For many patients who have COPD, oxygen therapy is a major feature of day-to-day life. If you use oxygen during the daytime, managing oxygen tanks and equipment inevitably becomes a routine part of almost every daily task and activity.
Supplemental oxygen can be a huge hassle to use every day, especially if your equipment is uncomfortable, unwieldy, or difficult to use. Because of this, the kind of supplemental oxygen equipment you use can have a major effect on your daily routine, and even affect your overall quality of life.
But if you choose equipment that's convenient and comfortable, you'll feel much less restricted and be better able to integrate supplemental oxygen therapy into your everyday life. That's why it's so important to review your options and choose an oxygen delivery system that is right for you.
Your supplemental oxygen therapy is a lifeline, not a tether, and it should be as simple, easy, and comfortable as possible. If you do your research and take the time to understand the different options, you'll be much more likely to find equipment that is convenient, comfortable, and adds a minimal amount of hassle to your daily life.
In this post, we're going to help you get the most out of supplemental oxygen therapy by showing you all of the different options that are available, including different types of oxygen tanks, oxygen concentrators, oxygen masks, and nasal cannula. We'll help you you understand the pros and cons of each oxygen device and delivery system so can find the equipment that is most comfortable and convenient for you.
More knowledge allows you take a more active role in your COPD treatment, and explore options outside of what's standard. Armed with information about all the different kinds of oxygen therapy devices and equipment will allow you to better work with your doctor and insurance provider to get the option that's right for you.
When you first start using supplemental oxygen, the whole process can be overwhelming, in part because of all the equipment you have to care for and keep track of. But learning more about supplemental oxygen delivery systems and how they work can help you feel more comfortable and at ease.
Choosing the Right Supplemental Oxygen Equipment
When choosing what kind of oxygen equipment to use, there are two main decisions to make: what kind of therapy device to use (e.g. compressed gas tanks, liquid tanks, or oxygen concentrators) and what kind of delivery system equipment to use for delivering the oxygen to your nose or mouth (e.g. Nasal cannula, face masks, and tubing).
Oxygen therapy devices tend to be very expensive, and many patients' choices are limited by what their insurance or medicare supplier will provide. However, many patients are able to get the therapy device they prefer by working with their insurance company, their oxygen supplier, budgeting, applying for financial assistance, or financing with low monthly payments.
Other oxygen equipment, like oxygen masks and tubing, tend to be much more affordable for the average COPD patient, although they have to be replaced regularly. You can choose from countless types of tubing, masks, and cannula that come in variety of different sizes, shapes and materials.
What kind of oxygen therapy device and delivery system is right for you depends on a variety of factors, including your oxygen prescription, doctor's recommendations, your activity level, face shape, and even your clothing choices. Much of it comes down your personal habits and preferences, and what's right for someone else will not necessarily be what works best for you.
Here are some of the major factors you should consider when choosing oxygen therapy devices and delivery system:
- Oxygen flow rates supported
- Oxygen concentrations supported
- Travel & portability
- Total oxygen capacity
- Ease of refilling or replacing
In the following sections, we'll introduce you to all the major options for oxygen devices delivery systems that are out there to choose from. We'll show you how each piece equipment works, explain what makes each one unique, and discuss the pros and cons of each option with regard to features, price, portability, aesthetics, and ease of use.
Types of Oxygen Therapy Devices
There are three main types of oxygen therapy devices: liquid oxygen tanks, compressed gas oxygen tanks, and oxygen concentrators. Oxygen tanks (also known as oxygen canisters) always have a limited supply of oxygen and must be replaced regularly, while oxygen concentrators create purified oxygen from ambient air.
The first thing you need to consider when choosing an oxygen therapy device is whether or not it can supply the oxygen concentration and oxygen flow rate that your doctor prescribed. It's important to have at least one device that can deliver the maximum amount you need; so if you use three liters per minute of supplemental oxygen at rest and six liters per minute during exercise, you must have an oxygen therapy device that can deliver the higher, six-liters-per-minute flow rate.
