OXYGEN USE IN ADULTS
Abstract The purpose of the Thoracic Society of Australia and New Zealand guidelines is to provide simple, practical evidence-based recommendations for the acute use of oxygen in adults in clinical practice. The intended users are all health professionals responsible for the administration and/or monitoring of oxygen therapy in the management of acute medical patients in the community and hospital settings (excluding perioperative and intensive care patients), those responsible for the training of such health professionals, and both public and private health care organizations that deliver oxygen therapy.
The Thoracic Society of Australia and New Zealand oxygen guidelines for acute oxygen use in adults: 'Swimming between the flags'. Read more here...
Travel and Flying with Oxygen
Ask a PH Specialist
Question: As a pulmonary hypertension patient, what can I do to make travelling easier for myself?
Travelling can be a stressful time for anyone. However, travel for people with pulmonary hypertension may be especially stressful with extra planning needed before a trip. Issues to consider include medication, blood clots, emergency contact information, overexertion, need for oxygen and eating on the road. For many patients who use supplemental oxygen or who have borderline low oxygen levels, method of travel will play a major role.
Travel to higher altitudes may present a specific challenge due to lower oxygen levels in the air. When travelling on the road by car, train or bus at higher elevations, increased levels of supplemental oxygen may be necessary, especially when above 4,000 – 5,000 ft. Symptoms to look for include fatigue, more shortness of breath at rest or with activity, rapid breathing, light-headedness, rapid heartbeats and headaches. On the road, the change in elevation may be gradual and not noticeable until you get out and move around. However, the change occurs rapidly if travelling by plane. Fortunately, passenger airplanes pump compressed air into their cabins when travelling above 10,000 ft. But oxygen levels are 25 percent lower in pressurized cabins compared to sea level. People who use oxygen only at night or one to two litres with activity typically do well without the need for oxygen during the flight. However, people who use two litres at rest or three to four litres with activity will likely need oxygen during air travel.
In some medical clinics, one can perform an “altitude test” using a special pressurized chamber to test oxygen levels at different altitudes to determine whether oxygen will be needed. The test, however, is not routinely needed prior to travel. Certain portable oxygen concentrators (POC) can be used in-flight but must be approved by the airline ahead of time. Empty oxygen tanks and POC can also be checked as luggage.
Recommendations for Travelling With Oxygen:
Certain medications like Epoprostenol (e.g., Flolan® & Veletri) require pumps, cooled storage and extra supplies. Carry extra tubing, needles, backup pump and extra medication. Be prepared in case of delays by having extra medication packed in your carry-on luggage. If your medication requires being kept cool, bring six to eight ice packs and a premixed dose. Anticipate how you could handle flight delays or cancellations.
Long periods of inactivity during travel may raise the risk of developing a blood clot. With air travel, get up and be active. Consider support stockings for your legs if you have had a blood clot in the past. If travelling by ground, stop frequently (at least every two hours) and walk for a couple of minutes.
Eating on the Road
We eat differently when we travel. Be aware of eating foods that are high in salt as extra fluid will be retained. Try to eat lightly with lots of fruits and vegetables and limit the temptation to eat fast food (high in salt).
Talk to your doctor ahead of time and come up with a plan in case you develop symptoms such as swelling in the legs, worsening shortness of breath, fatigue or other symptoms. Get your medical certificate at the visit. Carry your PH centre contact numbers with you. Ask your PH doctor who they would recommend you contact in the area you are travelling if you need medical attention.
The Quick Checklist
Flying with Oxygen Brochure
This is a great resource written by Jenni Ibrahim from LIFE support group (lung information & friendship for everyone). LIFE support group is the community education group for The Institute for Respiratory Health WA and together we are part of the Lung Leaders Network of WA.
Flying with Oxygen :
click here to read or download
Talk to your respiratory specialist in case you may need an altitude test. Plan your trip around airline policies, flight schedules and oxygen supply. Only then make your booking and get travel insurance.
Send the completed "Medical Clearance Form" to the airline. Organise oxygen by portable concentrator or bottle - unless the airline is to supply a bottle. Plan for your departure day. Have a safe and enjoyable flight!
PHNA Note: In a lot of cases the Pulmonary Hypertension Nurse Consultant at one of the main two treatment centres (FSH & SCGH) will play a pivotal role in assisting you with the organisation of any air travel so be sure to check in with them first).
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Pulmonary hypertension affects different aspects of a patient’s life, mainly due to symptoms such as shortness of breath, fatigue, dizziness or fainting spells, chest pressure or pain, swelling (edema) in the ankles, legs and eventually abdomen (ascites), cyanosis, and racing pulse or heart palpitations. As the summer approaches, many people are starting to think about vacations, which in the case of pulmonary hypertension patients can implicate some challenges.
The Medical Record has recently released a video with some recommends for having a safe vacation with pulmonary hypertension. “Traveling and going on holiday are fantastic, but if you have a medical condition you’ll need a bit of extra planning. Pulmonary hypertension patient Shani and cardiology doctor Jij give some top tips for having a stress-free jet-set experience,” as explained in the video shared on The Medical Record‘s YouTube channel.
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The 10 tips for a safe vacation include: