When should I be considering home oxygen for my patients?

Home oxygen therapy in patients with COPD: safety issues for nurse prescribers

Two landmark studies demonstrated survival benefit in chronic obstructive pulmonary disease (COPD) complicated by chronic hypoxaemia with the prescription of long-term oxygen therapy (LTOT). Best practice evidence therefore recommends that individuals with stable COPD and resting hypoxaemia (PaO₂≤7.3 kPa) should be assessed for long-term oxygen therapy. However, it is estimated that up to one-quarter of COPD patients prescribed LTOT continue to smoke. Oxygen therapy consequently presents an obvious fire hazard in the case of such patients, who are therefore at greater risk of death or sustaining devastating head and neck burns. This article critically analyses, through the context of a care study, the professional, ethical and legal issues involved in making a safe prescribing decision for LTOT in an individual with COPD who is a current smoker. Home oxygen prescription is a growing trend in the COPD population, and it is important for nurse prescribers to be aware of the issues highlighted in the article to ensure safe prescribing practices.

Oxygen therapy in palliative care

Breathlessness in advanced disease is a common problem, with the majority of people experiencing breathlessness in the weeks before death. The thrust of the new British Thoracic Society guidelines for home oxygen in adults is that oxygen therapy for home use is most useful in chronic hypoxaemia. However, clinicians make individual clinical decisions, cognisant of the guidelines but ultimately determined by what relieves the symptoms of the individual most effectively.