Referring for home oxygen

If considering referral for oxygen treatment, check:

• SpO₂ on air at rest for minimum 10 minutes
• SpO₂ when mobilising
• Ensure reading not hindered by nail polish/gel
• Check peripheries well perfused (use ear-lobe probe if required)
• FBC – rule out anaemia

• Optimise inhaled/cardiac therapy
• Do not refer during acute exacerbation
• Address reversible causes of dyspnoea
• Provide smoking cessation advice
• Ensure patient understands purpose and implications of home oxygen

Refer via SCI Gateway → Respiratory → General

Clinical Criteria

• Patients must be optimised on maintenance therapy.
• Patients with a resting stable Oxygen saturation (SpO2) of < 92% should be referred for an Arterial blood gas assessment to assess eligibility for Long Term Oxygen Therapy (LTOT 15-24 hrs/day).
• In patients with clinical evidence of peripheral polycythaemia (haematocrit > 55%) or Pulmonary Hypertension, referral for LTOT assessment may be considered at SpO2 levels < 94% to identify patients with resting PaO2 < 8.0kPa.
• Ambulatory Oxygen Therapy (AOT) assessment should be considered for patients with >4% drop below SpO2 90% that are mobile.

Required Information in Referral (SCI Gateway)

• Primary diagnosis
• Relevant secondary diagnoses
• SpO₂ on air at rest (10 mins)
• SpO₂ on mobilising
• Date of last exacerbation (treatment completed)
• Smoking status: Never / Current / Ex (include years stopped) / Vapes
• Risk assessment: Lives alone, memory issues, open fires, trips/falls, mobility issues, other risks
• Existing home oxygen: Yes/No – include details if applicable
• Patient consent confirmed for referral and consideration of home oxygen
• Any additional relevant clinical or social information

• Children < 18 years
• Patients during acute exacerbation
• Requests for oxygen solely for air travel (see 2011 BTS Guidelines)
• Unexplained dyspnoea without alternative causes ruled out