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January 2016

Liquid Oxygen Therapy

By 3 years ago 717 Views No comments

Liquid Oxygen Therapy

What is Medical Liquid Oxygen?

Liquid oxygen is used to treat respiratory disorders and has been found to be more effective than oxygen concentrators or oxygen cylinders. Medical liquid oxygen offers several key advantages over other methods of oxygen delivery. The primary benefit of liquid oxygen is that continuous flow oxygen can be supplied in a relatively small, lightweight container. The key advantages of liquid oxygen includes portable, continuous flow capability, 100% concentrated oxygen, low weight (less than 10 pounds) and long duration (over 18 hours). In comparison, portable oxygen concentrators, offer a concentration range of 86 to 97%, weigh from 15 to 25 pounds, and last for 1.5 to 9.5 hours until the battery needs to be recharged. Currently their are only five portable oxygen concentrator models that offer continuous flow oxygen, making liquid oxygen an additional option for people who live active lives.

To make medical liquid oxygen, the gas form of oxygen must be cooled to at least -297 degrees Fahrenheit or -183 degrees centigrade. At this low temperature, oxygen remains in a liquid form. In its liquid state, oxygen takes up less space and can be stored at much lower pressures than when in a gaseous state. This means more oxygen can be carried in a portable liquid unit, and the portable container is much lighter in weight and smaller in size than an oxygen gas cylinder. As the temperature for liquid oxygen rises, oxygen gas is produced and used for medical therapy. One liter of liquid oxygen offers approximately 860 liters of gaseous oxygen. A small amount of liquid oxygen may supply an oxygen therapy patient with a full day of service away from home. Medical liquid oxygen is stored under low pressure and is therefore safer than oxygen cylinders which are under high pressure.

Liquid oxygen has recently moved from hospital settings to use in homes. More recently, liquid oxygen has become available in lightweight portable units that can be used almost anywhere. These recent changes have allowed more people to use liquid oxygen as their primary source of oxygen therapy.

What is Liquid Oxygen Therapy?

Liquid Oxygen Therapy for Active Lifestyles

Liquid oxygen therapy is the medical process of providing additional oxygen to a patient who can not get enough oxygen on their own. Conditions such as asthma, cystic fibrosis, dysphasia, COPD, heart failure, lung disease, and pneumonia can be treated by liquid oxygen therapy. Doctors prescribing liquid oxygen usually do so for patients who live active lifestyles. The small size, low weight and long duration of liquid oxygen supports active patients better than most other oxygen alternatives.

There are two separate components to a liquid oxygen (LOX) system. Both components consist of insulated containers that are Thermos-like to maintain low temperature. The first component is a stationary unit or liquid oxygen reservoir which stores a large volume of liquid oxygen.

The Two Major Components of Liquid Oxygen Therapy

  1. Storage reservoir
  2. Portable, refillable container

Liquid Oxygen System Components

Liquid Oxygen Reservoir

The reservoir for liquid oxygen is basically a large insulated Thermos-like container. This reservoir tank is filled by an oxygen supplier once or twice a month. The reservoir system requires no electricity and has very few moving parts, requiring very little maintenance or repair. These three factors allow the reservoir tanks to be in operation for many years with little maintenance and few to no repairs. Typically a liquid oxygen reservoir weighs 90 to 170 pounds when filled. These reservoirs store 21 to 41 liters, or 49 to 110 pounds of liquid oxygen. This amount of liquid oxygen, when converted to gas form, becomes 16,750 to 37,916 liters of oxygen. At a flow rate of two liters per minute, 37,916 liters of oxygen would last 316 hours or 13 days.

Reservoir Evaporation

Because liquid oxygen systems lose oxygen through evaporation even when not in use, the 13 days of oxygen flow referenced above would be shortened. For instance, the HELiOS reservoirs lose around 1.2 pounds of oxygen daily to evaporation. With the addition of modern pulsed delivery or conserving devices, the loss of oxygen through evaporation is somewhat compensated.

