summer 2018 breathing matters - boc home oxygen service matters... · you need to have a rescue...

→ Summer 2018

08 Action for Pulmonary Fibrosis

12 Being safe with oxygen 16 Your condition and warm weather

Breathing Matters

BOC: Living healthcare

02 Breathing Matters // Summer 2018 03Breathing Matters // Summer 2018

Welcome

In this edition we provide you with some information on living well with COPD and managing your condition in hot weather.

We strive to improve our service to you and would welcome your feedback.

The “Your say” section at the back of this magazine gives you the chance to tell us what you like, what you don’t like and what you would like to see more of in future editions.

From everyone at BOC Healthcare we hope you all have a lovely summer.

BOC Healthcare

Andre’s safety message:

“With summer here it is still important to consider fire safety. Have you checked your smoke alarm? When did you last change the battery? Most Fire Services will provide bespoke advice on home safety and smoke alarms for FREE.

Also, with the football World Cup happening this summer, ensure you are safe when having BBQs and keep all oxygen equipment at least 3m away. Consider the impact of excessive alcohol consumption too, especially when cooking, and how it reacts with your medication.”

Andre TurnerEssex County Fire and Rescue Service

Summer bank holiday (England)Thurs 23 Aug 2018 Normal working day – last day to place order

before the bank holiday – order 8.30am - 5.30pm for delivery Friday 24 August

Fri 24 Aug 2018 Normal working day – order 8.30am - 5.30pm for delivery Tuesday 28 August

Sat 25 – Sun 26 Aug 2018 Emergency serviceMon 27 Aug 2018 (Summer bank holiday) Emergency service

Tues 28 Aug 2018 Normal service – next day delivery resumes

Summer bank holiday (Northern Ireland)Tuesday 10 July Normal working day. Order 8.30am – 5.30pm for delivery Wednesday 11 July

Wednesday 11 July Normal working day - order 8.30am – 5.30pm for delivery next working day Monday 16 July

Thursday 12 July Bank holiday. Emergency service only

Friday 13 July Bank holiday Bank holiday. Emergency service only

Important dates 2018Dear Reader,

BOC Healthcare would like to welcome you to our summer edition of Breathing Matters. We hope you enjoy it and find the content informative.

Important: Please remember to order in plenty of time for Bank holidays and any holidays you are planning.

Living well with COPDHere Debbie Phillips, a Respiratory Advisor in the North East shares tips on how how her patients’ manage living better with a respiratory condition.

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Tips for healthy living with COPD

Living with a lung condition can be difficult, but you can take practical steps to help you better manage respiratory symptoms.

Both non-medical and medical therapies can improve the lives of patients with a lung condition. Patients have told me over the years that by taking effective action and looking after themselves well their condition is easier to manage. It also means it does not stop them from taking part in activities that they enjoy.

1. Look after yourself. That is really important! Take your medication as prescribed including inhalers. This can prevent a flare up. Have a management plan in place that has been agreed with your GP/practice nurse. This will sign post you to identify changes in your condition which may indicate an exacerbation: wheezing, increased shortness of breath even at rest, tight chest, cough and increase in phlegm production, change of colour in phlegm, fever. It may be that you need to have a rescue script of steroids and antibiotics from

your GP to keep at home to take if you notice these changes. Your management plan should also signpost you to what action you should take with a traffic light system.

Green feel like usual self, take your meds, sleeping as usual, usual amount of phlegm.

Amber increased phlegm production, cough, loss of appetite, not sleeping well, less energy. Follow plan for starting rescue meds.

Red fever, chest pain, very short of breath, difficulty sleeping, high fever, confusion. Dial 999 and get help.

2. Stop smoking. If you do smoke, stopping can slow down or prevent further damage to your lungs. You can get smoking cessation support from you GP

or practice nurse or the local smoking cessation support group in your area.

3. Take exercise. Participate in Pulmonary Rehabilitation (see page 19), you can get a referral from your nurse or GP. Pulmonary rehabilitation is a programme of supported exercise and education, led by a specialist respiratory physiotherapist or nurse. It is designed to build your strength and help you manage your breathlessness better. It is also a chance to meet people living with the same condition.

4. Maintain a healthy weight. Carrying extra weight can make breathlessness worse. It’s a good idea to lose weight through exercise and healthy eating. Alternatively, some people with COPD find that they lose weight. Eating food high in protein and taking in enough calories is important to maintain a healthy weight.

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5. Protect against infection. COPD means you can be more vulnerable to infections so it is important to have your flu jab every year and a one-off pneumonia vaccination.