Oxygen equipment is expensive, and what you use might depend on what your insurance company will cover or what your medicare supplier can provide. The vast majority of oxygen tanks are provided as rentals, but, in some cases, you can work with your insurance company to cover some or all of the purchase price of some equipment (such as a home or portable oxygen concentrator).
The kind of oxygen therapy device that's best for you depends on your lifestyle, activity level, and the flow rate that your oxygen prescription requires. In the next sections, we'll introduce you to the three types of supplemental oxygen devices and compare their features, benefits, and drawbacks.
Compressed Gas Oxygen Tanks
Compressed gas tanks have long been the standard device used for supplemental oxygen therapy. They are simple, inexpensive, and come in many sizes to accommodate use both in the home and outside of the home.
The tanks are made of thick metal to contain the oxygen, which is highly pressurized inside the canister. Because of this, you have to handle the tanks very carefully, taking care to keep them upright and away from anything that could cause damage. If the tank becomes punctured, it could cause the tank to explode or turn into a dangerous projectile rocket.
Compressed gas tanks are designed for basic functionality and are extremely simple to use; all you have to do is turn a key to open or close the valve, which turns the oxygen flow on and off. They contain a moderate amount of oxygen and need to be replaced regularly as they get depleted.
Most people who use compressed gas tanks for oxygen therapy rent their tanks from an oxygen supply company, which comes to haul away empty cylinders and replace them with full tanks on a regular basis. It is typical for oxygen patients to have one or more large compressed gas oxygen tanks at home and a couple smaller, portable canisters for when they go out.
Large and medium-sized oxygen tanks can be placed in carts for easy wheeling around your home, or kept stationary in a secure place. Small, portable tanks can be carried by hand or secured in a special carrying case.
Here is a breakdown of the major pros and cons of compressed gas oxygen canisters:
The benefits of compressed gas oxygen tanks:
- Simple and easy to use
- Relatively inexpensive
- Come in a variety of sizes
- Always covered by insurance
The drawbacks of compressed gas oxygen tanks:
- Large and bulky
- Heavy and difficult to transport
- Can be dangerous if damaged, punctured, or leaky
- Have to be replaced at regular intervals
- Must always be secured upright in a safe place
- Compressed gas is volatile and requires extra care and caution
Liquid Oxygen Tanks
Liquid oxygen tanks are similar in appearance to compressed gas oxygen, except they hold liquid oxygen instead of gas. In order to store oxygen in liquid form, it must be kept at super-cold temperatures, around -300 degrees Fahrenheit.
|Photo by Nike Glover|
Since liquid oxygen is much more dense than gaseous oxygen, liquid oxygen tanks can hold much more oxygen than gas tanks. They can also store oxygen at a lower pressure, making liquid tanks less volatile and reducing the danger of leaks and punctures.
Like gas oxygen canisters, liquid oxygen tanks are usually rented and have to be refilled regularly by your oxygen supply company. However, unlike gaseous tanks that all come pre-filled, liquid oxygen is usually supplied from a large home reservoir that you store in your home, which you can use to fill up smaller canisters as needed.
Like gas canisters, liquid oxygen canisters come in a variety of sizes, with small tanks for portability and larger ones for home use. Many patients prefer liquid tanks because they are relatively light, safe, and last longer than compressed gas tanks.
However, liquid oxygen tanks don't come without any risk; contact with the pure liquid oxygen or touching the cold parts of the canister or tubing can cause serious burns or frostbite. The liquid oxygen itself is also extremely dangerous, and you must exercise extreme care when refilling canisters from your reservoir.
Also, the liquid oxygen in the tank has a limited lifespan; it evaporates and leaks out over time whether or not you use it. The liquid oxygen in the tank must be used up within one or two weeks, otherwise it will become depleted on its own.
Just like compressed gas oxygen cylinders, liquid oxygen cylinders can be transported in special carts and cases. Full tanks must also be kept upright and secured to prevent damage and leaks.
