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Palliative cancer care - dyspnoea - Management
What practical issues need to be considered when prescribing oxygen?
- Once a decision has been made to prescribe oxygen, consider the need for oxygen concentrators, oxygen cylinders, and liquid oxygen. The choice is determined primarily by the person's lifestyle and mobility and the need for either short-burst oxygen therapy or long-term therapy.
- A mask or nasal cannulae (consisting of two prongs) are options for oxygen delivery. Nasal cannulae are generally preferred to a mask because they do not impair speech or eating and drinking [Regnard and Hockley, 2004b], However, nasal cannulae can cause dryness and soreness of the nasal mucosa [Twycross et al, 2002].
- Oxygen should be prescribed at the lowest flow rate possible to produce benefit because of potential adverse effects:
- Clinical assessment may involve measuring breathlessness scores at different flow rates of oxygen. Most people require a flow rate of 2–4 L/min.
- People starting oxygen therapy should be provided with education and written instructions which include advice about the dangers of smoking near oxygen therapy.
- People should be reassessed regularly after commencing therapy, to determine the continuing efficacy of supplemental oxygen over the longer term.
[Booth and Dudgeon, 2006]
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