This Policy describes the measures and precautions to be taken for the safe handling of medical supplies of pure oxygen at the service user’s home. The Policy addresses safety issues for the service user and also the care staff, for whom the Organisation has a Duty of Care. This Policy should be read in conjunction with Policy No 3600 - “The Administration of Oxygen to the Service User”.
A: SAFETY PRECAUTIONS IN THE DOMICILIARY ENVIRONMENT - CARE STAFF & SERVICE USERS:
The following basic safety measures MUST be observed when handling and using oxygen in a home environment to ensure the safety of the service user and others present, and the Organisation’s care staff:
1. Ensure that oxygen cylinders are properly stored:
Do not store in the same area as flammable / oil-based materials (petrol, paint etc).
Keep oxygen cylinders upright, if possible using special carrying cradles.
Protect from extremes of heat or cold.
Store in an area that is clean, well-ventilated, and away from direct sunlight.
Keep oxygen source at least 3 metres away from fires and naked flames (cookers etc).
2. Ensure that oxygen equipment is properly handled:
Do not use grease or oil on any oxygen equipment.
Wash and dry hands thoroughly before handling any oxygen equipment.
Ensure cylinder valves are fully closed when not in use.
Open cylinders gently to avoid an undue rush of gas.
Close cylinder valves directly after use, and without unnecessary force.
Arrange for all empty cylinders to be returned directly to the supplier.
3. When using oxygen, DO NOT smoke or allow anybody else to smoke anywhere near the oxygen equipment. (See Part B of this Policy). Put up NO SMOKING signs.
4. Do not discharge aerosol sprays (air freshener, furniture polish etc) near the oxygen source.
5. Inform the local Fire Service that oxygen is being used and stored on the premises. They should assist in Advising on the following:
5.1 Keeping an appropriate fire extinguisher in the house and within easy reach.
5.2 Ensuring that smoke alarms are fitted, and that they are regularly checked.
6. Avoid drinking alcohol or taking sedative medication when using oxygen. They can cause the breathing rate to decrease.
7. If the service user is mobile, and is using portable (ambulatory) oxygen, ensure that he / she has an oxygen sticker for their car. These stickers are available from the Fire Service.
8. When using oxygen with twin-pronged nasal cannulae, moisturisers used on the lips and nose must be water-based, such as KY Jelly or similar. Petroleum-based products such as Vaseline petroleum jelly should NOT be used.
B: PARTICULAR CONSIDERATIONS WHERE THE SERVICE USER IS A SMOKER:
1. Reference clause A:3 of this Policy, home oxygen users MUST NEVER smoke, or allow others to smoke, where oxygen is being used. Oxygen is an oxidising agent which means that it helps things to burn more easily and more fiercely. Oxygen can build up unnoticed on clothing and in hair as it is breathed in, even while asleep. Bedding can also become oxygen-saturated. For this reason, home oxygen users are always at risk from their bedding, clothing and their hair catching fire as a result of smoking, or others in close proximity to them smoking. This can be especially dangerous if the service user falls asleep while smoking; for example, as a result of drinking alcohol or taking sleep-inducing medication. It is therefore critical that the requirements of clauses A:3 and A:6 of this Policy are put into practice.
2. However, set against this are 2 fundamental considerations:
2.1 The right of the service user to live his / her life in their chosen lifestyle, where mental capacity and the ability to take risks and make informed choices have been verified.
2.2 The Duty of Care that the Organisation has towards its care staff. Working in an environment where the service user insists on smoking where oxygen is being stored and used constitutes a hazardous working environment which is unacceptable.
3. Every effort must be made to point out to the service user in a sensitive manner the very real dangers of smoking in an oxygen-enriched environment, and to convince them of the need to comply with the appropriate safety precautions for the safety of all concerned. If necessary this may include consultation with the Regulatory Authority and / or the Fire Service. Should the service user insist upon continuing to smoke then appropriate action must be taken which could result in the ultimate sanction of withdrawing the care service completely from the service user. Should this be the case this will proceed in accordance with Policy No 4305.
Form No: 4-106 Supply of Oxygen - Service User Agreement
Form No: 4-107 Risk Assessment - Using Oxygen in a Smoking Environment
ADDITIONAL POLICY REFERENCES:
Policy No 3600 Administration of Oxygen to the Service User