Now that you understand how liquid oxygen tanks work, here's a closer look at the pros and cons:
The benefits of liquid oxygen tanks:
- Lighter than compressed gas tanks
- Contain more oxygen and last longer than compressed gas tanks
- Less dangerous because oxygen is stored at lower pressure
- Come in a variety of sizes
The drawbacks of liquid oxygen tanks:
- Must refill tanks by hand from reservoir
- Oxygen depletes with time even if you don't use it
- Risk of frostbite and burns from cold liquid oxygen
- Higher cost
- May or may not be covered by insurance
There are many different types of oxygen concentrators, both stationary and portable. They work by pulling in normal, ambient air and purifying it to create concentrated, breathable oxygen.
Home Oxygen Concentrators
Home oxygen concentrators are a great alternative to large tanks and reservoirs for home oxygen use. Most can provide up to 95 percent pure oxygen and provide up to 10 liters per minute of flow.
Home oxygen concentrators are very convenient because they never run out of oxygen or have to be replaced as long as they are plugged into a power source. Many are also light and easy to wheel around the house.
The sleek, plastic casing that home concentrators are made of is much more aesthetically pleasing than old, worn-out tanks, and they stand out in a room much less than large canisters do. They are also relatively lightweight and easy to wheel around the house, their compact design making them less of a nuisance and helping them stay out of your way.
Another great thing about oxygen concentrators is that they are very safe, and carry no risk of high-pressure explosions if punctured, as compressed gas oxygen canisters do. You also have to worry much less about leaks and flammability; oxygen concentrators have no risk of leaking oxygen into your home when not in use.
However, because oxygen concentrators need electricity to function, you should always have a backup supply of oxygen tanks if you use a home concentrator as your primary oxygen therapy device. In the case of a power outage or malfunction, you will need to use an alternative source of oxygen until your home concentrator can operate again.
The benefits of home oxygen concentrators:
- Easy to use
- Small, compact, and discrete
- Easy to transport around the home
- Don't require refilling or replacing
- Unlimited supply of oxygen
- Very low maintenance
- Decreased fire risk and reduced risk of oxygen leaks
- Can be cheaper than liquid or gas tanks if you use a large volume of oxygen every week
The drawbacks of home oxygen concentrators:
- Most only supply low to medium oxygen flow rates
- Can be noisy while operating
- Requires a backup oxygen supply in case of power outages and emergencies
- Tends to be more pricey than gas or liquid tanks unless you use a large amount of oxygen
Portable Oxygen Concentrators
The main difference between portable and home oxygen concentrators is that portable concentrators are much smaller and can operate off of battery power instead of just A/C. Even though their battery power is limited, keeping multiple batteries and switching them out as they get depleted can make them last for many hours in-between charges.
Many portable oxygen concentrators are much lighter and less bulky than portable tanks, making them ideal for using during physical activity and when you go out and about. Many even come with comfortable carrying bags so you can carry them on your back or over your shoulder.
Portable concentrators vary widely in size, shape, design, and function, so it's important to look at all the different brands and types available. Many can only deliver very low flow rates of 1-2 liters per minute. However, more and more new portable oxygen concentrators are being designed to provide higher flow rates so they can serve a wider number of oxygen patients.
The best thing about oxygen concentrators is that purify oxygen from the ambient air, which means they will never run out of oxygen. The only thing you have to worry about is keeping the batteries charged or making sure you have an outlet to plug your concentrator in to.
Oxygen concentrators also have the benefit of being much more sleek and stylish than the bulky, unwieldy gas and liquid oxygen tanks. They look more like small appliances or electronics than medical equipment, making them much more discrete than other oxygen therapy devices.
Many patients use portable oxygen concentrators as a secondary or backup oxygen therapy device. For example, they might use compressed gas tanks at home and during exercise, while using their portable concentrator when they leave their home. Even if a portable oxygen concentrator cannot provide the maximum flow rate you need, you can still use it during sleep, rest, and other less strenuous activties as long as it can provide the minimum flow rate in the range that your doctor prescribed.
