NEW 03/04/2020 Use of Oxygen in
COVID-19 patients/palliative - Key Messages
There has been no specific information published about the use of oxygen for
patients in primary care with suspected COVID-19.
Therefore current provision of oxygen is as per current arrangements
(using a Part A HOOF on https://www.airliquidehomehealth.co.uk/hcp/HOOFA )
and criteria for use.
BTS guidance should be followed.
- The BSW Primary Care model and guide during COVID-19 (Patient aged >12) states that if a patient with suspected COVID-19 would not benefit from
admission to hospital that the GP can consider Palliative Care/ Home Oxygen
if available & appropriate. GPs should be mindful of oxygen supplies and that
oxygen providers might struggle with demands during this crisis.
- Only institute a home oxygen prescription for patients who are hypoxic
- (sats ≤ 92%), rather than simply those with breathlessness who are not necessarily hypoxic.
- All patients should be given appropriate ‘just in case’ meds (e.g. opiates),
- which may well control their symptoms better than oxygen, even in hypoxic patients. See COVID-19 palliative care guidance
- Local COPD guidance found here; p5 for oxygen information.
Wiltshire Health & Care:
- WH&C staff are only visiting home oxygen patients who are unstable.
- All stable patients have had their time to the next visit extended.
- WH&C are reviewing all their oxygen patients virtually & removing oxygen
- from those considered “non-essential” to help preserve supplies.
- GPs should liaise with the BaNES IMPACT team as usual for all oxygen
SFT Respiratory clinic (oxygen):
- No face to face oxygen clinic currently running (no routine patients).
- Telephone advice still available. Patients would be seen if clinically urgent
- but would need to come into the hospital. Dealt with on a case by case basis.
- Routine reviews are not currently happening. Advice can be sought from
- the team for acute problems.
Contacts for oxygen referrals:
BaNES – IMPACT team BATHNES.email@example.com 01225 831 808
Swindon – Community COPD team
firstname.lastname@example.org 01793 646436
http://www.mg.salisbury.nhs.uk/media/1719/oxygenservicereferral.doc to the
resp. dept. at SFT
North, East and West Wiltshire – referral forms:
https://prescribing.wiltshireccg.nhs.uk/?wpdmdl=653 to Wiltshire
Health and Care community respiratory team GWH.WiltsO2@nhs.net
SECONDARY CARE ONLY
MHRA Alert - important information about High flow Oxygen therapy devices
(including wall CPAP and high flow face mask or nasal oxygen) during COVID-19 epidemic
General Information around prescribing OXYGEN
Home oxygen comes in many forms. Used appropriately it can improve mortality
in selected patients. However, it is often overprescribed and can pose a fire risk to
patients and those around them if used incorrectly.
Home oxygen should not be used to treat acute hypoxia or acute on chronic hypoxia.
If home oxygen does need to be prescribed you will need to complete a Part A Home Oxygen Order Form (HOOF) that will allow a temporary supply of oxygen to be
installed prior to a formal assessment by the community Home Oxygen Assessment Service.
When completing a Part A HOOF you will be asked what type of oxygen equipment
- Concentrator or static cylinder
- Flow rate required (in litres per minute) – this should be maximum 2 litres
- per minute
- Expected usage (in hours/day) – this should be maximum 16 hours per day
- Consumables required (nasal cannulae or mask) – usually nasal cannulae
When completing a Part A HOOF you will also be asked how quickly you need the
oxygen equipment installed. It is costly to request an urgent (ie 4 hours) installation
so please order ‘next day’ or ‘standard’ installation (ie 3 days).
Please check the patient has someone available to let the provider in to their home to install the oxygen equipment.
The Part A portal can be accessed using: https://www.airliquidehomehealth.co.uk/hcp/portal_a/ The webpage includes a
detailed guide on how to complete the Part A HOOF.
No password is required to complete a Part A HOOF.
Remember - Home oxygen is a fire risk, both to those who use it and to those
who live nearby. Patients who smoke, or have relatives who live with them and
smoke, should not be given home oxygen unless agreed after a detailed
multidisciplinary risk assessment has taken place.