6. Check the weather. Hot and cold weather can cause problems with breathing. Check the Met Office for weather alerts.

7. Watch what you’re breathing. Avoid triggers that can cause problems with breathing: dust, fumes, perfumes, smoke etc.

8. Health and wellbeing reviews. Have your regular reviews with your clinician. See your GP if symptoms get worse.

9. Learn breathing techniques. Pursed lip breathing, relaxed slow deep breathing. If your chest produces a lot of phlegm learn how to clear your chest through Active Cycle Breathing technique. You can learn this at Pulmonary Rehabilitation or from the British Lung Foundation website.

10. Talk to others. Difficulty breathing can often make you feel tired and depressed. Talk to your GP or your practice nurse if you have any questions. Living with a lung condition can make you feel isolated and lonely. Contact support groups who can offer information and support for people in the same boat as yourself.

11. Holiday planning. If you are planning a holiday speak to your GP or practice nurse. You may need a fitness-to -fly assessment. If you are on oxygen therapy you will have to make sure you have enough oxygen to fly with and whilst you are away. Tell your travel operator and airline before you book a holiday and you will also need a medical form from your GP. Always ensure you have all of your medication with you and enough to last your holiday. If you holiday in this country and have oxygen therapy this can be supplied by the oxygen supply company in that area.

For further information visit www.blf.org.uk and www.nhs.uk


08 09Breathing Matters // Summer 2018 Breathing Matters // Summer 2018

Action for Pulmonary FibrosisPulmonary Fibrosis is a progressive lung disease, which causes scarring of the lungs and increasing breathlessness. Idiopathic Pulmonary Fibrosis (IPF) is the most common form of the disease. Some 32,500 people across the UK live with the disease. It is incurable, with patients diagnosed experiencing a shorter life expectancy.

The national charity Action for Pulmonary Fibrosis was set up in 2013 by a group of patients, carers and clinicians to support patients and their families. APF has grown rapidly and provides support (support groups and a telephone support line), education for health professionals and funds research into IPF and other forms of the disease. We also campaign

for better NHS care for pulmonary fibrosis patients.

There are now almost 60 support groups in the UK and we hope to increase this number to over 100 by 2020. Our aim is that no Pulmonary Fibrosis patient in the UK should live more than an hour from a support group. Patients and families find support groups invaluable in meeting others, providing mutual support and getting information about the disease. Most support groups meet every two months. Meetings generally include a speaker on a medical or other topic, a discussion and social time. BOC regularly talks to support groups about oxygen therapy. Newcomers are warmly welcomed.

In East Anglia there are support groups at Papworth, Norwich, Chelmsford, Stevenage and Bedford. New groups are planned at Ipswich and Peterborough. In the North-East there are groups at Newcastle and Middlesbrough, with two new groups planned elsewhere in the region.

If you are interested in finding out more, please visit the website www.actionpulmonaryfibrosis.org or telephone 01543 442152.

Steve Jones is the Chair of Trustees of Action for Pulmonary Fibrosis

Chelmsford MP Vicky Ford (second left) at the launch of the mid-Essex Pulmonary Fibrosis Support Group in 2017.

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Being safe with oxygen

Patient Information Leaflet

Most of the following rules apply to all three modalities:

• Don’t smoke whilst using oxygen • Don’t vape whilst using oxygen• Keep your supply at least three

metres away from any ignition source

• Ensure your hands are clean and free from oils, greases etc

• Always refer to the instructions for use if in doubt

As with all pharmaceutical products, there are always things that you as the user must do, to ensure you are using the product in the correct and safest way. The rules for oxygen are straightforward and if followed, allow you to use your oxygen supply safely.

Oxygen is supplied to you in cylinders, in liquid form or through a concentrator.

Then for the oxygen cylinders always

• Remove the grey tamper evident seal on the side of the cylinder and recycle

• Remove the shrink wrap seal from the small cylinders (ZA)

• Turn your cylinder on slowly, using the on off wheel

• Ensure your tubing is connected to the cylinder

• Select the flow you require • Never place your cylinders on

your bed• Store the cylinders as directed

in the handbook

Following the above simple Instructions will ensure that you receive your oxygen in a safe way.

Please find enclosed with this newsletter an updated Patient Information Leaflet or PIL which is to be used with your oxygen supply. It contains details on what oxygen is used for, side effects, safety and how to operate the cylinder.

The Patient Information Leaflets contain the same level of information you would find on the Patient Information Leaflet contained in all other medicines, including those you may purchase over the counter from the pharmacy, and should be used in the same way.