Most insurance and medicare providers don't cover portable oxygen concentrators, but there are ways to get financial assistance or even get your insurance to cover some or all of the cost. Here at LPT Medical, you can even finance your portable concentrator and make it much more affordable with low monthly payments.
Although they will not work for everybody, portable oxygen concentrators are by far the lightest and most transportable oxygen therapy device available, and is one of the only types of supplemental oxygen that you can take with you on an airplane. Getting a portable oxygen concentrator can cut a great deal of hassle out of oxygen therapy and make a huge improvement in your quality of life.
Now that you have a better understanding of portable oxygen concentrators, let's break down the pros and cons:
The benefits of using a portable oxygen concentrator:
- Simple to use
- Rechargeable (many include car chargers, too)
- Can be used with batteries or plugged into wall power
- Don't need to be refilled or replaced
- Variable flow rates
- Many have digital interfaces for convenience
- Many are allowed on airplanes (check your brand and model before flying)
- Multiple batteries available to extend battery life
- Convenient and comfortable carrying cases
- Small and compact
- Stylish and discrete
The drawbacks of using a portable oxygen concentrator:
- Can only deliver lower flow rates
- Limited battery life (when away from A/C power)
- May not work efficiently at very high altitudes
- Some can be noisy while operating
- Many work best on pulse-flow and have limited continuous flow options
Types of Oxygen Delivery Systems: Masks, Nasal cannula, and Tubing
Choosing the right oxygen therapy device can significantly improve the convenience of oxygen therapy and make it easier to travel and stay active. However, choosing the right delivery system for breathing the oxygen is just as important, and can spare you a great deal of discomfort and pain.
Some oxygen masks and nasal cannula can be very uncomfortable to wear on your face every day, and put weight on your ears that can cause severe discomfort over time. However, you can make your oxygen experience much more pleasant if you take the time to find the right mask or cannula that fits you snugly and comfortably.
There are many different options to choose from; cannula and masks come in a variety of different sizes, shapes, and materials. Some are even designed for specific functions, like high-flow oxygen or for recycling carbon dioxide. What works best for you depends on the contours of your face, your aesthetic preferences, and what personally feels more comfortable for you.
However, it's important to understand that your options may be limited depending on your prescribed oxygen concentration, flow rate, and other aspects of your individualized oxygen therapy. Make sure to talk to your doctor before buying a new oxygen face mask or nasal cannula to make sure that it is appropriate for your condition.
A nasal cannula is a type of tubing that delivers oxygen to your nose through two hollow prongs, one for each nostril. Nasal cannula are preferred by the majority of patients for low flow, continuous oxygen use because they are convenient, hands-free, and less bulky.
The best thing about nasal cannula is that they are discrete and stay out of the way, allowing you to eat, talk, and breathe without interruption. However, most can only provide limited oxygen concentrations and low flow, so they are generally only used by patients in stable condition whose blood oxygen saturation levels are only slightly below normal. Standard nasal cannula can only deliver up to 30 percent oxygen at up 4 liters per minute, and special high-flow cannula are necessary for anything above 4 liters per minute.
The main problem that oxygen patients tend to have with nasal cannula is ear discomfort, which affects the majority of oxygen patients who use them. This is because nasal cannula are held in place by hooking over your ears, and the weight of the tubing pulls down and causes ear pressure that can be extremely uncomfortable and even painful after awhile.
Because of this, there are many different types of nasal cannula that try to solve this problem through softer materials and creative design. What is most comfortable for you will depend on the unique shape of your face and ears and how sensitive you are to the pressure.
Nasal cannula can also dry out your nose and hurt the skin on your face. The tubing can irritate your skin from abrasion and the nasal prongs can wear on the inside of your nose. That's why it's important to find a cannula with nasal prongs that are soft enough for your skin and to position them correctly in your nose.
When it comes to choosing the right nasal cannula, you may need to try a few different types before you find the best fit. You might even want to keep several different kinds of nasal cannula around to use on different occasions; for example, you might want to use a bulkier, more secure nasal cannula at home and use a slimmer, more discrete cannula when you go out.
