHLESS WEBSITE: This site was founded by John Kirtley. Sadly he died in 2008
It is now run by David Boswell and Terry Mackay
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Oxygen Equipment Suppliers
In February 2006 the supply of oxygen to patients changed very dramatically. Prior to this date it was supplied by pharmacies, now it has been privatised. Needless to say there were teething troubles to start with and when John Kirtley first wrote these pages some areas were in a very sad state. Allied Respiratory one of of the companies selected to supply oxygen was the subject of a BBC Watchdog report. Two years on things have improved. (I live in in Hertfordshire and my supplier is BOC Vitalair. I have nothing but praise for them). Terry.
Concentrators
A concentrator is a machine that takes in the ambient air and it filters out the oxygen and delivers this to the patient via tubing to either a facemask or a nasal cannula (a piece of tubing that passes under the nose with two small prongs resting just inside the nostrils). Concentrators are usually supplied to patients on LTOT (Long Term Oxygen Treatment) or have usage requirements when mmoving around their home or garden above a certain limit. Last time I heard that limit would be at least 2 hours.
The concentrators (pictured below) will deliver all the oxygen the patient needs at home. The one I have will supply up to 5 litres per minute (lpm). The machine uses mains electricity; the cost of running the concentrator is refunded by your supplier every 3 months so you will not have to be concerned about this. You will be supplied with 2 back-up cylinders in case of power failure.
It is advisable to inform your electricity supplier that you are dependant on oxygen and that you have a concentrator. They will then put you on their at risk list in case of power loss.
For safety you may request that the tubing is secured to skirting boards and door-frames and up the stairs. The supplier will also install diverting taps to re-direct the oxygen upstairs into your bedroom and bathroom.
Cylinders
You will be supplied with portable cylinders for use when not at home. These come in 2 sizes as seen in the above picture on the left. There are other high capacity cylinders but you will not normally be supplied with these apart from the back-up ones for your concentrator.
You will have no problem being supplied with the larger of the two cylinders but I understand that the smaller one is charged to the PCT at a rate of £21- £25 per day so they will be somewhat reluctant to supply them to everyone.
I understand that the smaller cylinders are only about 0.5Kg (1lb) pound lighter than the large ones. So does size matter? Probably YES, but you will need to convince your GP or Nurse of the benefit to you or you will only be supplied with the larger heavier option.
Conserver
A conserver is a device that prolongs the life of your cylinder i.e. without a conserver a normal portable cylinder on a rate of 2 lpm will last about 3 hours but with a conserver it should last about 16 hours. How is this possible? The cylinder on its own gives a constant flow of oxygen, with a conserver it only gives oxygen when you breathe in. You will need to be assessed by your GP or nurse before you can be issued with a conserver. If they agree that it would be beneficial for youthey will complete the necessary forms and your supplier will deliver it and show you how to use it.
Because the oxygen is delivered by a pulse action some people find it difficult to adjust to. Others will adapt to it without any problems.
Liquid Oxygen
In exceptional circumstances these systems can be made available, but as they are very expensive, again you are only likely to be supplied with them if you can convince your GP or Nurse that you have a need for them.
An extract from the BOC Vitalair patient’s handbook.
Liquid oxygen systems provide excellent mobility for patients who do not want oxygen therapy to compromise their active lifestyle in any way. The system has a compact base unit, which contains approximately 30 litres of liquid oxygen. This is used to refill the portable unit with oxygen as and when you need it. The lightweight portable unit provides enough supplementary oxygen for a full day's activity and is perfect for trips away from home. The base unit holds enough oxygen to last around 9 days on continuous flow or 2+ weeks if used purely for ambulatory purposes. ** Our Patient Service Representatives will demonstrate how to use and store your liquid oxygen.
** Portable unit will last approx 8 hours based on a flow rate of 2 lpm
Portable concentrators
These are not usually supplied by the Service Providers on the NHS, but can be purchased privately.
