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presented by Bryan Beatty, RRT, CPFT
Financial: Bryan Beatty receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.
Non-Financial: Bryan Beatty has no competing non-financial interests or relationships with regard to the content presented in this course.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
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Bryan Beatty, RRT, CPFT
Bryan Beatty, RRT, CPFT is the clinical program manager at the University of Louisville, Pulmonary Division. He is a clinical researcher and a respiratory therapist, managing a full-service pulmonary function lab and occupational health program. He has been involved in research and education for 35 years. He has been a long-standing American Lung Association volunteer,…
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1. Long-Term Oxygen Therapy and CMS Criteria
Long-term oxygen therapy (LTOT) has been a critical part of home care for patients with chronic lung disease since the 1970s. The current oxygen guidelines from the Center for Medicare and Medicaid Services (CMS) are based on the arterial oxygen levels in the blood. To receive LTOT at home, a patient must have an arterial partial pressure of oxygen (Pa02) at or below 55 mmHg or arterial oxygen saturation (Sp02) < 88%. Once a patient qualifies, then comes the decision on equipment and what fits the needs of the patient. This decision is crucial due to the 60-month CMS contract for LTOT coverage.
2. Delivery Devices: Advantages and Disadvantages
Home oxygen therapy may be delivered by the following methods: compressed gas, liquid oxygen, and oxygen concentrators. Each of these methods has advantages and disadvantages. The newest modality, portable oxygen concentrators (POC), offers smaller, less intrusive options for LTOT but have limitations that are often overlooked. Additionally, this chapter will cover the effect of CMS policy on the availability of liquid oxygen (LOX).
3. Oxygen Therapy: Meeting the Patient’s Oxygen Needs
The goal of oxygen therapy is to maintain Sp02 levels at an optimal level. To achieve this you must measure Sp02 at rest and with activity. During this chapter, I will present a brief case study detailing the obstacles that may be encountered as the patient’s needs change and the options available to address those obstacles.
4. Safe Administration of Oxygen Therapy in Home Care and Hospice
Oxygen is a combustible, nonflammable element. The idea that you will cause an explosion with oxygen is a myth that is perpetuated in movies and television. However, oxygen will fuel a fire and can cause horrific burns when not used correctly. The most common safety issue associated with oxygen therapy is a patient who continues to smoke. There are other safety issues associated with home oxygen therapy that will be addressed in this chapter.
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