Children s Home Healthcare s. Oxygen Parent Handbook

Transcription

1 Children s Home Healthcare s

2 Information and Instructions For Parents Who Have A Child Who Uses Oxygen Your child s physician prescribed home oxygen therapy for. The current order states that you are to run your child s oxygen at liters per minute (lpm) for. It is important for you to use only the exact amount of oxygen your child s physician has prescribed. Oxygen is a drug and the flow rate must never vary from what your child s physician prescribes because too much or too little oxygen could cause serious complications for your child. There are certain safety precautions that you need to be aware of when you have supplemental oxygen in your home. Oxygen is not an explosive gas, but it does support combustion. Oxygen will not start a fire, but it will cause an existing fire to burn much more vigorously. For this reason you should keep the oxygen away from a heat source or open flames. Carefully review the safety rules that are in this booklet. If you have any questions, at any time please call Children s Home Healthcare and ask to speak to a respiratory therapist (RT). Our 4 hour per day, 7 days per week phone number is or We would be happy to assist you with any questions. Oxygen Safety Rules 1. Please display the provided Oxygen / No Smoking signs at all times to all entrances to your home.. Do not permit the use of open flames or burning tobacco in the room where oxygen is being used or stored. 3. Do not use any household electric equipment in an oxygen enriched atmosphere. (Examples: electric razors, electric heaters and blankets). KEEP THESE ITEMS AT LEAST FIVE (5) FEET FROM YOUR CHILD S OXYGEN. 4. Do not use oily lotions, face creams or hair dressings that contain petroleum or paraffin products while using/receiving oxygen. 5. Don not use aerosol sprays in the vicinity of oxygen equipment. 6. Do not oil or grease oxygen equipment. 7. Do not allow oxygen tubing to be covered by ANY object i.e. blankets. 8. Do not leave oxygen on when equipment is not in use.

3 9. Do not abuse or handle oxygen containers roughly. 10. Do not store oxygen in a confined space. 11. Do not allow untrained persons to use or adjust your child s oxygen equipment. 1. Do not attempt to fix or repair oxygen equipment; call us immediately, we will take care of any repair needed. 13. Do not store oxygen containers near radiators, heat ducts, steam pipes or other sources of heat. 14. Do not open the cylinder valves quickly. 15. Do not transport oxygen in an enclosed area or the trunk of your car. 16. Do secure cylinders either by a chain, cord or stand. 17. Travel Tips and Points of Emphasis: Do contact Children s Home Healthcare and ask for a respiratory therapist to discuss if you are planning to travel with your child who needs oxygen. Do transport oxygen in the back seat of your car and secure it properly. Do provide good ventilation in the vehicle when transporting oxygen equipment. Oxygen Tank Instructions The oxygen tank that Children s Home Healthcare provides for your child will be in a portable cart or a stationary stand. A regulator/flow meter is attached to the tank to deliver the prescribed liter flow. To turn the tank on: 1. Turn the handle on the top of the tank counter-clockwise until it stops. Look at the gauge needle. It indicates how full the oxygen tank is. Be sure to turn this handle off when not in use, unless this tank is intended for emergency use and is connected with an Ambu bag.. Turn the flowmeter to your child s prescribed liter flow. 3. Attach your child s cannula or other oxygen delivery device to the tank. 4. Listen and feel the oxygen coming out of the delivery device to assure the flow is working. When your gauge on the regulator reads 1/4 full or 500 psi, switch to another oxygen tank or contact Children s Home Healthcare (CHHC) to request additional tanks be delivered to your home.

4 Changing the Regulator: Our respiratory therapist will instruct you on the proper procedure for changing the regulator on your child s oxygen tanks. The procedure is as follows: 1. Tear the white plastic tab off the top of the tank. Ensure that a washer is available.. Crack open tank by turning handle. Some of the tanks have a handle that is attached to the tank and other tanks require a plastic handle to turn tank on. If tank requires handle be sure to keep it attached to the tank, so it does not get lost. Turn the handle counter clockwise slowly, to let it blow off small amount of pressure. This gets rid of any dust or other particles that may be present. Then turn clockwise to shut off. 3. Now place the regulator on the top of the oxygen tank, lining up the 3 holes on the tank with pins on the regulator. Place the washer on the largest of the 3 outlets, if a metal washer is not already in place. 4. Then tighten the regulator on the wing nut until regulator is on securely. 5. Turn on, by turning handle counter clockwise carefully. 6. The small round gauge on the regulator should show that the tank is full. 7. Turn the flow meter to the prescribed liter flow. 8. Check nipple to ensure oxygen is on and functioning by checking for oxygen flow. 9. If child is going to be on oxygen for extended period of time a humidity bottle will need to be attached to nipple. If child is on tank for short period of time or to be used as portable, do not need to place humidity on tank. 10. Some regulators will need to have a green Christmas tree adapter in order to attach oxygen tubing, others will not. 11. Attach oxygen tubing to nipple, Christmas tree or humidity bottle and then to child. 1. Monitor child to ensure they are getting proper oxygenation. 13. Remember to ensure tank is safely secured, see oxygen safety rules. 14. When gauge on regulator reaches 500 PSI or is a, it needs to be changed to a new tank.

