How to prescribe gaseous oxygen?
Gaseous oxygen, mainly used for acute and short-term treatments, can be supplied directly by the ULSS of the patient's residence or, alternatively, by affiliated pharmacies on the basis of a red SSN prescription (oxygen is excluded from the dematerialization process of the NHS prescription paper ...
For high quantities of gaseous oxygen consumption, a request can be made to the reference pharmacist, for direct delivery and collection at home by Vivisol. The cylinders are equipped with an indicator that shows the amount of oxygen still present.
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Liquid oxygen has the undoubted advantage of occupying much less space than the compressed oxygen gaseous contained in classic cylinders, making it possible to supply abundant quantities of liquid gas at a low temperature which avoids the inconvenience associated with continuous " come and go "...
The service provides for the delivery to the patient by the General Practitioner or the Pediatrician of free choice of the prescription of the Home Liquid Oxygen Therapy (OTL) on a red paper prescription with the words “Liquid oxygen 26.520 liters”.
If he decides to administer liquid oxygen, he must activate a prescription form, to be renewed every six months, with which the patient goes to the pharmacy. The pharmacist then contacts the company in charge of supplying oxygen, which delivers it to the patient's home.
Who prescribes oxygen therapy? Oxygen is a drug. Consequently, it is the specialist doctor (pulmonologist) who assesses when it is necessary to prescribe it. The prescription takes place through the compilation of specific forms, which will be sent to the local health company.
The use of the oxygen concentrator obviously entails a cost for the consumption of electricity. This cost, calculated for a 400 watt appliance that works for 20 hours a day, is around 25-30 euros per month.
damage to the middle ear, such as a ruptured eardrum; In adults, oxygen overdose syndrome, also called Lorrain-Smith syndrome, can occur: there is a lung injury caused by long-term exposure to high partial pressure of oxygen.
Home oxygen therapy is usually carried out for several hours during the day (15-18 hours) and at variable flows; the quantities of oxygen are determined by the doctor after careful evaluation (arterial blood analysis, spirometry, etc.).
A cylinder of 14 liters at 200 bar used with a flow of 2lt / min for 24 hours will have an autonomy of about 23 hours ?.
It is possible to prescribe no more than two cylinders per prescription, with the exception of patients with exemption for chronic-disabling disease (Ministerial Decree 329 / 99e sm) or for rare disease (Ministerial Decree 279/01), for which it is possible to prescribe three cylinders per prescription up to to cover a maximum of 60 days of therapy.
OXYGEN cylinder 14 liters 200 bar - filled with 3 m171.15 of gas, complete with valve. € 208.80 / Pcs. € XNUMX / Pcs.
Oxygen therapy is necessary in those situations that involve a reduction in oxygen levels (PaO2) in the blood. Obviously, in the air we breathe, oxygen is present with a FiO2 (percentage of O2 in the air) of 21%.
Oxygen desaturation occurs when the levels of this gas in the blood drop. If the saturation falls below 90% we are in the presence of a serious situation and it is necessary to intervene promptly by administering oxygen or, in the most serious cases, with assisted ventilation.
between 92 and 90% means that oxygenation is insufficient and it is advisable to undergo blood gas analysis (EGA); there are some exceptions in which values around 90% may be normal, for example in patients suffering from chronic obstructive pulmonary disease (COPD)
The patient must strictly adhere to the O2 flows prescribed by the doctor, in fact an excess of O2 can cause an increase in CO2 in the blood, especially in patients who are already hypercapnic, causing drowsiness and difficulty in staying awake up to a coma in the most serious cases.
The toxicity of oxygen on the central nervous system (Central Nervous System) is called "CNS toxicity". Neurological effects can include seizures, blindness and coma. It usually does not occur unless the oxygen partial pressure approaches or exceeds 1,6 bar.
- High flows of non-humidified oxygen can produce dryness and irritation of the mucous membranes of the airways (congestion or occlusion of the paranasal sinuses with pain and blood loss) and of the eyes, as well as a slowing of the mucociliary clearance of secretions.
Oxygen concentrators work based on the principle of the rapid adsorption of nitrogen from the ambient air on a molecular sieve of zeolite, due to the variation produced in atmospheric pressure (PSA). The nitrogen is subsequently released with the return of the pressure to ambient values.
The oxygen concentrator is a machine capable of extracting the oxygen contained in the air and conveying it to a tank for administration to the patient. The oxygen concentrator can be useful in patients who need to undergo oxygen therapy, usually used in the home setting.
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Oxygen therapy is prescribed in 3-4 days if PaO2 is less than 6 kPa (45 mmHg), in 15 days if PaO2 is stable, and in 30 days if PaO2 varies by more than 10% between determinations. and the other.
The duration of the sessions in a hyperbaric chamber at a pressure of 2 to 3 atmospheres (ie between 2,026 and 3,039 bar) is between 60 minutes and 4-6 hours.
Pressure = 150 bar. Volume = 5 liters. Therefore: 150 x 5 = 750 liters of O2 contained in the cylinder. Considering for example a consumption of 10 liters / minute, the cylinder will have an autonomy of 75 minutes (1 hour and 15 minutes).