Companion LOX Reservoir HELiOS Liquid Oxygen Reservoir

Links to Liquid Oxygen Reservoirs

Portable Liquid Oxygen Unit

The second component of a liquid oxygen system is the portable unit which can be refilled from the reservoir. The portable unit may be carried by the patient in a backpack or shoulder bag and is filled from the reservoir unit. The reservoir unit is filled every 1-3 weeks by a local medical liquid oxygen provider. Neither component requires electricity to operate. This added benefit is a significant advantage not shared by oxygen concentrators. Oxygen patients who live in areas of frequent electrical blackouts can fare much better with liquid oxygen instead of oxygen concentrators.

When at home, patients use the stationary unit as their source of oxygen. When away from home, the portable unit supplies patients with oxygen. Most portable units provide the option for continuous flow or pulse flow oxygen. Patients merely select the flow level they need for their given situation.

Refilling the Portable LOX Unit from LOX Reservior

Examples of Liquid Oxygen Portable Units

Liquid Oxygen Maintenance Requirements

There is very little maintenance for liquid oxygen systems. The stationary reservoir tank should be placed on a level surface. Securing the tank to the wall would also be beneficial. If a drainage bottle is used for collecting excess condensation, it should be emptied and cleaned regularly. Cleaning the outside of the tank with a damp cloth should be done occasionally to remove dust. The reservoir tank should be refilled by a professional service provider. Refilling the portable unit should be accomplished in accordance with manufacturer instructions. Procedures for recovering from a freezing incident should also be handled in accordance with manufacturer instructions.

Prescribing Portable LOX Liquid Oxygen

Doctors prescribe liquid oxygen for patients who are mobile and active outside their homes. The advantages of low weight, small size, continuous and pulse flow, and high concentration provide a strong argument for liquid oxygen therapy. Patient compliance and outcomes have been shown in medical studies to be improved over patients using other oxygen delivery systems.

Comparing Portable Liquid Oxygen to Portable Oxygen Concentrators

Portable liquid oxygen offers two flow options: continuous flow and pulse flow. On the other hand, most portable oxygen concentrators provide only pulse flow oxygen. Currently there are five portable oxygen concentrators that provide continuous flow along with pulse flow. These five concentrators are listed below with links to more information.

  1. SeQual eQuinox offers highest oxygen output, lowest power consumption and 24/7 operation.
  2. Oxlife Independence provides 24/7 operation and extraordinary durability.
  3. Eclipse 5 has the lowest noise output and 24/7 operation.
  4. SimplyGo offers the smallest profile and lowest weight.
  5. DeVilbiss iGo has the lowest price and low maintenance requirements.

The two charts below display a comparison between oxygen concentrators and liquid oxygen. The data is averaged for the five portable oxygen concentrators with continuous flow capability and the Helios and Companion series of liquid oxygen products.

Comparing Liquid Oxygen to Portable Oxygen Concentrators

As shown in the comparison chart above, LOX does better in every measurement. LOX portable units are significantly smaller in size and weigh significantly less than continuous flow cable portable concentrators. Oxygen output is also significantly higher for liquid oxygen units. LOX offers up to 13.7 hours of more run time than portable oxygen concentrators and takes less than two minutes to refill compared to 3-1/2 hours of battery charging for a concentrator. LOX units produce no sound to operate while concentrators average 44 dBA.

Comparing LOX to Pulse Flow Portable Oxygen Concentrators

As shown in the comparison above, LOX performs better in every category except one—size. Pulse flow portable oxygen concentrators are smaller in size (107 cubic inches) and weight (1 pound). LOX outperforms concentrators in oxygen output, duration and noise.

Liquid Oxygen Review

Liquid oxygen therapy offers many advantages and few disadvantages. Listed below are the key advantages and disadvantages oxygen patients can expect to experience when using liquid oxygen therapy.