5 15. When finished administering oxygen, turn off the tank by turning handle clockwise. Do not leave tank on and just shut off flowmeter, this causes pressure to be constant against the regulator and is unsafe. NOTE: All size oxygen tanks should be secured while in use, by rack, cart, bag, or donut ring. If you have any questions, be sure to call CHHC by dialing or Oxygen Concentrator Instructions Your child s oxygen is being supplied by an oxygen concentrator. This is an electronically powered unit that pumps in air from the room, separating the nitrogen content from the air and allowing the oxygen to be concentrated in a reservoir to be inhaled by your child. This is a simple inexpensive means of supplying oxygen in the home. Along with the concentrator, you will have a back-up tank of oxygen to use in case of a power failure or mechanical equipment malfunction. This tank should be used only for emergencies. If a portable oxygen tank is needed for ambulation or travel; please contact CHHC by calling or We hope your child s oxygen concentrator will be a comfortable addition to your home. The following instructions will inform you how to operate and clean the concentrator. They will also describe the precautions you will need to take while using oxygen in your home. If you have any questions, please contact us. 1. Place the concentrator in an open central, convenient location in the home. Do not place against any wall, drape, or other possible obstruction of the intake filter. Extra oxygen tubing length can and will be provided to you for the use of oxygen for your child. The concentrator is mobile and may be moved from room to room if desired.. An initial POWER INTERRUPT ALARM CHECK will be done by a CHHC RT when the concentrator is set up. This test is done before plugging the concentrator into an electrical outlet by turning the ON/OFF switch to the ON position and listening for the alarm to sound. This checks the condition of the internal battery. This is the sound heard if there were to be a power failure in your home, or if the concentrator becomes unplugged. NOTE: If the alarm does sound during a power interruption, switch your child to your child s back-up oxygen cylinder source and contact CHHC. 3. An INTERNAL FUCNTION TEST is done each time you turn the concentrator on. When the unit is plugged in and the power switch is turned on, the

6 concentrator alarm should sound approximately three to 0 seconds up to maximum of 60 seconds. The unit should start and the power light will illuminate. This indicates the self check is complete and the concentrator is ready to use. NOTE: If the alarm continues to sound longer than the maximum 60-second period and there is no power interruption noted, switch your child to your child s back-up tank and contact CHHC. 4. If your child is using a mask for oxygen delivery, liters per minute (lpm) must be at least 5 lpm. If the prescribed liter flow is less than 5 lpm, use a nasal cannula. 5. An adapter will be delivered with the concentrator to attach your nasal cannula or other delivery device to the concentrator. Tubing must not exceed 50 feet. 6. When you are ready to use the concentrator, turn the power switch ON. The power light will come on and the unit will start. Turn the flowmeter on the front of the concentrator to the prescribed liter flow as prescribed by your child s physician. The indicator ball should be centered on the prescribed flow line. DO NOT USE MORE OXYGEN THAN IS PRESCRIBED BY YOUR CHILD S PHYSICIAN. 7. Daily, the concentrator filter (located on the back or side of the machine) should be checked and cleaned. Remove the filter from the concentrator. Wash the filter by hand using tap water and pat dry between two towels. Be sure that the filter is dry before putting it back on the concentrator. NOTE: DO NOT OPERATE the concentrator without a filter or use the concentrator with a dirty filter. NOTE: Newer model concentrators may not require routine filter cleaning. Always refer to your manual for filter cleaning frequency, or call CHHC RT if you have any questions about cleaning your filters. 8. The outside of the concentrator may be wiped off with a damp cloth and liquid dish detergent. It is best to unplug the unit before attempting to wash it. Do not use any harsh abrasive cleansers (such as Comet or Ajax) on the concentrator. Do not remove any of the knobs or other metal covers when cleaning. Do not remove the cover on your child s concentrator for any reason. 9. The concentrator unit should be kept well ventilated and not against a wall, drapes or other possible obstruction for the air intake filter.