I personally have had two, both of which I had to buy myself. The first was the Freestyle, this one I bought from John Kirtley second-hand. When first purchased by John it was £3500. It was light compact and easy to use, it would deliver 1, 2 or 3 lpm on a pulse system (you get oxygen only when you breath in) . I found it ideal for use in the car where it could be plugged into the cigarette lighter socket. However it was of limited use when walking or exercising.
Below is a picture of John with the Freestyle Portable Concentrator.
If you have used one of these please let us know your views.
The second portable I have just bought at a cost of £2990, (less the trade-in on the Freestyle) This one is called the Evergo. It is bulkier than the Freestyle and marginally heavier. Again it is a pulse delivery system but will deliver up to 6 lpm. At 2 lpm it has an 8-hour battery life, and it has been approved in the USA for use on aircraft. I have only had it for a week and so far I am very pleased. However if I find any drawbacks rest assured I will say so.
Service Providers (To be updated)
Air Products : Covers the N West Yorkshire East and West Midlands Wales and North London regions
24/7 Freephone Helpline 0800 37 35 80
Allied Oxycare/Medigas : Covers: Hampshire; Isle of Wight; Kent; Medway; South East London; South West London; Surrey; Sussex; Thames Valley
24/7 Freephone Helpline 0500 82 37 73
BOC : Covers Bedfordshire; Cambridgeshire; Essex; Herts; Norfolk; Suffolk and the south-west
24/7 Freephone Helpline 0800 13 66 03
Linde Gas : Covers: County Durham; Northumberland; Tees Valley; Tyne & Wear
24/7 Freephone Helpline 0808 202 09 99
What follows is an e-mail from Jim, an American patient source, but it explains the principles clearly. David, 17 May 2009
There are 3 basic types of portable oxygen systems that you can use. The compressed gas Oxygen tanks, the LOX liquid Oxygen portables, and the Portable Oxygen Concentrators. Each has advantages and disadvantages, which I will try to explain.
1. Compressed gas tanks - these are the most common portables that you will see, and are available from almost all Oxygen suppliers. Each tank will only supply a specific amount of Oxygen at a given rate of flow when full.
Typically about 4 hours worth at the common 2 Liter rate or 2 hours worth at the 4 Liter rate I need. These tanks are heavy and are generally on a cart to be pulled around, and if you will add more time than a single tank will provide you must have spares with you, and you must exchange the tanks when the first empties which will take a short time until you get used to doing
this.
2. LOX - liquid Oxygen portables - You need to refill these yourself from a reservoir of Liquid Oxygen (LOX). These are available with both continuous flow Oxygen or pulsed flow Oxygen. The pulsed flow will last twice + as
long at each filling than a continuous flow of the same size, but not everyone is comfortable with the pulsed delivery, and not all the pulsed units perform the same. (I'm uncomfortable with the Helios, but others are
OK for me) so try them out.) Often LOX providers will supply enough liquid so you do not need a concentrator at your home and this will save you as much as $50 a month on your electric bill, but you will have regular
deliveries of the LOX to refill your reservoir's) I have 4, and my provider comes every 4 weeks to refill them.
3. Portable Oxygen Concentrators (POCs) - These are powered by rechargeable batteries and 1 battery usually will last about 3 hours. Almost all will sell you additional batteries that can easily replace a discharged battery,
but most will plug in to a power brick that can be attached to a car, truck, boat or even an airplane. These will also plug in to an AC adapter for use in a home or office. If they are plugged in these will recharge their own batteries at the same time they are providing you with Oxygen. The only time you are really depleting it's battery is when you are walking around or where you cannot plug in. I've taken my Inogen One on a 28 hour train trip successfully because I could plug it in whenever I was in our roomette.
There are at least 5 brands of these Portable Oxygen Concentrators that have been approved by the FAA for use on commercial Aircraft, and these are the ONLY portable oxygen devices that you can take on an airplane (they even need advance notification and doctors Rx). NO OTHER portable Oxygen is allowed on a Commercial Flight...(unless the airline provides it themselves for extra $$$)
Jim Baber - Fresno CA - mailto:
jim@baber.org
If you have any other questions, please call the British Lung Foundation helpline on 08458 50 50 20 - Mon - Fri 10am - 6pm