Advantages of LOX

  1. Better therapy outcomes than alternative methods of oxygen delivery.
  2. 100% oxygen concentration levels.
  3. Higher oxygen output.
  4. Provides higher continuous flow volumes up to 15 LPM.
  5. Long oxygen supply duration.
  6. No sound emissions.
  7. More discreet oxygen therapy with less attention being drawn from others.
  8. Requires no electricity.
  9. Large oxygen capacity.
  10. Lightweight.
  11. Reservoir doubles as a home oxygen dispenser and as a refill station for the portable unit.
  12. Supplies continuous flow oxygen for up to 13 days (at 2 LPM)
  13. Short refill time for portable LOX units of less than 2 minutes.

Disadvantages of LOX

  1. Limited availability of liquid oxygen service providers in many areas to refill the reservoir tank.
  2. Limited shelf life due to evaporation loss. (around 1.2 pounds daily)
  3. Requires regular reservoir refills from a medical oxygen service.
  4. Produces annoying noises while refilling the portable unit. (Less than 2 minutes duration.)
  5. The connection between the reservoir and the portable unit can become frozen if the filling is not done properly. All connections should be airtight.

Summary of Liquid Oxygen Therapy

Liquid oxygen therapy offers oxygen patients many advantages not found in other therapy options. The biggest hurdle to using liquid oxygen therapy is the availability of a local service provider for home delivery of liquid oxygen. Liquid oxygen for patients living in rural areas may not be a viable option due to the lack of liquid oxygen sources. Patients living in large metropolitan areas have more access to this type of service and can therefore take advantage of the better outcomes and the higher oxygen output of liquid oxygen therapy.