Please take the time to read it and if you have any questions please consult your Healthcare Professional (HCP)

5. HOW TO STORE COMPRESSED MEDICAL

OXYGEN CYLINDERSExpiry dateDo not use Medical Oxygen after the expiry date

which is stated on the cylinder batch label.

Medical Oxygen should be used in strict rotation so

that cylinders with the earliest filling date are used

first.

Cylinder storageStore your Medical Oxygen cylinders:

• so that they can not fall over and cause injury

• in clean, well ventilated and dry conditions, not

exposed to extremes of heat or cold

• away from oil, grease and flammable material

• in a designated area, where they can be kept

separate from other medical and non-medical

cylinders, with empty and full cylinders kept

apart• out of sight and reach of children Handling cylindersAlways handle your Medical Oxygen cylinders

with care, only moving them using an appropriate

trolley, handling device or carrying bag.6. FURTHER INFORMATIONWhat Medical Oxygen Contains

Your Medical Oxygen cylinder contains a minimum

of 99.5% Oxygen.There are no other ingredients.

BOC: Living Healthcare

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Compressed Medical Oxygen Medicinal gas, compressed Package Leaflet: Information for the User

Medical Oxygen cylindersMedical Oxygen is supplied in the following size

cylinders to hospitals and clinics:

Medical Oxygen is supplied in the following size

cylinders for homecare use:

Cylinder Size Cylinder Contents(Litres)Cylinder Size Cylinder Contents(Litres)

AZ*170

IQX2000

ZA300

HX*2300

D*340

ZX3040

CD460

G*3400

ZD605

J*6800

E*690

W11300

F*1360

Cylinder Size Cylinder Contents(Litres)Cylinder Size Cylinder Contents(Litres)

ZA300

AF*680

CD460

DF*1360

DD460

ZH2400

The colour coding of the shoulder of Oxygen

cylinders is white. The body is colour coded white

apart from the cylinders marked (*) in the table

above which for a limited period may have a black

body.

Oxygen

Shoulder of cylindersviewed from above

Body of cylinder typesviewed from the side

• check the contents gauge on the cylinder or the

regulator before you start to make sure there is

enough gas available for your use• check that the tubing is correctly fitted to the

outlet• select the flow prescribed by your healthcare

professional , as advised by your homecare provider• ensure that all your cylinder and any additional

delivery equipment is kept free from oil and

grease• open the cylinder valve slowly• turn the cylinder valve ‘OFF’ with moderate

force only when the cylinder is not in use

• if a leak occurs, this will be evident by a hissing

noise. Close the cylinder valve and check the

connection of the tubing to the outlet. If the

leak continues close the valve and contact your

homecare provider.• close the valve when the cylinder is empty using moderate force only• always use your Medical Oxygen exactly as your

homecare provider has shown you. You should

check with your homecare provider if you are

not sure.

DO NOT SMOKE or let anyone else smoke near

your Medical Oxygen gas cylinderDO NOT USE your oxygen cylinder near open fires

or naked flames as oxygen will make a flame

burn much more violently.NEVER use oil based moisturising creams with

your cylinder equipment. If using alcohol gels

allow plenty of time for the alcohol gel to dry

before handling oxygen equipment.

If you use more Medical Oxygen than you should

In most cases it is unlikely that an overdose could

occur if you follow your healthcare professional’s

advice.

If you are concerned that you have used too much

Medical Oxygen and feel unwell or if you have any

questions on the correct use of Medical Oxygen,

please ask your healthcare professional.4. POSSIBLE SIDE EFFECTSLike all medicines, Medical Oxygen may cause side

effects, although not everybody will get them.The side effects that may occur whilst using

Medical Oxygen are:• soreness of the chest associated with coughing

and breathing difficulties after breathing pure

oxygen for a prolonged period (6-12 hours).

This is made worse by smoking and exposure to

cold air• dizziness, fits and loss of consciousness after

2-3 hours of exposure, which can occur if you

are treated with high pressure (hyperbaric) oxygen in pressurised chambers

• eye damage (retrolental fibroplasia) which can result in blindness, which may occur with

new born babies if they are exposed to oxygen

concentrations of more than 40%.Reporting of side effects If you experience any of these side effects, or if

you notice any side effects not listed in this leaflet,

contact your healthcare professional immediately.

You can also report side effects directly to the

Medicines and Healthcare Products Regulatory

Agency (MHRA) via the Yellow Card Scheme www.

mhra.gov.uk/yellowcard and to BOC Healthcare. By

reporting side effects you can help provide more

information on the safety of this medicine.


