Oxygen is essential for life, valuable therapy for many patients, and can be surprisingly dangerous.

You may not think of oxygen as dangerous. After all, it is all around us in the air we breathe. But the oxygen concentration in ordinary air is a mere 21%. Increase that concentration by only a little, and the risk of fire grows dramatically.

In oxygen-enriched atmospheres (defined as greater than 23% oxygen), fires can be easily started and spread by means that would not happen in ordinary air. Many materials that do not burn in air will burn easily and vigorously in oxygen-enriched atmospheres.

What's more, these fires burn hotter and faster than ordinary fires. The higher the level of oxygen, the worse the fire.

• What You Need to Know About Oxygen Therapy

  Your doctor may have prescribed supplemental oxygen therapy. The good news is that many people lead very active lives despite needing oxygen. But using oxygen can also put you at risk. So it is important that you know how to keep yourself and those around you safe.

• How Does Oxygen Therapy Work?

  Oxygen therapy is used to increase the supply of oxygen to the lungs, which in turn, makes more oxygen available to other body tissues.

  It can be delivered from high-pressure cylinders, cryogenic liquid containers, or oxygen concentrating devices (e.g., oxygen concentrators). The oxygen flows from the supply through a long, thin plastic tube that connects to a breathing device worn by the patient. Breathing devices include nasal cannulas, facemasks, and tracheostomy tubes.

• What Are the Risks?

  One of the greatest risks of using oxygen is the potential for fire. Smoking while oxygen is in use or nearby is the greatest cause of oxygen-users' deaths. Smoking while breathing supplemental oxygen can cause the cigarette to burst into flames, causing severe facial burns or fire.

  Fires in the home pose a risk for neighboring residences and buildings to catch fire as well. Many ordinary things can cause a fire on or around the oxygen supply or a patient using oxygen, such as the flame from a match, candle, lighter, furnace pilot light, space heater, hair dryer, static sparks and more.

  It is recommended that anyone using oxygen stays at least 25 feet away from any of the above heat sources or another person smoking.

  The oxygen supply device itself can also be hazardous and explode if improperly used, stored, hit, dropped, or if it leaks. Oxygen use in a car without good ventilation can start a fire.

• In Case of Fire, What Should I Do?

  Should there be a fire involving oxygen or an oxygen supply, act quickly:

  1. Shut off the oxygen supply or remove tubing from supply, if possible and if safe to do so

  2. Get away from the oxygen delivery device, oxygen supply, and the fire

  3. If the fire is on you, remove the oxygen delivery device, then stop, drop and roll.

  4. Extinguish the fire with water or a fire extinguisher, if possible and if safe to do so

• Safety Tips for Patients Using Oxygen Therapy

  Patients who smoke while using oxygen are at risk of fire and facial burns.

  Preventative measures include:

  1. Patients, caregivers, visitors should not smoke in any part of the house where oxygen is used
  2. Patient/caregiver to use signage “No smoking - oxygen in use.”
  3. Arrange for removal of any oxygen equipment not in regular use
  4. Ensure smoke detectors are fitted and in working order

  
  Exposure to open flames from gas fires, open fires, candles and cooking appliances puts the patient using oxygen at risk for explosion and fire.

  Preventative measures include:

  1. Patient to maintain a safe distance from fires and open flame appliances while wearing oxygen
  2. Oxygen must be securely positioned and stored away from heat and open flames

  
  Patients using oxygen are at risk of little to complete restriction of oxygen if entrapment or kinking of tubing occurs in or under furniture, doors, wheels or other heavy objects.

  Preventative measures include:

  1. Check there are no kinks in the tubing
  2. Check that the tubing is not trapped between furniture or trapped (e.g. under bed or wheel, etc.)
  3. Use only tubing supplied by the oxygen provider or hospice

  
  Patients who use petroleum-based products while using oxygen are at risk of local burning of affected area.

  Preventative measures include:

  1. Patients (or caregivers) should not use petroleum on or near patient’s nostrils
  2. Patients should not use oils or gels on or near a patient’s nostrils

  
  Patients using oxygen are at risk for trips and falls when using tubes to receive oxygen therapy.

  Preventative measures include:

  1. Patients and caregivers to check position of tubing daily to minimize risks of falls
  2. Patients and caregivers to check position of tubing, particularly if patient using a walker, etc.
  3. Current oxygen tubing must be of an appropriate length to meet the needs of the patient, and if needed contact hospice to alter the tubing length

  
  Patients using oxygen are at risk of no oxygen supply if the power supply to the oxygen concentrator is turned off.

  Preventative measures include:

  1. Ensure patient has a backup cylinder
  2. Patient should not use back up cylinder unless there is power failure to concentrator

  
  Oxygen-sensitive patients are at risk of worsening respiratory failure if an unauthorized adjustment of flow rate on equipment occurs.

  Preventative measures include:

  1. Patient and caregiver will know and understand the reason for oxygen
  2. Patient and caregiver will know and understand prescribed flow rate and hours of use
  3. Patient and caregiver understand how to operate equipment safely
  4. Patient and caregiver know the importance of not adjusting oxygen flow rate without seeking appropriate clinical advice and assessment

  
  Non-compliance with oxygen treatment prescribed for the patients puts them at risk of low oxygen remaining untreated.

  Preventative measures include:

  1. Patients will be educated on when and how to use oxygen at the time of prescribing
  2. Reason for oxygen will be discussed at each review of care plan
  3. Significant caregivers, family and others involved with the patient to be educated on why oxygen has been prescribed

• How Can I Keep Myself Safe?

  1. Read, understand, and follow the oxygen device instructions for use and safety.
     
     
  2. Never smoke while using oxygen or near an oxygen supply.
     
     
  3. Keep yourself and the oxygen supply at least 25 feet away from:
     ✓ any fire, candles, stove, oven, grill, or other heat source or open flame
     ✓ electrical appliances that make sparks
     ✓ elements that produced high heat, such as an electronic igniter, toaster, space heater, hair dryer or electric motor
     ✓ anyone smoking
     
     
  4. Do not use flammable aerosol sprays (such as spray paint, hair spray) near the oxygen supply because they may spontaneously burn.
     
     
  5. Do not use cosmetic oils, waxes, petroleum-based products or greases because they can easily burn in supplemental oxygen.
     
     
  6. Avoid static electric spark conditions. For example, do not use synthetic blankets because sparks could occur near the site of oxygen use.
     
     
  7. Keep oxygen concentrators, containers and cylinders on an upright position. Oxygen cylinders must remain on a securing device such as a cylinder rack to prevent the tank from falling or being knocked over.
     
     
  8. Never cover or place anything over an oxygen supply.
     
     
  9. Keep a fire extinguisher in the area of oxygen use.
     
     
  10. Keep a phone near patients who may have difficulty escaping in a fire.