Resources

  1. Liquid Oxygen Use Time Duration Chart for several liquid oxygen devices manufactured in the USA.
  2. HELiOS and Companion LOX Specifications provided by Chart Industries.
  3. Cancaster B, Ranking the Top Portable Oxygen Concentrators with Pulse Flow includes concentrator review and comparison.
  4. Cancaster B, Ranking the Best Portable Oxygen Concentrators with Continuous Flow includes concentrator comparison chart.
  5. Nasilowski J, Przybylowski T, Zielinski T, Chazan R, Comparing supplementary oxygen benefits from a portable oxygen concentrator and a liquid oxygen portable device during a walk test in COPD patients on long-term oxygen therapy. Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.
  6. Croxton TL, Bailey WC. Long-term oxygen treatments in chronic obstructive pulmonary disease: recommendations for future research: an NHLBI workshop report. Am J Resp Crit Care Med. 2006; 174(4): 373-378.
  7. Doherty DE, Petty TL, Bailey W, et al. Long Term Oxygen Therapy (LTOT): Recommendations of the 6th long-term oxygen therapy consensus conference. Respir Care. 2006; 51(5):519-525.
  8. Timms RM, Khaja FU, Williams GW. Nocturnal Oxygen TherapyTrial Group. Hemodynamic Response to Oxygen Therapy in Chronic Obstructive Pulmonary Disease. Ann Intern Med. 1985;102:29-36.
  9. Weitzenblum E, Sautegeau A,Ehrhart M, Mammosser M, Pelletier A. Long Term Oxygen Therapy can Reverse the Progression of Pulmonary Hypertension in Patients with Chronic Obstructive Pulmonary Disease. Am Rev Respir Dis. 1985;131:493-498.
  10. Morrison DA, Stovall JR. Increased Exercise Capacity in Hypoxemic Patients after Long Term Oxygen Therapy. CHEST. 1992;102:542-550.
  11. Heaton RK, Grant I, McSweeny AJ, Adams KM, Petty TL. Psychologic Effects of Continuous and Nocturnal Oxygen Therapy in Hypoxemic Chronic Obstructive Pulmonary Disease. Arch Intern Med.1983;143:1941-1947.
  12. Nocturnal Oxygen Therapy Trial Group. Continuous or Nocturnal Oxygen Therapy in Hypoxemic Chronic Obstructive Lung Disease: A Clinical Trial. Ann Intern Med. 1980;93:391-398.
  13. Medical Research Council Working Party. Long Term Domiciliary Oxygen Therapy in Chronic Hypoxic Cor Pulmonale Complicating Chronic Bronchitis and Emphysema. Lancet. 1981;1: 681-686.
  14. Couser JI Jr, Make BJ. Transtracheal Oxygen Decreases Inspired Minute Ventilation. Am Rev Respir Dis. 1989;139:627-631.
  15. Barker AF, Burgher LW, Plummer AL. Oxygen Conserving Methods for Adults. CHEST. 1994;105:248-252.
  16. Hida W, Sakurai M, Okabe S, Hajime, Kurosawa, Kikuchi Y, Takishima T. Home oxygen therapy using liquid oxygen system. Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Dec;30 Suppl:164-8.
  17. O'Donohue WJ Jr, Plummer AL. Magnitude of usage and cost of home oxygen therapy in the United States. Chest 1995;107:301–302.
  18. Swinburn CR, Mould H, Stone TN, Corris PA, Gibson GJ. Symptomatic benefit of supplemental oxygen in hypoxemic patients with chronic lung disease. Am Rev Respir Dis 1991;143:913–915.
  19. Dean NC, Brown JK, Himelman RB, Doherty JJ, Gold WM, Stulbarg MS. Oxygen may improve dyspnea and endurance in patients with chronic obstructive pulmonary disease and only mild hypoxemia. Am Rev Respir Dis 1992;146:941–945.
  20. Neff TA, Petty TL. Long-term continuous oxygen therapy in chronic airway obstruction: mortality in relationship to cor pulmonale, hypoxia, and hypercapnia. Ann Intern Med 1970;72:621–626.
  21. Gorecka D, Gorzelak K, Sliwinski P, Tobiasz M, Zielinski J. Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxaemia. Thorax 1997;52:674–679.
  22. Oswald-Mammosser M, Weitzenblum E, Quoix E, Moser G, Chaouat A, Charpentier C, Kessler R. Prognostic factors in COPD patients receiving long-term oxygen therapy: importance of pulmonary artery pressure. Chest 1995;107:1193–1198.
  23. Timms RM, Khaja FU, Williams GW. Hemodynamic response to oxygen therapy in chronic obstructive pulmonary disease. Ann Intern Med 1985;102:29–36.
  24. Aubier M, Murciano D, Milic-Emili J, Touaty E, Daghfous J, Pariente R, Derenne JP. Effects of the administration of O2 on ventilation and blood gases in patients with chronic obstructive pulmonary disease during acute respiratory failure. Am Rev Respir Dis 1980;122:747–754.







Burt Cancaster, Author

Vitality Medical
7910 South 3500 East, Suite C
Salt Lake City, UT 84121
(801) 733-4449
[email protected]


Burt Cancaster Profile

Pet Health, Your Health

By 3 years ago 411 Views No comments

Family. Best friend. Partner in crime.

Puplight

No matter how you view your feline or canine companion, it's important to see that their health is really your health. In fact, the Centers for Disease Control and Prevention point to data that links pet health to our health.

The CDC reports that dogs spur childrens' social, emotional and cognitive development. For adults, dogs aid in stress reduction and can boost activity levels through walks, games of fetch and even friendly tug-of-war bouts. The CDC notes that cats are similarly beneficial, providing emotional support and mood-enhancing companionship. They offer tremendous socialization benefits for the homebound or disabled, boosting morale.

So, how do you keep your pets from getting into "ruff" shape?

Exercising your pet

Leisurely park strolls or a vigorous swims are a great place to start. Beyond increased physical activity for you -- and all the accompanying benefits -- the impact on pets' health is tremendous. The Association for Pet Obesity Prevention estimates that a staggering 54% of U.S. dogs and cats are overweight or obese. Although fluffy kitties and plump puppies seem cute and extra cuddly, weight problems can usher in joint ailments, kidney disease, ligament injury and a shorter life. Not to mention there are quality of life issues for you both -- it's no fun watching a pet struggle to jump onto a favorite spot on the couch.

