Published: August 2009

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Medical oxygen in the home - Safety considerations

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Prescriber Update 30(3): 18
August 2009

Prescribers of medical oxygen are reminded of the potential hazards when used in the home and that these hazards need to be managed to ensure the safety of all concerned.

The patient's capabilities, access to support and home environment should be assessed prior to initiating medical oxygen in the community. This assessment should ensure safe storage of equipment and ensure the patient or carer is able to manage their oxygen therapy at home. This includes an understanding of the operation of the equipment and the ability to manage shut off valves, flow meters and other controls.

Patients or carers should be given basic training in the use of home oxygen equipment and how to manage simple problems, preferably with available reference material. Appropriate signage should also be provided to alert healthcare professionals and emergency services that oxygen therapy equipment is on the premises.

Patients or carers need to be made aware of the dangers when oxygen is used or stored in proximity to readily combustible materials, particularly:

• Open fires.
• LPG or other fuel gases (includes gas stoves and gas fires).
• Oils, including cooking oils and lubricating oils.
• Petrol, kerosene and paint solvents.

Also, consideration should be given to the type of equipment provided. When oxygen concentrators are provided it is important to ensure:

• An electrical circuit with sufficient capacity is used to prevent overloading and power outages.
• The concentrator is not used in proximity to electric fires or heaters as these pose a fire hazard.
• The concentrator is never operated in confined spaces such as cupboards or behind curtains or drapes. This may also pose a fire hazard due to a build up of heat in the presence of high oxygen concentrations.

When oxygen cylinders are provided it is important to ensure:

• They are securely supported to prevent accidental toppling when in use and during storage.
• They are stored in a well-ventilated area away from combustible materials or ignition sources.
• They are positioned during use so the user can operate the flow meter controls and shut off valves without having to move or tilt the cylinder.

Guidelines on the use of oxygen in homecare environments have been published by the European Industrial Gases Association (EIGA). While based on European regulation, the document 89/09E "Medical Oxygen Systems for Homecare Supply" also includes patient training material and an environment risk assessment template. This document is available at www.eiga.org, from within the IGC/MGC Documents listed under "Publications".