7 10. Follow up care will be provided by a CHHC respiratory therapist with home visits. Routine maintenance will be performed during these visits to assure that the unit is functioning properly. 11. SERVICE INTERUPTION: In the event of an emergency, natural disaster, or inclement weather which has raised a concern for continued oxygen delivery, you should call Children s Home Healthcare (CHHC) immediately by calling or If you are unable to contact CHHC and CHHC staff have not contacted you please take your child to the nearest health care facility until services can be resumed. The need to transport should be based up usage table for E tanks by liter flow of individual patient and time to reasonably reach the health care facility in a safe manner. If you have any questions, or any concerns, please call Children s Home Healthcare at any time, 4 hours per day, seven days per week at or Home Oxygen Safety Expectations As an organization, Children s Home Healthcare feels strongly about home safety especially for children that require home oxygen. We want to minimize the risk of an oxygen supported fires in the home. Children s Home Healthcare has the following expectations: The family is encouraged to have a functioning smoke detector. The family is encouraged to have a functioning fire extinguisher. There should be No Smoking signs displayed in the front door as long as oxygen is in the home. No Smoking in the home will be encouraged. If the parents/caregivers smoke they will be encouraged to do so outside of the home and will be provided with safe smoking tips. See page 8 for the tips. The family is encouraged to have a fire safety plan in the event of a home fire. Children s Home Healthcare will provide the family with information where to purchase items i.e. smoke detectors and fire extinguishers. See page 8. Children s Home Healthcare is required to notify the child s physician in the event that any of these items are missing or non-functional so the physician is aware of the home safety hazard.

8 In addition the physician will be notified if parents/caregivers continue to smoke in the home. Each subsequent visit by the respiratory therapists (RT) or delivery personnel the parent/caregiver will be asked to confirm if the parent/caregiver has tested their smoke detector and checked the condition (charge level) of their fire extinguisher in the last 30 days. If the respiratory therapist or delivery personnel find defective equipment (i.e. smoke detector or fire extinguisher) then the parent/caregiver will be notified to either replace the defective equipment or get the equipment fixed. The parent/caregiver will be required to notify CHHC once the repairs or replacement has been completed. The RT will check all medical equipment provided for the home oxygen therapy on a routine basis. The parents/caregivers will allow CHHC into the home to check the equipment. If parents do not allow a home visit by the respiratory therapist the child s physician will be notified. The RT or delivery personnel will re-educate the parent/caregiver of the importance of fire safety when using oxygen in the home at each home visit. Important Oxygen Safety Information Important Tip #1: Do not store oxygen tanks in a confined area such as a closet. If the tanks would have a slow leak (while stored in a closet and the door to the closet was closed) the closet could become a contained environment. If there was a spark, such as the burner igniting to the furnace (if located next to the closet), the whole closet could become engulfed with flames.

9 Important Tip #: Do not cover your child s oxygen tubing with blankets. If there would be a slow leak in the tubing the blanket could entrap the oxygen. Then if the crib rail were to cause a spark while going up or down the child could be engulfed in flames causing severe bodily harm or even death. Do not cover O tubing with blankets..keep the tubing on top! Important Tip #3 How Smokers Can Reduce A Fire Risk With Home Oxygen 1. If you smoke, smoke outdoors.. Use deep, wide, sturdy ashtrays on a safe, sturdy base. 3. Make sure cigarettes are OUT before leaving them unattended. 4. Check for cigarettes that may have fallen out of sight. 5. NEVER SMOKE IN A HOME WHERE OXYGEN IS USED. 6. Stay alert to control your cigarettes. Do not smoke when you are sleepy. Important Tip #4 You Can Purchase Smoke Detectors & Fire Extinguishers: 1. Any hardware store, Ace, Lowes, and Home Depot.. Purchase the items from the Internet, Amazon.com. 3. The cost for a smoke detector runs from $10-$ The cost for a fire extinguisher $0-$60+.

10 Important Tip # 5 Questions Asked at Each Delivery or Respiratory Therapist visit: 1. You will be asked if you have a functioning smoke detector.. You will be asked if you have a functioning fire extinguisher. 3. Staff will look for the No Smoking signs which should be located in the front door. 4. Parents/Caregivers will be asked if the safety equipment i.e. smoke detector and fire extinguisher has been checked within the last 30 days. 5. Parents/Caregivers will be asked if anyone smokes in the home and if so if they smoke outside of the house. 6. Parents/Caregivers will be asked if the family has a safety plan in the event of a home fire. 7. Parents/Caregivers will be asked to allow the respiratory therapist to inspect the home medical equipment. 8. Parents/Caregiver will be instructed not to use petroleum or paraffin products on the child who uses the oxygen. Petroleum and paraffin products have been known to cause fires with patients who have been using oxygen. Oxygen E Cylinder Time Table Pressure Gauge Reading Flowmeter Setting Hours left to 500 PSI Hours left until Empty 15 ml/min /8 lpm ml/min 3 41 ¼ lpm

