The Community Respiratory Service consists of:

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The Community Respiratory Service consists of
South East Essex Community Healthcare

• Catherine Deeming and Gina Logan
• Respiratory Clinical Nurse Specialists
• Lucy Butler Respiratory Physiotherapist
• Cheryl Davis Spirometry Technician
• Natalie Pope Data Coordinator

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Aims of the Home Oxygen Service

• The Home Oxygen service started 1st February
  2006.
• It aims aim to
• Improve Patient access to a wider range of
  technologies e.g. ambulatory.
• Introduce a robust assessment process reflecting
  BTS guidance for LTOT and Ambulatory oxygen.
• Ordering of LTOT and SBOT using a HOOF.

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Domiciliary Oxygen Therapy

• Long term Oxygen Therapy
• (15 hours per day)
• Ambulatory Oxygen Therapy
• (supplementary oxygen during exertion)
• Short Burst Oxygen Therapy
• (Palliation of breathlessness)
• Temporary/Emergency Oxygen Therapy
• (Acute episodes)

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Shortburst.

• No clear evidence regarding benefits.
• Large cylinders or concentrator.
• Based on Oxygen saturation readings.
• Difficulty in monitoring usage

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LTOT

• Identified by SATS below 92
• Formal assessment required when patients
  condition stable.
• Assessment involves capillary ear lobe gases on 2
  separate occasions.
• Must have trial on oxygen.
• Concentrator.
• Mask/ nasal cannulae
• Minimum 15 hours.
• Will be monitored in accordance with BTS
  guidance.
• Changes should not be made without further formal
  assessment.

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Ambulatory

• For people who are active and go out walking!
• Formal assessment when stable
• 6 minute walk without oxygen monitoring
• Distance walked
• Oxygen saturations
• Time needed to rest
• Breathlessness based on BORG score
• If Sats below 90 repeat on oxygen.
• Conserving device
• Monitor in accordance with BTS guidance.

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Oxygen Categories
Category 1 Emergency
Category 2 Short burst/small amounts
Category 3 Long term home oxygen
Category 4 Ambulatory and home oxygen
Category 5 Ambulatory oxygen
Category 6 Lightweight ambulatory and home oxygen
Category 7 Lightweight ambulatory
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Criteria for Long Term Oxygen Therapy (LTOT)

• Arterial blood gases -chronic hypoxaemia PaO2 at
  or below 7.3Kpa(55mm Hg) or 8Kpa(60mmHg) if there
  is evidence of heart failure or secondary
  polycythaemia.
• Measured during a period of clinical stability
  (absence of exacerbation for 5 weeks)
• At least three weeks apart

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Blood gases

• Arterial blood gases-radial artery -gold standard
• Arterialised capillary blood gases
• Good evidence to show correlation with good
  technique (Pitkin Thorax 1994 49 364)
• Less invasive, less painful
• Portable machines are available
• Flexibility of where to perform CBGs
• Must be interpreted by experienced team

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Earlobe capillary gases
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Assessment

• Ensures correct oxygen prescription
• Flow rate
• Hours on oxygen
• Method of delivery
• Minimise risks of supplying oxygen
  inappropriately
• Reduce wasted resources
• Advice/information increases compliance
• Pepin J 1996 Chest 109, 1144-1150, long-term
  oxygen therapy at home. Compliance with medical
  prescription and effective use of therapy- 45
  compliance

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Ordering

• A copy of the latest version of the HOOF template
  v2.3 is available on the Primary Care Contracting
  Website www.pcc.nhs.uk/hoof,
• The HOOF once completed to be faxed to
• Fax No 0800 169 9989 and a copy faxed to the PCT
  on Fax No. 01702 508514
• In Line with BTS guidelines and PCT Prescribing
  Advisors, GPs should only order Short Burst O2
  Therapy (SBOT).
• http//www.brit-thoracic.org.uk/Portals/0/Clinica
  l20Information/ Home20Oxygen20Service/clinical
  20adultoxygenjan06.pdf
• LTOT and Ambulatory O2 can be accessed by
  referral to the Community Respiratory Team who
  manage the Home Oxygen Service.

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http//www.pcc.nhs.uk/uploads/HOS/July202009/hoof
_v2_3_final.doc
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Contact details

• The Community Respiratory Service are based at

1st Floor Suffolk House Baxter Avenue Southend
on Sea Essex SS2 6HZ TEL [phone]