Puplight

Starting small is easy

The right accessories can make all the difference in comfort, convenience and safety. For instance, the PupLight and Visiglo Nylon Collars add visibility to your pet during pre- or post-work walks. If the thought of carrying a water bottle and dog doo bags is off-putting, consider the all-in-one Water Walker Leash. This handy unit contains an integrated serving tray, water bottle and built-in bag dispenser to minimize clutter and hassle.

Since we're on the topic of food, Vitality Medical would like to point out that how you feed your pets is extremely important. Placing water and food dishes on the floor can be quite a strain for older dogs, as well as larger breeds. For example, the manufacturers of the Our Pets Healthy Diner claim that elevated pet sets provide the proper feeding ergonomics that aid digestion and posture. Minimizing excessive stooping also reduces joint stress; elderly dogs or those with bone and/or joint ailments may have an easier time eating and drinking. If joint health is already a health concern for your pet, nutrient-dense supplements such as Zuke's Hip Action Daily Hip and Joint Support Treat For Dogs can bolster hip and joint health.

Rover on the road

Car safety is another overlooked aspect of pet -- and guardian -- health.

While it may seem compassionate, or "fun" to keep your pet close in the car, the results from even a minor accident can be tragic. Airbags typically inflate within 25-50 milliseconds -- nearly 200 MPH! Airbags work in concert with seat belts and humans, meaning the life-protecting force from an airbag could be fatal for unrestrained dogs or those tethered in the front passenger seat. Moreover, an impact means that an unrestrained dog could harm occupants.

Bergan Travel Harness - Pet Seatbelt

Fortunately, several companies have cost-effective workarounds that let you and your pet ride comfortably and you confidently. The Midwest Universal Wire Barrier gate is ideal if staining and upholstery tears are concerns. The barrier fits behind the second or third row of crossovers, minivans and other five-door vehicles (i.e., wagons and hatchbacks). This prevents large dogs from climbing on occupants, distracting drivers and being injured by an airbag during a head-on, side or off-set collision. Alternatively, the Bergan Travel Harness secures pets to the backseat. The harness will withstand forces generated from sudden stops. Consider this, and products like it, a form of accident avoidance -- pets are kept from distracting drivers or blocking access to primary controls (e.g., pedals or shift levers).

While the barriers and harnesses sound wonderful in theory, many pampered pets may experience separation anxiety and excessively cry during car trips. Several veterinarians and animal behavioral specialists suggest starting small by getting your pet accustomed to a stationary vehicle before progressing to short trips. During this process, guardians may need help calming nervous pets. This is where herbal supplements such as Ark Naturals Happy Traveler for Dogs and Cats Anti Anxiety Herbal Formula may help. The formula contains valerian, German chamomile, L-Tryptophan and St. John's Wort -- which are all reputed for their calming properties.

While your dog's goofiness or cat's calming presence may pull on your heartstrings, there's much more happening. According to the CDC, pets can help lower blood, pressure and cholesterol levels. Your feline or canine's wellness, physical health and car safety are truly an extension of your own! Making the right choice can ensure years of companionship.

Here's to a life full of Vitality!

Resources:







Paul Garcia, Author

Vitality Medical
7910 South 3500 East, Suite C
Salt Lake City, UT 84121
(801) 733-4449
[email protected]


Paul Garcia Profile

Patient Safety

By 3 years ago 462 Views No comments

Patient Safety in 2016

There is nothing more important in the world of healthcare than patient safety. The Institute of Medicine (IOM) has even said that they consider patient safety as being "indistinguishable from the delivery of quality health care." Above all else, when a patient is in the care of others, they and their loved ones want to rest assured that their safety is being considered and taken seriously.

Patient safety products are crucial when caring for a patient who may be prone to falling or otherwise putting themselves or others at risk. We are certainly conscious of patient safety and are here to help. In this article, we will deal specifically with fall protection and detail some of the products that can greatly enhance the safety of an experience in a hospital or care facility.

