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Do I Need a Prescription to Buy a Portable Oxygen Concentrator?
Do I Need a Prescription to Buy a Portable Oxygen Concentrator?
When a patient first learns that they will require supplemental oxygen to improve their breathing, they are likely to have many questions. Patients often wonder about how to get their oxygen and what steps they will need to complete in order to get the oxygen delivery device they need. If your doctor has recommended supplemental oxygen therapy to you, read on to learn more about where to go from here.
What Is the Difference Between Nasal Cannulas and Portable Oxygen Masks?
Both a nasal cannula and face mask can be used to deliver supplemental medical oxygen to patients. They attach to the oxygen delivery device—typically an oxygen concentrator or oxygen tank—via tubing to improve oxygen intake. A nasal cannula is a flexible tube with two prongs that go inside the patient’s nostrils, while a face mask is a plastic, rubber or silicone mask that covers the nose and mouth. There are several different kinds of oxygen masks, depending on what the patient needs. [1]
The most notable difference is that an oxygen mask fits over the patient’s nose and mouth, making it difficult for the patient to talk while receiving oxygen therapy. A nasal cannula, on the other hand, fits directly into the nostrils, allowing the patient to receive oxygen therapy while carrying on a conversation, eating, drinking and more. Nasal cannulas are significantly less obtrusive, so most health care teams opt for a nasal cannula whenever possible.[1] However, for patients who need a constant, predetermined level of oxygen, a face mask called a Venturi mask is the most common choice. A Venturi mask is able to provide an accurate concentration of oxygen by mixing high-flow oxygen with room air. A Venturi mask is also able to prevent carbon dioxide retention, which can help avoid hypercapnia (elevated carbon dioxide levels) and the suppression of the respiratory drive. [2]
What Is the Advantage of Using an Oxygen Mask vs. a Nasal Cannula?
Nasal cannulas offer the advantage of being significantly less intrusive, allowing patients to eat and speak during oxygen therapy. They are also more comfortable to wear since the cannula itself consists of just one small tube and two prongs inside your nostrils. [1] The tubing can sit over your ears or at the back of the head, so you can adjust the fit in a number of different ways. Some patients can experience nasal dryness, which can generally be resolved with a topical water-based lubricant. [2] A face mask, on the other hand, sits over the top of both your nose and mouth with a strap around the back of your head. The mask itself can impede your ability to speak easily, and it is not possible to eat or drink while wearing an oxygen mask. Oxygen masks can also be drying when tightly sealed, and can make coughing difficult as well. Some patients find face masks confining and may feel claustrophobic with the mask on, which can make patients resistant to wearing them. [3]
However, in some cases, using a face mask is necessary, even if it is less convenient. For example, if a patient requires a higher concentration of oxygen or a precise concentration, nasal cannulas may be unable to accommodate the prescription. Additionally, patients who are prone to retaining carbon dioxide (hypercapnia) or who have experienced a suppressed respiratory drive may require a face mask called an air-entrainment mask (another name for a Venturi mask) to help ensure they get the correct concentration of oxygen at all times without becoming over-oxygenated.[4]
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How Much Oxygen Can You Use with an Oxygen Mask vs. a Nasal Cannula?
Typically, your doctor will be the one to choose whether you use an oxygen mask or a nasal cannula, since it is generally dependent on your prescribed flow rates and oxygen concentration requirements. That said, each delivery device can provide a different flow rate, or number of liters per minute. There are low-flow options and high-flow options, which have differing abilities to provide controlled amounts of oxygen to the patient. Below, see how much oxygen you can use with each of the most commonly used oxygen delivery devices for oxygen therapy.
Delivery Device
Approx. oxygen delivery
Flow Rate
Comments
Nasal Cannula[3]
24-40%
1-6 LPM
May be drying to nares above 4L/min.
HighFlowNasalCannula[5]
21-100%
up to 60 LPM
Can deliver warmed and up to 100% humidified oxygen
Simple face mask (low-flow system) [3]
40-60%
6-10 LPM
Non re-breather mask[3]
60-80%
10-15 LPM
Efficiency depends on how well mask fits and the patient’s respiratory demands
Venturi Mask[6]
24-60%
up to 15 LPM
Can deliver a more precise level of oxygen but mask must be properly fitting
When Should You Switch From Nasal Cannula to Oxygen Mask?