Here are some of the main types of nasal cannula to choose from.
Standard Nasal Cannula
Standard nasal cannula are worn across your face by hooking the tubes over your ears and inserting the prongs into your nostrils. They can only handle low oxygen flow rates up to six liters per minute and oxygen concentrations up to 40 percent.
High Flow Nasal Cannula
High-flow cannula are designed for patients who require higher oxygen concentrations and a higher flow rate. They can deliver oxygen concentrations up to 90 percent at a flow rate of up to 40 liters per minute.
However, many patients cannot tolerate high-flow nasal cannula because they can be very loud and uncomfortable. In fact, even with a standard cannula, flow rates above 2 liters per minute tend to cause nasal dryness and discomfort.
Soft Touch Nasal Cannula
Both standard and high-flow cannula are available in versions made with softer, more flexible tubing materials. These cannula are designed to cause less ear discomfort and reduce skin irritation and chafing.
Single-sided Nasal Cannula
Recently, some oxygen equipment stores have begun selling a new kind of single-sided nasal cannula. This cannula is meant to be less bulky, more discrete, and reduce ear pressure, and it comes with a clip to secure the tubing to your clothes, protecting it from getting yanked or tugged out.
One type of single-sided cannula, the Oxy-Breather, is made with extremely soft tubing and has a single hook that goes over one ear, instead of two. Another type, the Uni-flo, has a similar design but only has one nasal prong, instead of two.
The best part about single-sided nasal cannula is that they hook on to one ear and come across only one cheek, leaving the other side of your face completely free and uncovered. This makes single-sided cannula much less noticeable and less in the way of your face.
Another type of specialty nasal cannula is the Oxy-Glasses, which are designed for even more discrete and unobtrusive oxygen use. The tubing from the nasal cannula is actually built into the glasses, so that the tubes are hidden by the glasses frames instead of being draped across your face.
You can use Oxy-Glasses with plain glass lenses or, if you have an eyeglass prescription, you can get them fitted with prescription lenses. However, Oxy-Glasses are pricey and not covered by insurance or Medicare.
The Pros and Cons of Nasal cannula
Now that you have a better understanding of how nasal cannula work and what options are available, let's take a closer look at the pros and cons:
The benefits of using a nasal cannula:
- Simple to use
- Inexpensive to buy
- Covers only a small part of your face
- Doesn't interfere with eating, drinking, or talking
The drawbacks of using a nasal cannula:
- Can only be used for lower oxygen concentrations and flow rates
- Ear pressure and discomfort
- Nasal dryness and discomfort
- Skin irritation and chafing
- Doesn't work for mouth breathing
- Not recommended for high flow rates
You may need to try several different kinds of nasal cannula before you figure out what is most comfortable for you. If the standard delivery system that came with your oxygen tanks or concentrator is not comfortable for you, don't suffer needlessly; there are many different options out there to choose from, and you're bound to find one that works and fits you well.
Many patients, especially those with more severe breathing problems, use oxygen masks instead of nasal cannula as a primary means of breathing supplemental oxygen. While they are more bulky and cover both your nose and mouth, they have other benefits, including the ability to deliver high-flow oxygen and treat severe hypoxemia.
You can use an oxygen mask by hand, raising the mask to your face whenever you take a breath, or you can secure it onto your face for more continuous use. Most masks come with straps on the back so you can secure it to the back of your head.
Oxygen masks also have the benefit of being able to deliver higher oxygen concentrations, higher flow rates, and have the means to better control the amount oxygen and carbon dioxide that you breathe with each breath. Some masks, called re-breathers, have reservoirs with one-way valves that can keep outside air out and control the amount of carbon dioxide you take in with every breath.
The main drawback of using an oxygen mask is that it covers up so much of your face. It can also make it very difficult to eat, drink, and talk, since you have to remove the mask every time you speak or take a bite.
Some people need to use oxygen masks instead of nasal cannula because masks can better control higher oxygen concentrations, carbon dioxide re-breathing, and how much ambient air mixes in with the oxygen. Others cannot tolerate the discomfort of nasal cannula and simply find oxygen face masks more comfortable to wear.
