[Major points]

1. Oxygen therapy means using various oxygen therapy devices to provide more than 21% oxygen to the patients.
2. Home oxygen therapy can enhance sleep and life quality.
3. When a nasal cannula is used, remove the nasal cannula every 8 hours and give the patient nasal and oral care with a wet cotton swab.
4. To meet the needs of patients, a greater concentration of oxygen does not mean a better the outcome.

What is oxygen therapy:
Oxygen therapy is the administration of oxygen via various devices at concentrations greater than that in ambient air (21%) with the intent of preventing or treating the symptoms of hypoxia.

Why needs home oxygen therapy:

When the patients have been diagnosed with chronic hypoxemia, it means they have chronic hypoxia. Long-term oxygen therapy is required in order to improve their physical function and quality of life.

1. Improve hypoxia or low blood oxygen.
2. Reduce the energy needed for breathing.
3. Improve activity tolerance.
4. Avoid hypoxia complications.
5. Improve sleep quality.
6. Promote life quality.

1. Chronic obstructive pulmonary disease(COPD)
2. Interstitial lung disease. 
3. Bronchiectasis.
4. Sleep apnea syndrome.
5. Congestive heart failure.
6. Terminal cancer.

Preparation of home oxygen equipment before discharge:

1. The doctor will undertake an assessment to determine what type of home oxygen equipment the patient needs to use.
2. An oxygen concentrator or an oxygen tank or a pulse oximeter for home use can be assessed from Assist Device Center and rent or buy from the medical equipment store. 
3. If a home ventilator is needed please talk to vendors to know the types and prices of home ventilator for rental.
4. Before discharge, the home ventilator will be tested at the ward to ensure the ventilator setting is appropriate for the patients.
5. Assure the home ventilator function normal and suitable for the patient, and the caregivers can operate it correctly.
6. The home ventilator will be brought home with the patient and regular maintenance from the vendor is required.  
7. Patient will be assessed by the physician for the need of medical devices (ex, oxygen concentrator). The patient who has a disability certificate will consult the specialist physician in related medical field. After evaluation, the specialist physician will prescribe a medical certificate to apply for the medical devices. The medical certificate will be submitted to the social bureaus of the county and city governments for subsidy.

Precautions for home oxygen therapy:

1. The doctor will write a prescription of oxygen flow rate for patient. Do not adjust the flow rate or turn off the oxygen without the physician’s order.
2. Seek medical attention as soon as possible in the event of hypoxemia.
   1. Symptoms of hypoxemia: difficult breathing, pale, headache, purple lips or fingers.
   2. Symptoms of hypercapnia: lethargy, confusion.
3. Seek medical attention as soon as possible if there are symptoms of infection such as fever, chills, difficult breathing, increased sputum with color changes and thickening.
4. When using an oxygen concentrator, prepare a small oxygen tank in case of power outages or machinery failures. Make sure you turn off your oxygen supply when not in use to avoid oxygen leakage. You should know how much oxygen is left in a tank. The oxygen equipment (ex, oxygen tank, concentrator and ventilator) should be properly placed and keep away from fire.
5. Nasal cannula:
   1. Remove the nasal cannula every 8 hours and give the patient nasal and oral care with a wet cotton swab.
   2. Check the nasal cannula prongs frequently for obstruction by secretion. If there is any secretion obstruction, wash the cannula.
   3. Replace with a new nasal cannula when the prongs become stiff.
   4. Ears and cheeks should be properly protected to prevent pressure injury.
6. Face masks:
   1. The face mask should cover the patient’s mouth and nose.
   2. Ears and cheeks should be properly protected to prevent pressure injury.
7. Notice the side effects of long term oxygen use: hypoxemia, hypercapnia or oxygen poisoning.

1. Frith, P., Sladek, R., Woodman, R., Effing, T., Bradley, S., van Asten, S.,…& Phillips, P.A. (2020). Pragmatic randomised controlled trial of a personalised intervention for carers of people requiring home oxygen therapy. Chronic Respiratory Disease, 17, 1-11.https://doi.org/10.1177/1479973119897277 
2. Lacasse, Y., Tan, A.M., Maltais, F., & Krishnan, J.A. (2018). Home oxygen in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 197(10), 1254-1264.https://doi.org/10.1164/rccm.201802-0382CI 
3. Lacasse, Y., Krishnan, J.A., Maltais, F., & Ekström, M. (2019). Patient registries for home oxygen research and evaluation. International Journal of Chronic Obstructive Pulmonary Disease, 14, 1299-1304. https://doi.org/10.2147/COPD.S204391