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Compressed Medical Oxygen Oxygen 99.5% Medicinal gas, compressed

Read all of this leaflet carefully before you start using this medicine.• Keep this leaflet as you may need to read it again.• If you have further questions, ask your healthcare professional (doctor, nurse or pharmacist) or homecare provider.• This medicine has been prescribed for you. • Do not pass it on to others as it may harm them, even if their symptoms are the same as yours. • If any of the side effects become serious, or if you notice any side effects not listed in this leaflet, please tell your healthcare professional or homecare provider immediately.

This leaflet gives you information about:1. What is Compressed Medical Oxygen and what is it used for2. Things to consider before use3. How to use Compressed Medical Oxygen4. Possible side effects5. How to store Compressed Medical Oxygen cylinders

6. Further Information

1. WHAT IS COMPRESSED MEDICAL OXYGEN AND WHAT IS IT USED FOR?Compressed Medical Oxygen is a medicinal gas, supplied in cylinders filled to a high pressure. Medical Oxygen is used:• during anaesthesia and for recovery following surgery

• to treat or prevent oxygen deficiency in the body in many different situations such as:• surgery or major trauma such as a road traffic accident• heart attacks• severe blood loss• carbon monoxide poisoning• severe lung and heart conditions• very high fevers• for resuscitation of adults, children and babies.• for treatment of cluster headaches

2. THINGS TO CONSIDER BEFORE USEMedical Oxygen is only prescribed to you by a healthcare professional.

Ensure that your healthcare professional is aware of any medical conditions that you may have.


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Introducing live chat

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Instant messaging with BOC Patient Service Advisors is now a reality thanks to BOC LiveChat. It provides online communication as an alternative to telephone contact for those who prefer to use their smartphone or PC to contact us. It is available to both patients and home oxygen clinicians and has seen successful trials and positive feedback.

Why not try it today?Our Patient Service Advisers are ready to assist between 8am and 6pm Monday to Friday for general enquiries and for cylinder replenishments.

To access LiveChat please visit our website at www.bochomeoxygen.co.uk and follow these three easy steps.

Step 1 Simply select the tab on the right side of the screen

Step 2 Enter your name and email address and select chat

Step 3 When the chat is over please take a few moments to score 1 to 5 stars and leave a comment on the service provided.

A text message will be sent to you on the evening before or on the morning of the delivery with an estimated arrival time.

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Your condition and warm weather

Breathing Matters // Summer 2018 15Breathing Matters // Summer 2018

Here are some top tips to help you remain active, and reduce symptom flare up over the coming months:

Avoid the heat. Keep in touch with the weather forecast. If it’s going to be a heatwave, avoid going out when temperatures tend to peak, this is between 11am and 3pm. Plan your day around the morning or early evening when the air is cooler.

Avoid the direct sun. Wear a high sun factor cream. Wear loose, cool clothing and a hat. Check the information leaflet of your medications or discuss with your pharmacist, as some medications can make you more sensitive to sunlight.

Take your essentials with you. For example any medications you may need, water bottle and handheld fan.

Summer is hotting up and we are waiting (hopefully) for a steady flow of warm air to cheer us through the summer months. If you’re living with a lung condition, you may find that high temperatures cause your symptoms to flare up.

This may be due to air pollution, which can change depending on the weather and the season. During still, sunny weather it’s harder for the pollution to disperse, resulting in areas of high pollution episodes. This may impact on towns and cities but also the countryside, as the wind blows the pollution across the country. You can check the pollution levels and pollen counts daily from the radio and online.

Keep active safely. Exercise brings multiple benefits when you have a lung condition, but there are additional precautions to take when exercising in hot weather. Carry out your exercises indoor in a cool, well ventilated room, taking care not to overheat. Activities like gardening and cleaning should be done during morning or early evening, when the temperature is lower.

Remember your breathing. Use control techniques, and positions of ease for when you do get breathless.

Keep hydrated. Make sure you drink plenty of fluids. Drinking cold water even when you are not thirsty will keep you hydrated. Avoid alcohol, as it can have a diuretic effect which might make you pass more urine, which could lead to dehydration.

Eat as normal. Your body will still need calories for energy, and replacement of any salts through you sweating. Eat smaller portions more frequently if your appetite is less, but its important to keep your

energy levels up. Cold food like salads and fruit are good, as they contain water which will also help keep you hydrated.

Keep your house cool. Close your blinds or curtains during the day, to help bring the temperature down. Open windows if it is safe to do so.

Use a fan. Have a handheld fan with you at all times to help ease the sensation of breathlessness and cool you down. Larger fans can help cool down rooms, and may help you sleep at night. Make sure the environment is clean, so the fan doesn’t blow dust around.

