Introduction
When a person breathes in, a gas in the air called oxygen goes into the lungs. Oxygen is carried through the lungs into the blood before travelling throughout the body.
Oxygen is an essential part of keeping your body running properly. The body cannot live without enough oxygen.
Some children need extra oxygen because they cannot get enough into their bloodstream by breathing. This can happen in children who have:
- serious viral infections, including COVID-19 and influenza
- cystic fibrosis
- heart disease
- lung disease.
Home oxygen therapy is a way to help your child get the oxygen they need without needing to be in the hospital.
In home oxygen therapy, a specific amount of oxygen gas your child's doctor prescribes will be pushed through their airways using a special tube or mask.
Before treatment
Before your child starts home oxygen therapy, they will have tests to decide how much oxygen they need.
Your child's doctor will prescribe a specific amount of oxygen and give you information about:
- what equipment is used
- how to set everything up
- when to use the oxygen – all the time or in certain situations
- where to get the oxygen canisters and disposable items like tubing and tape.
Your child's treating team will show you how to check the equipment and give you information about what to do in an emergency.
During treatment
Home oxygen therapy is usually given through a tube connected to a mask or looped around the ears and under the nose, held in place by small prongs in the nostrils. The tube connects to a machine called a concentrator or a gas cylinder.
Children already using a continuous positive airway pressure (CPAP) device or Bi-level positive airway pressure (BiPAP) device at home can attach their oxygen to the machine's tubing using a separate connection.
During home oxygen therapy, you will need to:
- make sure the settings on the oxygen flow do not change
- check to see if the cylinder is empty (RED) or full (GREEN) before using
- label and separate all empty or nearly empty canisters from the full canisters
- check the flow meter is upright and the centre of the ball is in line with the correct oxygen level
- check that the oxygen is flowing with no kinks or damage to the tubing
- check the tubing and nasal prongs for stiffness, blockage, or changes in colour
- replace any damaged, stiff, or discoloured tubing and nasal prongs
- regularly clean the air filter on the oxygen concentrator machine
- keep a good supply of backup oxygen cylinders in case of emergency.
Check your child for breathing that is:
- fast
- noisy
- difficult
- stopping at any point.
If this happens, or your child is showing a dusky blue colour around their lips, call an ambulance on triple zero (000) and tell the operator that your child is using oxygen.
After treatment
The length of time your child uses home oxygen therapy will depend on what they are being treated for. You must not stop the oxygen on your own without speaking to your child's doctor first.
Your child will have regular appointments and tests with their doctor to check how they are doing and whether there need to be any changes to the home oxygen therapy.
Management
Safety and home oxygen therapy
Oxygen gas is stored in a metal canister under high amounts of pressure.
Oxygen canisters must be taken care of as they can cause explosive fires and severe injury if not handled properly.
Storing the canisters safely by keeping them:
- out of direct heat and sunlight
- uncovered and away from loose materials like curtains or blankets
- out of small spaces, like cupboards
Always turn the oxygen canister off when not in use, and never try to service or fix the equipment yourself.
Your child's treating team will give you information about replacing broken equipment and servicing the machine.
Make sure your child stays away from heat and fire, including:
- cooking appliances
- heat styling tools for hair
- heaters
- open fires.
Parents and carers must not smoke in the home while their child is using home oxygen therapy, and remember to check your home fire alarms are working well.
Travelling with oxygen
Home oxygen therapy is portable, so your child can take it with them away from home.
Make sure the tubing fits well, and the canister is secure when travelling. You can use a special carry bag, trolley, pram, or car attachment.
When travelling with oxygen in a car, keep a window open slightly and make sure the flow meter on the canister is upright and able to be read correctly. If the canister is lying flat, make sure it is secured.
Flight assessments
In order to travel on an aeroplane with home oxygen therapy equipment, your child must do a flight assessment.
The air in an aeroplane cabin is pressurised and generally thinner than ground-level air. This means there is less oxygen, which can cause problems for children with breathing conditions.
A flight assessment checks if your child is at risk of having breathing problems during air travel. It can also be used to figure out whether your child needs oxygen therapy while they are flying and what level of oxygen they need,
The flight assessment is done in a specialist respiratory unit and takes about 20 minutes.
Your child will sit in a sealed room and breathe in air with the same oxygen level as in an aeroplane.
Your child will wear a probe on their finger to check their body's oxygen level and any changes in how their body responds to the change.
If your child uses home oxygen therapy, CPAP or BiPAP, they will wear their equipment during the test.
Your child's doctor will have the final say in whether it is safe for your child to travel in an aeroplane. They can sign any insurance paperwork or travel clearance forms for you if they are given a reasonable amount of time before travelling.
Airline travel
Every airline will have different rules about travelling with home oxygen therapy equipment.
Contact the airline before booking tickets to make sure you have all the information you need, including whether you:
- can take your child's specific equipment on board, in line with the airline's list of approved equipment
- need pre-approval for your child's equipment
- will need to purchase oxygen canisters directly from the airline
- can access an in-flight power supply on board the flight.
Power supply
Some airlines will not have a direct power supply. If this happens, you must have enough battery power in your child's equipment to last 150% of the flight time to cover you in case of cancellations or long layovers.
For example, a 10-hour flight will need a battery supply of 15 hours.
Paperwork
Most airlines will have their medical clearance form downloadable on their website.
Make sure you print the form and have it completed by your child's doctor well before your travel date. If you do not have an approved form, the airline may not let your child onto the flight.
Insurance and health care
Travel insurance is important when flying domestically and internationally.
You should also check whether the country you are flying to has a shared health care arrangement with Australia for emergencies.
Funding for equipment and supplies
Your child's treating team may give you a starting supply of:
- oxygen canisters
- nasal prongs
- tubing
- tape.
You will then be responsible for purchasing these items for your child to have home oxygen therapy. Your child's treatment team will tell you where to buy this equipment.
You may be eligible for government support to help with the cost of your child's medical equipment, including a discount on electricity to run the machine. Speak to your child's doctor for more information.
Power outages and insurance
You can apply for an electricity rebate if your child uses an oxygen concentrator machine.
Submitting this form to your electricity company will automatically put your family on the 'priority list' for reconnecting power after an outage at home.
You must let your insurance know in writing that you have medical oxygen in your home, as this can affect some policies.