Your oxygen prescription and goal setting
We suggest you complete this document with your doctor, or a member of your healthcare team. We also sugges...
We suggest you complete this document with your doctor, or a member of your healthcare team. We also suggest you take this with you each time you visit your doctor, so you can record any changes to your treatment and ask any new questions you may have written down. Your prescription explains when you should use oxygen and the flow rate you should use.
When should I use oxygen? Record the instructions from your doctor here. You may need to tick more than one box.
q q q
I need to use oxygen while sleeping I need to use oxygen when exercising or being more active I need to use oxygen for a minimum of 18 hours a day
Planning the hours when you will usually use oxygen each day and night helps to make sure that you are using enough hours to get maximum benefit. Put O2 on:
pm. Take O2 off
am. Hours used
.
Put O2 on:
pm. Take O2 off
am. Hours used
.
Put O2 on:
pm. Take O2 off
am. Hours used
.
Total hours used per day Write any extra instructions here:
q
Other times to use oxygen include:
How much oxygen do I need? “Flow rate” is the level of oxygen that flows to you from your oxygen equipment. Flow rate is measured in litres per minute and is often written as LPM or L/M. You may be prescribed one flow rate by your doctor, or different flow rates for different situations. Ask your healthcare team to fill in your flow rate instructions here:
litres per minute during normal awake hours
litres per minute when I am exercising or more active
litres per minute when I am sleeping
Record any other prescribed flow rates here:
litres per minute when I am
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Your oxygen prescription and goal setting
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Using an oxygen conserving device An oxygen conserving device (or OCD) is a piece of equipment which may be connected to your oxygen cylinder to make it last longer. Here are some questions to ask your doctor about OCDs: Is there any reason why I should not use an OCD?
q No q Yes.
If yes, write down the reason/s here
Should I adjust my flow rate when using an OCD?
q No q Yes.
If yes, write down the change/s here
Are there any times I should not use an OCD (such as when sleeping or exercising?)
q No q Yes.
If yes, write down the times here
It is important to ask your healthcare team what flow rate you should use with an OCD, as it may be different to the flow rate you use with a concentrator. Record your flow rate instructions when using an OCD here:
litres per minute during normal awake hours
litres per minute when I am exercising or more active
litres per minute when I am sleeping
My next review It is important to have your prescription reviewed in the first 4 to 8 weeks after starting oxygen therapy, and then at least once a year following that. Record here when your prescription is next due for review: My next review is
Your questions Make a list of any questions you may have regarding home oxygen therapy, so you can work through these with your healthcare team. Sometimes discussing your concerns with your team can help you be more informed and feel more comfortable with your treatment.
Are there things about home oxygen therapy that you are a little worried about? Write these here.
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Setting your goals Sometimes when you start new therapies it is helpful to set yourself some goals. What improvements would you like to see from using home oxygen therapy? What things would you like to try to do now you are on oxygen, that you could not do before? Discuss these with your healthcare team to see if they are realistic.
Achieving your goals After a few months of home oxygen therapy you may want to review the goals you set for yourself. How are you going at reaching your goals? Write down the benefits you have found from using home oxygen.
Maybe you have not achieved all of the goals you set for yourself. Record here any frustrations you are experiencing, so you can ask your healthcare team for help.
Your personal support team Record here the full details of the individuals and organisations that assist you on a regular basis.
Healthcare team Respiratory specialist
Respiratory nurse / clinician
General practitioner
Allied health professional eg. physiotherapist, occupational therapist, social worker.
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After hours and emergency After hours general practitioner service
Location of my usual hospital or the closest hospital emergency department
Emergency contact number for my electricity supplier
Supplier of my emergency call system (if you have one)
Emergency contact number for my closest friend / neighbour / relative
If a telephone is unavailable, my emergency plan is
Day-to-day support My carer
Community health nurse
Home nursing service
Pulmonary rehabilitation group or exercise group (if one is available)
Patient support group
Pharmacist
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Equipment Supplier/s of oxygen equipment (include any after hours number)
Person to contact regarding funding of equipment (ie. where I had my initial oxygen assessment)
Lung Foundation Australia Phone 1800 654 301 or log on to www.lungfoundation.com.au
Additional support Record any extra information important to you here:
