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In the community an oxygen prescription falls into 2 categories:
- Long-term oxygen therapy (LTOT) for patients with defined chronic respiratory failure.
- Ambulatory oxygen therapy.
Oxygen is a medicine and has to be prescribed. Inappropriate concentrations may have serious or even lethal effects. Advise patients and their families of the risks of burns and fire with oxygen. Oxygen can be delivered either nasally or by mask.
Long-term domiciliary oxygen therapy (LTOT)
Home oxygen services, previously delivered from local community pharmacies, have been transferred over to a nationally coordinated service provided by Dolby Vivisol.
Only specific consultants (eg Respiratory, Palliative Care, Cardiology) will be authorised to prescribe home oxygen, any new patient believed to require home oxygen must be referred to the appropriate consultant for their assessment and the production of a Scottish Home Oxygen Order Form (SHOOF) for transmission to the provider Dolby Vivisol.
The National Advisory Group for Respiratory Managed Clinical Networks ‘Domiciliary oxygen service - national guidance/best practice’ emphasises that:
- oxygen therapy is only indicated for patients with persistent hypoxaemia at rest
- oxygen has no effect on breathlessness
- palliative patients alone may get some symptomatic relief. See also Oxygen flowchart.
- Patients who meet the criteria should be referred via the SCI Store to the local Respiratory Team.
Ambulatory oxygen for intermittent symptom control
The respiratory teams at Raigmore Hospital and Lorn and Islands District General Hospital are available to formally assess patients for ambulatory oxygen therapy as specified in HDL (2004) 01.
Oxygen use in palliative care
Refer to Scotland’s national guidelines for palliative care are available at: http://www.palliativecareguidelines.scot.nhs.uk/ or seek specialist advice.
Emergency oxygen use
Guidelines for emergency oxygen use in adult patients are available at www.brit-thoracic.org.uk.