Oxygen – Adolescents

Many types of chILD make it harder for the lungs to move oxygen to the body.  

When a person breathes, air passes through the airways into tiny air sacs called alveoli. These alveoli are where the oxygen we breathe passes into the blood. This is also where carbon dioxide (a waste gas from our cells) leaves the blood so we can breathe it out. Doctors can measure the amount of oxygen in the blood (oxygen saturation) using a pulse oximeter. If oxygen saturations are low, your child may be given oxygen to use at home.  

How do I give my child oxygen? 

There are different ways to use oxygen. 

• Nasal cannulas are the most common way oxygen is given. This is tubing that sits at the nose and delivers a constant flow of oxygen. It is made out of soft, light plastic tubing. 
• Face masks are sometimes used to deliver oxygen to the nose and mouth. These masks can be hard to find depending on the equipment company and insurance coverage. 
• Positive pressure can be given with oxygen flowing through the machine and into the mask or tracheostomy tube.  

How much oxygen will my child need? 

Oxygen is a medicine. Just like other medicines, it needs a prescription. Your medical team will decide how much oxygen your child should have. The amount of oxygen will depend on your child’s lungs and their oxygen saturations. Your child will have a goal oxygen saturation. This is usually over 90-92%. Children who also have pulmonary hypertension may have a higher saturation goal. Some children only need oxygen with sleep or during physical activity. Some children need oxygen all of the time.  

Oxygen is measured in liters-per-minute (L/min) or percent (%) flow. This amount may go up or down depending on how the lungs change over time.  

What equipment will I need in my home? 

Having oxygen at home will mean having special equipment for your child. Your medical team will send orders to a Durable Medical Equipment (DME) company. The DME owns the oxygen equipment and will usually take care of delivery and teach you how it’s used.  

There a several important pieces of equipment: 

• Oxygen concentrators are machines that pull in air from the room and separate out the oxygen from the other gasses. This oxygen is then delivered to your child. These are usually called stationary concentrators because they plug into a wall outlet and need electricity to work. They are large machines (about the size of a kitchen trash can), though they can be moved.  

• There are smaller, portable concentrators available. These can be used in older teens and young adults. Sometimes they are difficult to get covered by insurance. 

• Oxygen tanks hold oxygen in gas form under high pressure. This oxygen is delivered to your child. These tanks come in different sizes. Some are small and can be used for travel. Others are large and stay in one place. 

• Nasal cannulas or face masks are two of the ways to deliver oxygen.  

• These should be the right size for your child. The prongs of the nasal cannula should fit comfortably into the nostrils. The mask should cover the nose and the mouth and have very few gaps around the sides of the face. Your DME can give you samples of other sizes to find the right fit. 
• Nasal cannulas wrap around the head behind the ears to stay in place. There are small stickers or types of tape that will help keep them in place. The names of these include Tendergrips or Tegaderm. 
• A tracheostomy mask or cool mist trach collar can be used to deliver oxygen directly to the tracheostomy tube. 

• Pulse oximeters (“sat” monitors) are machines that measure the amount of oxygen carried in the blood. These can be worn all of the time or be used to check the oxygen levels occasionally. Your care team will decide if your child should have a pulse oximeter.  

• You will get probes that wrap around a finger or toe. Sometimes your doctor may need to work with insurance to have more probes delivered each month. 
• These monitors will alarm if the oxygen levels in the blood are too low. They will also alarm for a drop in heart rate. If the machine is not getting a good signal (due to movement or a probe problem) it can also alarm. 

• Humidifiers add moisture to the oxygen flow. Without this, oxygen can be drying to your child’s nose, mouth, and throat. Use distilled or sterile water to fill the water bottles or tank. Empty and refill them with fresh water at least once a day. 

Will my child be able to leave the house with oxygen? 

Yes! Having oxygen at home does not mean your child cannot leave the house. There are small, portable tanks that can be used to deliver oxygen outside of the home. Your medical team and DME company can work together with the school to make sure your child has the right equipment to support them at school. 

Is it dangerous to have oxygen at home? 

If there is a fire at home, oxygen will cause the fire to burn more easily and spread quickly! There should be no smoking, open flames, electric equipment, or sparks within 10 feet of the oxygen device. Always keep a fire extinguisher handy. Make sure every person in the home knows how to use it. 

If the oxygen tanks are bent or cracked, they can become like a missile. Tanks should be stored in their holders or lying flat. When driving with oxygen, secure the tanks on the floorboard. Don’t let them roll around or store them in the trunk. 

What if my child has low oxygen levels or I need help with equipment? 

Every child’s case is different. Your medical team and DME company will work on a plan for what to do if oxygen levels go low.  

• If you are having trouble with equipment but your child is breathing normally and has normal oxygen levels, you can call your DME company or medical team for help. 
• If you are ever worried about your child’s oxygen levels you can call 911. An ambulance is the fastest way to get help. It is unsafe to drive your child in the car when they have low oxygen levels. 

Having a child with oxygen can feel scary and complicated at first. You are not alone! There are other families who have been where you are. Other families can be really helpful and may have tips or tricks to make things easier. Connect with other families here. 

Author(s): Katelyn Krivchenia  Reviewer(s): Katelyn Krivchenia  Version: 1.0