11 500 ml/min ½ lpm ml/min ¾ lpm Less than 30 min 3.7 **If you have D tanks the above time table would be cut in ½. Oxygen E Cylinder Time Table Pressure Gauge Reading Flowmeter Setting Hours left to 500 PSI Hours left until Empty minutes

12 1 75 minutes 1.5 Less than 10 minutes Less than 45 min 1 Less than 0 min 4 min min 1.4 Less than 30 min 1 Less than 10 min 56 min Less than 10 min 4 min **If you have D tanks the above time table would be cut in ½. Oxygen H Cylinder Time Table The H stands for HUGE Pressure Gauge Reading Flowmeter Setting Hours left to 500 PSI Hours left until Empty 15 ml/min 71 hours 9 days 91 1/8 lpm 68 6 days days days days days days days day 51

13 50ml/min days 480 ¼ lpm days days days days days days days > 1 day ml/min days 30 ½ lpm days days days days days days day > 1 day ml/min days ¾ lpm days days days days days days > 1 day 56 7 > 1 day 41.9 How to Make a Fire Escape Plan 1. Make sure there is a working smoke detector on every level of the home. Use the test button on the detector to verify that it is working properly. This testing should be done once a month along with a good vacuuming of the detector. The smoke detectors will give you an early warning that there is a problem. Make it a family rule that no one disables a smoke detector.

14 . Check the numbers on the outside of the home to assure that they are posted on the house and are at least 4 inches high that contrast with their background (show up) so they can easily be seen from the street. 3. Draw a simple floor plan of the home. This does not have to be to scale and do not include the furniture. Do include windows and doors in each room. Also, use one piece of paper per floor. 4. Mark the easiest way out of a room with one color of crayon. This should be the way you typically go in and out of the room. 5. Using a different color crayon or pen mark the second way out of every room. In most rooms this would be a window. 6. With your plan in hand, walk through your home. Check every window marked as an exit and be sure that it opens properly and easily. Make sure that furniture or other items have not occluded its use as an exit. Check each door to assure it opens and closes properly. Never block a door so remove any items in a doors way. Assure that all locks and handles work properly and easily. 7. As a family choose a meeting place in front of the house. This meeting place needs to be something permanent such as a tree. Do not choose things that move such as cars which may cause confusion for small children. Make sure the location is in a spot where you can easily see the fire department when they arrive. Also be sure that everyone understands to leave everything and get out. Do not waste precious time looking for things. Things may be replaced people can not! Pets are precious too but they are not worth your life. Many times dogs and cats will find their own way out anyway. Tell the fire department of a pet that is missing. 8. Hold a family meeting to review the plan. Explain to each member what their role is if there is a fire. Make sure each member of the family understands that they have two exits to choose from in order to get out of the house. 9. Post the plan in a place where the whole family can see it on a regular basis. The refrigerator, a family bulleting board or office is a good suggestion. Small children especially may benefit from having a plan of their own posted on their wall of their bedroom. 10. Have regular drills to practice the plan. Review on a regular basis. A good suggestion is to review with every family member s birthday. This way it is reviewed regularly and for large families it is reviewed more often than families that only have three members. 11. Fire drills need to be fun for the children, this is one way they remember information. Call it the Fire drill game. Have everyone go to their bedrooms and announce the fire

15 drill. Time from the announcement of the drill until everyone is at the designated meeting place in front of the home. 1. Make a copy of the plan and give it to small children as they enjoy having their own copy. Also place a flashlight in each child s room on the floor by the bed to reassure the child and this will give everyone a little added sense of security. 13. Try to improve on your previous time. If your family gets really good at the fire drill then test the family members in a different way. Make a sign that says FIRE and place it in the pathway of an exit. Make the family members choose the second exit. Teach them to close the door to the room, place something in the crack under the door to decrease the amount of smoke in the room. Take the screen off of the window and open the window. If it is safe and there is more than one person you could exit the house on the roof. If you are unable to get out safely, instruct them to wait at the window for the fire department. If you hear the fire trucks make a lot of noise calling attention to yourself so the fire department can rescue you. NOTE: Stop drill before anyone actually climbs out of a window so that no one gets hurt! 14. Avoid fires by using electrical and heating equipment properly. When cooking, be sure to stay beside the stove and watch what you are cooking. Do not leave candles burning unattended. Do not leave grills outside unattended. Most importantly keep fire tools such as lighters and matches in a secure place locked and away from small children. Thank you for trusting Children s Home Healthcare (CHHC) to care for your child. It is a responsibility we take very seriously!