Cool washes. If you feel overheated, use a tepid sponge to cool you down, or take a cool shower or bath if able to. If you feel unwell, follow your self management plan, or contact a healthcare professional for further advice.


Back-up cylinders are supplied with a concentrator to ensure you receive a constant supply of oxygen in case of an emergency, such as a power cut. You will receive the appropriate cylinder(s) to provide you with eight hours of oxygen at your indicated prescription flowrate.

Your Patient Service Representative (PSR) will supply you with all the necessary accessories (tubing and appropriate connectors for cannula or mask) and patient literature, as well as provide full training to you or your carer on how to use the back-up cylinder in the case of an emergency. Pulmonary Rehabilitation is a

specialist NHS programme to support people diagnosed with a lung condition. It will help you cope with breathlessness, improve your fitness levels, and give you a better understanding of your condition: Living with breathlessness doesn’t mean life has to be an uphill struggle.

Pulmonary Rehabilitation can reduce the impact of breathlessness on your daily life.

Ask your GP or respiratory care team about Pulmonary Rehabilitation classes in your local area.

Or contact us directly on 0800 012 1858 or via www.bocclinicalservices.co.uk for more information.

Inappropriate use of the back-up cylinders:• For hospital appointments• Use for travelling• Use for holidays• Instead of using ambulatory

cylinders• Instead of using the concentrator

unless in an emergency.

Where to store your backup cylinderOur PSRs will advise on the best place to store the back-up cylinder on installation dependent on the house. The back-up cylinder needs to be easily accessible and stored in a well ventilated, clean dry place.

If an emergency situation arises please call our Patient Service Centre on 0800 136 603, who can remind you how to use the back-up cylinder.www.bochomeoxygen.co.uk

Please do not use this cylinder for any other use, inappropriate use means the cylinder will not be available in a true emergency.

Back-up cylinders – purpose and storage

Does breathlessness make everyday feel like an uphill struggle?



Support groupswww.actionpulmonaryfibrosis.org Action for pulmonary fibrosis.

www.blf.org.uk British Lung Foundation.

www.bliss.org.uk Support for premature and sick babies and their families.

www.chfed.org.uk The Childrens Heart Federation.

www.cafamily.org.uk Contact a family charity for families with disabled children.

www.newlifecharity.co.uk Newlife Foundation for disabled children.

www.wellchild.org.uk WellChild the national charity for sick children.

www.parentsforinclusion.org Parents of Inclusion.

www.cftrust.org.uk Cystic Fibrosis Trust.

www.hearts4teens.org.uk Hearts4teens Support for teenagers with heart defects.

http://www.phauk.org Support for those with pulmonary hypertension

www.skill.org.ukNational bureau for students with disabilities.

www.ouchuk.org Ouch UK Organisation for the Understanding of Cluster Headache.

www.asthma.org.uk Asthma UK.

www.walkingforhealth.org.uk Working for health supporting you to get active and stay active.

www.nhs.uk/smokefree Smoke Free NHS Advice and support in giving up smoking.


1. How would you rate the patient bulletin “Breathing Matters”? (Please circle)

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What (if any) improvements would you like to see on this bulletin?

2. Our Patient Service Representatives (PSRs) How would you rate their service?

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3. Our Patient Service Centre (PSC) a. How would you rate the

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b. How would you rate the questions asked to identify and verify your details?

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What (if any) improvements could be made to the service provided by our PSC?

Your sayAs you know your feedback is really important to us and we would appreciate hearing from you regarding the service you receive from BOC.

Please complete and return the short survey using the pre-paid envelope.

continued overleaf...

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4. Have you visited our website www.bochomeoxygen.co.uk? Yes / No

If ‘Yes’ how would you rate its usefulness to you as a patient?

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What (if any) improvements would you like to see on this website?

5. Have you raised an issue with

BOC, if so was it resolved to your satisfaction?

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For more information on your Home Oxygen Service, please visit our website www.bochomeoxygen.co.uk

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BOC Healthcare is the trading name of BOC Limited, registered office: The Priestley Centre, 10 Priestley Road, Surrey Research Park, Guildford, GU2 7XY, England. Number 337663 – English Register. Authorised and regulated by the Financial Conduct Authority, register number 715528. BOC is a trading name used by companies within The Linde Group. The BOC logo and the BOC word are trademarks of Linde AG. Copyright © 2017. Linde AG.

Breathing Matters // Summer 2018

summer 2018 breathing matters - boc home oxygen service matters... · you need to have a rescue...

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