There are several different types of oxygen masks designed for high- or low-flow oxygen and patients with varying blood oxygen saturation levels. What mask is best for you depends on your oxygen prescription and disease severity, what fits your face snugly, and what works most efficiently and comfortably for you.
Simple Oxygen Masks
A simple oxygen face mask fits over your nose and mouth and is held onto your face with a strap that goes around your head. The tubing from your oxygen therapy device attaches to the bottom of the mask while ports on the front of the mask let outside air in and allow carbon dioxide to flow out when you exhale.
This type of mask works best for low oxygen flow rates and oxygen concentrations between forty and sixty percent. It's important to find a mask that fits and seals against your face completely in order for it to work correctly.
Venturi masks are masks designed to deliver high oxygen flow rates and high oxygen concentrations. They have a special valve at the bottom that helps control how much air mixes with the flow of oxygen, making it easier to control FiO2, or the concentration of oxygen that you actually breathe (not the concentration of oxygen supplied by your tank or concentrator).
|The Venturi Effect|
Venturi masks can provide a FiO2 of up to fifty percent and can provide 30-50 liters per minute of oxygen flow. These masks are generally used for patients with more severe hypoxemia.
Reservoir masks are a special type of face mask that has an attached reservoir bag for collecting extra oxygen or carbon dioxide. They are used to deliver high oxygen flows up to 50 liters per minute and are able to more precisely control FiO2. There are two main types of reservoir masks: partial re-breather masks and non-re-breather masks.
Both types of mask are able to prevent outside air from getting in with a one-way valve that allows air to escape when you exhale. Re-breather masks also collect about one-third of the carbon dioxide that you exhale with each breath. This carbon dioxide acts as a respiratory stimulant and is re-cycled for the next breath you take.
A non-re-breather mask doesn't recycle carbon dioxide, but uses the reservoir bag to store extra oxygen, instead. This type of mask is very efficient at conserving the highly-concentrated oxygen as you breathe, and can reduce the amount of oxygen that gets wasted. These masks are generally used for patients with very severe COPD.
The Pros and Cons of Oxygen Masks
Now that you have a better understanding of how oxygen masks work and what varieties you have to choose from, let's take a closer look at the pros and cons:
Benefits of using an oxygen mask:
- Works better for high oxygen flow rates
- Can treat more severe hypoxemia
- Works for both mouth and nose breathing
- Can prevent outside air from mixing with the oxygen you breathe
- Allows better control of oxygen concentration
- Reservoirs allow for carbon dioxide recycling (rebreathing)
Drawbacks of using an oxygen mask:
- Bulky; covers both your nose and mouth
- Interferes with your ability to talk, drink, and eat
- Can be difficult to find the right size and fit
Just like with nasal cannula, you may need to try several different types or styles of face masks before you find one that fits snugly and is comfortable enough to wear for extended periods of time. Even if your doctor prescribes a certain type of mask to use for oxygen therapy, you can still experiment with masks made in different sizes and from different materials until you find a good fit.
Starting supplemental oxygen therapy is an adjustment, and the number of options for oxygen delivery can be overwhelming at first. But now that you have a better understanding of all the different varieties of oxygen equipment, you should be able to navigate your options with more confidence.
Choosing your oxygen delivery system is a major decision that can significantly affect your day-to-day life, which is why it's so important to know what you have to choose from. But even if your oxygen prescription and physical condition limits your options, understanding all the different options will allow you to be more informed and more involved in your treatment.
Now that we've shown you all the different varieties of oxygen therapy devices, delivery systems, and equipment, it's up to you to find the product that is right for you. Just make sure whatever you choose will work with your oxygen prescription, and double check with your doctor.
Remember that, even if your insurance doesn't cover the equipment that's best for you, you may be able to find other financial assistance options or get financing with monthly payments. It's worth exploring your options and budgeting for medical equipment that can significantly improve your quality of life.