Raised Toilet Seat

Fall Protection

Falls are among the leading causes of injuries among the elderly. Of course it's no secret that when people age, they become more fragile, so falls can be very serious for elderly individuals, as well as incredibly expensive. Among other things, falls can lead to hip fractures and hip fractures are no joke. They can greatly decrease individuals' overall health, and make people 5 to 20 percent more likely to die than any other age group. Furthermore, those who have fallen often require long-term or intensive assistance or nursing facility care.

Safety Around the House

Grab Bars

There are some simple and effective steps that can be taken to not only enhance the safety of any care facility, but to greatly reduce the risk of falling around the house as well. In addition to ensuring that walking paths are clear, loose cords are out of the way, and rugs and carpets are tightened or completely removed, there are some tools that you can put into place to make for a safer living space as well. Such as grab bars that aid in standing and getting in and out of the bathtub; shower chairs, which give individuals prone to instability a way to shower without the difficulty of standing up; raised toilet seats, which offer increased stability and ease in getting on and off of the commode; and reachers that can help with getting those out-of-the-way items off the shelf.

Shopper's Tip:

Another item that can greatly improve the patient's lives via increased safety and comfort is a pair of non-skid socks. These socks are available in a wide variety of styles, but most feature a tread or skid-resistant rubber sole, and are usually much warmer than standard socks, much more like a house slipper. No matter the style, they all offer greater traction and decrease the chance of slipping and falling, whether at home or in the hospital.

Bed Safety

Bed Safety Rails

While tripping or stumbling while moving is certainly the most common type of falling, it is not the only kind. Many individuals are also prone to falling out of bed while sleeping. It's a common misconception that this a problem that only occurs during childhood, but it can actually happen during any stage in life. To prevent patients and loved ones from rolling out of bed, bed safety rails can be set in place, safeguarding against fall-related injuries. There are bed safety rails for all bed sizes. Keep in mind that hospital bed rails are different than homestyle bedrails. Be sure to select the correct rails for your specific bed.

Shopper's Tip:

Aside from bed rails, fall mats like the Tri-Fold Bedside Fall Protection Mat can offer protection from falls by providing a high-density layer of foam to absorb impact and drastically reduce the risk of injury.

Medical Alarm Monitoring

Patient Alarm Monitors

Another great way to enhance the safety of your patients or loved ones is by installing a patient safety alarm. There are several different types of patient alarms, from door alarms to bed alarms, all convenient and easy to use. These alarms give caregivers the ability to monitor the activity of patients or loved ones who may be prone to either falling out of bed, wandering, or sleep walking and potentially putting themselves or others at risk of harm.

Mobile Safety

Fall-related injuries can also lead to extensive and long-lasting rehabilitation. Certain safety aids can definitely make rehabilitation safer and smoother. One of those is a safety roller. Safety rollers are similar to standard walkers, but have four wheels as opposed to the typical two or none, enabling people who struggle walking the ability to move a bit more fluidly while also receiving sturdy support. There are both posterior, or rear facing, and anterior, or front facing safety rollers. Whichever you choose, they are all ideal for stabilizing individuals during rehabilitation and recovery. For some patients for which rehabilitation is not likely, patient lifts and transport chairs are better suited to meet their needs. One good example is the 4-in-1 Body Up Evolution Patient Lift that serves as a commode chair, bath/shower chair, indoor wheel chair or transfer chair.

Rollator Walkers

We hope this has enriched your understanding of the options available to you to enhance your patients or loved ones' safety in 2016 and that you continue to have a safe and happy year.

Resources:

Mitchell, P.H. Defining Patient Safety and Quality Care. NCBI
Patient Safety. Institute for Healthcare Improvement







Jared Soper, Author

Vitality Medical
7910 South 3500 East, Suite C
Salt Lake City, UT 84121
(801) 733-4449
[email protected]


Jared Soper Profile