What happens during an oxygen assessment?

The lungs do a fantastic job of getting oxygen into the body and it is only when lung disease or severe illness occurs that extra oxygen may be needed. However, oxygen is a drug and so has to be prescribed correctly because there are some instances where extra oxygen can be bad for you.
When you have an oxygen assessment it is important that you are clinically stable. This means that you are feeling well, have not had any chest infections in the previous 6 weeks, and are not taking any extra antibiotics or steroids on top of your usual medication.

Long-Term Oxygen Therapy

When you arrive at the hospital for your assessment an oxygen probe will be placed on your finger or ear lobe; this detects the amount of oxygen in your blood by passing a light through the finger or earlobe. This is completely painless. If the oxygen level is low you will need to have a blood test which measures the exact levels of oxygen and other gases in your blood. This is usually taken from your earlobe or an artery in your wrist.

If the blood test also shows that your oxygen level is low, you may be given supplemental oxygen via nasal cannula or a mask and have the blood test repeated after 30 – 60minutes to see how the additional oxygen alters your blood oxygen and carbon dioxide levels. This process will continue until the oxygen and other gases in your blood have improved to suitable levels. Some patients are not suitable for oxygen if they retain or build up levels of carbon dioxide in their blood.

Ambulatory Oxygen Assessment

If you are an active person whose oxygen levels decrease when you are moving about, then you may be suitable for portable oxygen. Portable oxygen is usually supplied in small cylinders; these weigh about 2-3kg (6-7lb) and come with a shoulder carrying case. The oxygen will last for approximately 2-3 hours (depending on the amount of oxygen you require).

If your healthcare professional thinks you may be suitable for ambulatory oxygen, you will need an assessment of your oxygen levels during exercise. You will usually be asked to walk as far as possible in six minutes with an oxygen probe (oximeter) on your finger or earlobe to monitor your oxygen levels. The walk may be repeated several times with and without oxygen, to determine if oxygen will be of any benefit to you during exercise. During the test you will be able to stop as often as you need and you can walk at your own pace. A rest period is allowed between each walk test. Once the walk tests have been completed the healthcare professional will decide if you need ambulatory oxygen.

What Happens Next?

A home oxygen order form will be completed by the healthcare professional performing your assessment. This is then sent directly to the company who will supply the oxygen to you and everything you need will be delivered to your home within 3 working days of your assessment.
A representative from the oxygen supply company will contact you by telephone to arrange the best time for the engineer to visit and install the equipment. It is often helpful to have a friend or relative present when the engineer delivers the equipment.

Will I Need To Be Assessed Again?

It is necessary to review your oxygen requirements at regular intervals. You may become slightly better or get slightly worse over time so it is important to ensure you are receiving the correct amount of oxygen. Again the assessment requires you to be clinically stable.
In order to re-assess your oxygen needs the healthcare professional performing your assessment will ask you to turn off your oxygen (if you are using it) and breathe room air for around thirty minutes. After this time you will have your blood oxygen levels checked without and then with oxygen to find the right level for you.

Who will be conducting my tests?

Who are respiratory physiologists / clinical scientists?

It is highly likely that you will be tested by a healthcare scientist. These are highly trained professionals can have a variety of different job names and descriptions (see below) but most will have a university degree, 1-2 years of clinical experience and will also undergo independent professional exams:

• Clinical Physiologist
• Healthcare Scientist
• Clinical Scientist

Healthcare scientists are not required to be on a compulsory register in order to practice (unless they are a Clinical Scientist in which case they have to be registered with the Health and Care Professions Council) but most volunteer to be registered with either:

• The Registration Council for Clinical Physiologists
• The Academy for Healthcare Science 

This is because healthcare scientists passionately believe that they should be upheld to high professional standards, conduct, ethics and offer protection to the patients they interact with daily. Each of these bodies have a searchable register where you can check the registration status of any professional you have encountered and contain details of the standards they are expected to uphold.

Simple lung function tests like spirometry can be performed in Primary Care, for example at your G.P.s surgery; in special local clinics or in Secondary Care Centres (Hospitals). There are many G.P.'s surgeries now offering a spirometry testing service to patient's and your tests will normally be carried out by the Practice Nurse, who will have been trained to do this.
In some areas there are now local centres specialising in COPD (chronic obstructive pulmonary disease) where they will perform spirometry and they may also do oxygen assessments and rehabilitation classes. In these centres your tests will usually be performed by specially trained nurses or physiotherapists.