Home Oxygen Use, Pediatric

• When to give oxygen. More or less oxygen may be needed at various times, such as when eating, sleeping, or traveling to locations with a change in altitude.
• How long to give oxygen.
• How quickly oxygen should be delivered (flow rate), in liters per minute (LPM).

• A nasal cannula. This is a device or tube that goes in the nostrils.
• A breathing tube (tracheostomy tube) that is surgically placed in the windpipe. This may be used in severe cases.
• A mask that covers the nose and mouth or covers the tracheostomy tube.

• A tank. Tanks hold oxygen in gas form.
• A liquid oxygen device. This holds oxygen in liquid form.
• An oxygen concentrator machine. This filters oxygen in the room. It uses electricity so you must have a backup cylinder of oxygen in case the power goes out.

What are the risks?

• Fire. This can happen if the oxygen is exposed to a heat source, flame, or spark.
• Injury to skin. This can happen if:
  • Liquid oxygen touches the skin.
  • The oxygen tubing causes a pressure injury.
• Damage to the lungs or other organs. This can happen from getting too little or too much oxygen.
• Strangulation. This can happen if the tubing gets wrapped around your child's neck.

Supplies needed:

• A mask, nasal cannula, or supplies necessary for a tracheostomy.
• An oxygen tank, a liquid oxygen device, or an oxygen concentrator.
• The tape that your child's health care provider recommends to secure the tubing (optional).

• A humidifier.
• A low-flow delivery system.

• A pulse oximeter. This device attaches to your child's finger, toe, or earlobe. It measures your child's oxygen level and heart rate.
• An apnea monitor. This is a machine that attaches to your child's chest. It detects heart rate and breathing and will sound an alarm if your child stops breathing.

How to use oxygen

1. If you use an oxygen concentrator, make sure it is plugged in. If you use a tank, check the oxygen level to make sure there is enough.
2. Place one end of the tube into the port on the tank, device, or machine.
3. Make sure the liter-flow setting on the machine is at the level prescribed by the health care provider.
4. Turn on the machine or adjust the knob on the tank or device to the correct liter-flow setting.
5. If you need to check if the unit is working, place the end of the tubing in a cup of water. The water will bubble if oxygen is flowing.
6. Wash your hands with soap and water for at least 20 seconds before touching your child.
7. Get comfortable with your child.
8. Place the mask over your child's nose and mouth. Or, place the nasal cannula and secure it with tape if instructed. If your child has a tracheostomy, connect the tubing to the oxygen source as directed. You may need another person to help you keep your child's hands from grabbing the tubing. You may also try giving your child a toy to play with while you secure the mask or cannula.
9. When you are done, turn off and unplug the machine, or turn the knob to OFF.

How to clean and care for the oxygen supplies

Nasal cannula

• Clean it with a warm, soapy, wet cloth at least once a week or as needed.
• Replace it every 2–4 weeks.
• If your child has a cold, change the cannula when your child gets better.

Mask

• Replace it every 2–4 weeks.
• If your child has a cold, change the mask when your child gets better.

Humidifier bottle

• Ask your child's health care provider or the medical supply company how often to change and wash the humidifier bottle. To do this:
  • Wash it with soap and warm water.
  • Rinse it thoroughly.
  • Air-dry it.
  • Refill it with distilled water.

Oxygen concentrator

• Replace the air filter at least once a month or according to directions from your home medical equipment and service company.
• Wipe down the cabinet every day. To do this:
  • Unplug the unit.
  • Wipe down the cabinet with a damp cloth.
  • Dry the cabinet.

Other equipment

• Change any extra tubing every 1–3 months.
• Follow instructions from your child's health care provider about taking care of any other equipment.

Safety tips

Fire safety tips

• Keep your child's oxygen and oxygen supplies at least 6 ft (2 m) away from sources of heat, flames, and sparks at all times.
• Do not allow smoking near your child's oxygen. Put up "no smoking" signs in your home.
• Do not use materials that can burn (are flammable) while you use oxygen. This includes:
  • Rubbing alcohol.
  • Petroleum jelly.
  • Hair spray or aerosol sprays.
  • Hand sanitizer.
• Keep a fire extinguisher close by. Let your fire department know that you have oxygen in your home.
• Test your home smoke detectors regularly.

Traveling

• Secure the oxygen tank in the vehicle so that it does not move around. Follow instructions from your medical device company about how to safely secure the tank.
• Make sure you have enough oxygen for the amount of time your child will be away from home.
• If you are planning to travel by public transportation (airplane, train, bus, or boat) with your child, contact the company to find out about its policies for portable oxygen delivery. You may also need documents from a health care provider and medical device company before you travel.

General safety tips

• Try to have extra supplies on hand, including an extra cannula or mask, along with extra tubing.
• If you use an oxygen cylinder, make sure it is in a stand or secured to an object that will not move (fixed object).
• If you use liquid oxygen, make sure its container is kept upright.
• If you use an oxygen concentrator:
  • Tell your electric company. Make sure you are given priority service in the event that your power goes out. It is important to have a backup cylinder of oxygen to use until power returns.
  • Avoid using electrical extension cords.
• Make sure you have access to a telephone in case of an emergency. Keep emergency numbers handy, such as your child's health care provider and the medical supply company.
• Talk to your child's health care provider about strangulation concerns and how to keep your child from becoming tangled in tubing.

Follow these instructions at home:

• Give oxygen only as told by the health care provider.
• Know how and when to order a refill of oxygen.
• Always keep a spare tank of oxygen. Plan ahead for holidays when you may not be able to get a prescription filled.
• Use water-based lubricants on your child's lips or nostrils. Do not use oil-based products like petroleum jelly.
• To prevent skin irritation on your child's cheeks or behind your child's ears, tuck some gauze under the tubing.
• Keep all follow-up visits as told by your child's health care provider. This is important. Regular follow-up visits are required to assess changes in your child's condition and ongoing oxygen needs.

Contact a health care provider if:

• Your child seems more tired than normal and lacks energy.
• Your child has dry, irritated skin.
• Your child has nosebleeds.
• Your child is not eating or sleeping well.
• Your child is irritable.
• Your child is having more coughing or congestion.

Get help right away if:

• Your child is limp or weak.
• Your child's breathing is faster than normal.
• Your child is struggling to breathe.
• Your child's skin looks gray or bluish around the lips, gums, or eyes.
• While breathing, your child:
  • Makes wheezing noises.
  • Makes grunting noises.
  • Pulls in at the chest.
  • Has flaring nostrils.
  • Is belly breathing.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

Summary

• Oxygen is a medical treatment that requires a prescription and extra training.
• Your child's health care provider or a person from the medical device company will show you how to use the oxygen device and how to give oxygen. Follow his or her instructions.
• If you use an oxygen concentrator, make sure it is plugged in. It uses electricity so you must have a backup cylinder of oxygen in case the power goes out.
• Make sure the liter-flow setting on the machine is at the level prescribed by the health care provider.
• Keep oxygen and oxygen supplies at least 6 ft (2 m) away from sources of heat, flames, and sparks at all times.