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We understand that taking a child home from the hospital on oxygen can be a difficult process.
As discharge approaches, you may feel anxious and overwhelmed. This guide provides specific and practical information for families caring for a child on oxygen. We hope it will assist you in a smooth transition to home.
Many children need oxygen when they go home from the hospital. Oxygen is used for many different conditions, including:
Your child's doctor and health care team will determine if your child needs additional oxygen in order to keep the right amount of oxygen in the blood.
Oxygen is often needed to keep the child comfortable, decrease the amount of work needed to breathe and, in some cases, help your child grow. Some children are placed on oxygen to prevent problems with their heart.
Download Oxygen Cylinder Chart for Pediatric Patients (PDF)
There are three different types of oxygen therapy systems:
These systems consist of a large silver main tank and one or two portable units. The portable units are used as needed for travel outside of the home. When they are empty, they can be refilled from the large tank. Portable units weigh 8 to 10 pounds and can be carried with a shoulder strap or cart. Liquid oxygen will evaporate if not used frequently; therefore, portable units should be filled just prior to use. The liquid systems are often more costly.
You will have a regulator/flow meter delivered with your home oxygen system. The amount of oxygen your child gets is measured in liters per minute and, in some cases, fractions of a liter per minute. Make sure you have the correct type of flow meter to deliver the prescribed amount of oxygen for both your main and portable systems.
Oxygen extension tubing is also available. However, for small children on small amounts of oxygen, it is recommended that no more than 14 feet of extension tubing be used.
Your oxygen supply company should supply written information to you on the set up, care, use and troubleshooting of your child's oxygen system.
If your child is discharged on an aerosol mask, you will have the following equipment delivered to your home in addition to your oxygen system:
Distilled water is used to fill the nebulizer jar to create the mist for humidification. The nebulizer jar is attached to one of the oxygen systems and the air entrainment device. Oxygen is then "bled-in" using an oxygen adapter. You will need to dial the appropriate setting to create the percentage of oxygen that has been prescribed for your child.
For aerosol set-ups, the home care company will use an oxygen analyzer in your home to verify oxygen percent delivered. A chart with compressor flow and oxygen flow to get the specific oxygen percentage should be provided by your home care agency.
If your child is discharged home with a tracheostomy collar, you will have the following oxygen delivery equipment delivered to your home in addition to the oxygen system:
Distilled water is used to fill the nebulizer jar to create the mist for humidification. The nebulizer jar is attached to the air compressor and the air entrainment device. Oxygen will be "bled-in" using an adapter. You will need to dial the appropriate setting to create the percentage of oxygen that has been prescribed for your child.
The following people should know that you have a child at home on oxygen and/or apnea monitor:
Put together an emergency phone number list to keep available at each phone, in your purse or bag and in your child's diaper/travel bag. This list should include:
Taking the following precautions will ensure the safety of your child and other family members:
Your child's feeding time is a special time for sharing, interacting and bonding. Children requiring oxygen often are difficult to feed and meals may take longer.
Feed your child in a quiet, relaxed environment. Your child may need frequent breaks during the meal. Position your child for maximum comfort. Be patient and your child will soon establish a pattern for meals.
You may need to feed your child smaller, more frequent meals. Talk to your child's doctor and dietitian about a prescribed diet.
Timing is important. If your child receives breathing treatments, chest physiotherapy (CPT), and/or suctioning, do the treatments approximately 30 minutes before a meal. This will allow your child time to recover and settle down before eating.
For infants, it is very important that you plan to feed them several times before you go home from the hospital. Work with your child's nurse or health care provider to establish a feeding schedule. Holding and interacting with your child during mealtime is crucial — particularly if your child is getting feedings through a nasogastric tube. As the person interacting and monitoring your baby at home, you need to establish a relationship as soon as possible.
Infants on oxygen need to be burped more often than other babies. They tend to suck more air into their tummies when eating. Babies who eat in a hurry may not finish a meal or may throw up. Burping also gives your child a chance to rest.
Children with respiratory conditions — such as BPD and cystic fibrosis — who require oxygen often need to be positioned to breathe easier. Most children, like most adults on oxygen, are comfortable in a semi-upright position. Infants can be placed in an infant seat or car seat. An infant's bed can be slightly elevated by putting rolled up blankets under the mattress at the head of the baby's crib. Infants should not be placed on pillows or beanbags.
Older children can be placed on pillows on their backs, their stomachs or their sides. Repositioning every two to three hours is also important for comfort. If your child is quiet and resting comfortably, take this to be a good position.
Many children who are on oxygen experience times when they require extra oxygen. During feedings, after periods of activity, or when they have a cold, are usually the times when they will experience respiratory difficulty. You should look for the following symptoms:
Ask your doctor, nurse or health care provider exactly what to do in the event that these symptoms occur. You should not feed your child during an episode of distress unless specifically instructed by your child's doctor.
Your child may be traveling outside of the home while on oxygen. Thinking about potential obstacles will make travel easier for you and your child:
When you make a doctor's appointment for your child, tell the clinic staff your child is on oxygen. Tell them again when you arrive. The clinic can use their supply of oxygen while you wait and are seen in the clinic.
Children with public aid coverage who do not have any means of transportation are eligible for Medicare transport to and from clinic appointments. Ask your child's social worker for information on how to arrange this service.