Your health care providers will decide whether you need to switch from a nasal cannula to an oxygen mask. However, that decision is likely to be based on how much oxygen you need at any given time. Typically, patients who need higher or more precise concentrations of oxygen are more likely to need to use a portable oxygen mask like a Venturi mask. Selection should be based on preventing and treating hypoxemia and preventing complications of hyper-oxygenation. Factors such as how much oxygen is required, the presence of underlying respiratory disease, age, the environment (at home or in the hospital), the presence of an artificial airway, the need for humidity, a tolerance or a compliance problem, or a need for consistent and accurate oxygen must be considered to select the correct oxygen delivery device.[3] They will also talk to you about what you struggle with when it comes to oxygen therapy, because your comfort does play a part in the success of your oxygen therapy. Your healthcare providers will make any decisions and adjustments to your oxygen delivery device based on information about your overall respiratory health.
Adjusting to Your Nasal Cannula or Face Mask
The fact is that oxygen therapy, and the required oxygen equipment, does take a little getting used to at first. Whether you are getting accustomed to wearing a nasal cannula or a face mask, there will be times you experience frustration as you get used to wearing them comfortably throughout the day and navigating around the tubing. Optimizing outcomes often depends on selecting the correct oxygen administration device. [2]
If you have questions about your oxygen delivery device, or are interested in exploring a different kind of face mask or nasal cannula, talk to your doctor today. The right oxygen delivery device is essential for helping to make your oxygen therapy as successful as possible.
Oxygen Administration: What Is the Best Choice?, RT Magazine, MEDQOR Media, 12 Oct. 2015, www.rtmagazine.com/products-treatment/monitoring- treatment/therapy-devices/oxygen-administration-best-choice/.
What Is a Blood Oxygen Level?
When you measure your blood oxygen level, you are measuring how much oxygen your red blood cells are carrying at the time the measurement is taken. Because every cell in your body requires oxygen to function properly, maintaining a normal blood oxygen level is essential to your health. If you struggle with breathing problems or heart problems, it is likely that your health care team will want to carefully monitor your blood oxygen level to ensure that your body is getting the oxygen it needs. [1] If your blood oxygen level is below normal, which is called hypoxemia, you will need to treat the condition quickly. Hypoxia is a condition or state in which the supply of oxygen is insufficient for normal life functions; hypoxemia is a condition or state where there is a low arterial oxygen supply — often these terms are used interchangeably.[2]
Acute vs. Chronic Bronchitis: Understanding the Differences
Bronchitis is a respiratory illness that causes inflammation of the tubes that carry air to the lungs—also known as the airways or bronchial tubes. When the airways become irritated, swollen and inflamed, less air is able to travel to and from the lungs and mucus begins to form in them. This generally causes an irritating cough that may be accompanied by shortness of breath, more mucus production and other bothersome symptoms.[1]
There are two types of bronchitis: acute and chronic; the symptoms can be quite different for acute vs. chronic bronchitis. Read on to take a look at how these types of bronchitis differ.[1]
Transient nocturnal desaturation, also known as nocturnal hypoxemia, is defined as a temporary drop in oxygen saturation during sleep. Patients diagnosed with sleep disordered breathing from chronic obstructive pulmonary disease (COPD) or obstructive sleep apnea (OSA) are at a greater risk for nocturnal desaturation. A substantial number of patients will have both COPD and OSA.[1]
Transient Nocturnal Desaturation is a significant problem in COPD, affecting a relatively large number of COPD patients. In fact, one study suggests that 27-70% of COPD patients with daytime oxygen saturation levels of 90-95% experience substantial desaturation at night, particularly during a period of sleep known as rapid eye movement (REM) sleep. In people with severe COPD, desaturation during sleep is even more profound than desaturation during exercise, which is also common.[2]
OSA is defined by intermittent collapse of the upper airway, which results in repetitive hypoxemia and arousal. It is estimated that OSA occurs in 4% of American men and 2% of women, meaning almost 10 million people in the United States are affected, although that is probably an underestimate. Obesity is a risk factor for the development of OSA. As obesity rates have risen over the last 15 years, the current prevalence of OSA is almost certainly much greater.[1]
A substantial number of patients will have both OSA and COPD. This “overlap syndrome” causes more severe nocturnal hypoxemia than either disease alone. This common combination of OSA and COPD has important implications for diagnosis, treatment, and outcome.[1]
