Oxgyen

If your preemie has to come home on oxygen, it can cause a lot of worry, anxiety, questions and confusion. Here is what I have learned about questions to ask and information that can be helpful to make the process as easy as possible.

Equipment
- What size tanks do I have? Tanks all have different letters and numbers that correspond to its size. Ask your equipment provider what size or sizes you have and make a note of it. A customer service provider may not look at your records before placing an order so to make sure you are getting the correct tanks delivered – know what you’re ordering.

- How do I put the regulator on and off the tank? This is an important skill to know. Make sure that the RT who trains you on the equipment shows you how to put the regulator on and then take it off. After the RT has show you, do it yourself to make sure you can do it from start to finish. If you don’t know how to do it and you’re in a hurry than it makes the situation much more stressful and difficult.

- How do I open/close the tank once the regulator is on? This is also essential to know – you tank won’t put out oxygen unless it’s open. You also need to close the tank before taking the regular off. There is a specific tool that you need to open and close the tank – make sure you always have it with you. We attached ours to the oxygen tank travel bag so we never have to look for it or worry about where it is.

- How long does each tank last? Surprisingly enough I found this to be a tricky question. Many employees and/or companies aren’t used to dealing with babies on oxygen so they haven’t calculated out flow/timing for small amounts. My daughter is on ½ liter and most employees were used to patients who are on 1-2 liters. Obviously you need to know how long your tank will last so make sure you get the correct information. Sometimes it might just take some simple math – if a tank lasts 4 hours on 1 liter and if your baby is on ½ liter the tank will last for 8 hours (and so on). If the company can’t tell you for sure, put your baby on a travel tank at home and time out how long it takes for it to empty so you know for sure.

Equipment Provider
- Who do I call if there are problems on a weekend or after hours? This is important to know. Make sure that the company has an after hour number and the capability to respond if you suddenly have an issue with your equipment.

- When will my tanks be delivered? If possible, try and get an established date for when your new tanks will be delivered. It may take a couple of weeks while you (and the company) figure out how quickly you go through the tanks but when possible, ask for a scheduled delivery date. You may still have to call ahead to confirm the number of tanks needed. When you are ordering smaller tanks (for traveling), make sure you check your upcoming schedule so you know if you will need extra tanks for doctor visits, trips to the store, outings, etc.

Nasal Cannula
Getting the nasal cannula working and staying in my daughter’s nose was one of the most challenging things for me because my daughter is a regular Houdini when it comes to pulling that thing out of her nose.

- How often can I get new nasal cannulas? The equipment provider should provide you with new cannulas so find out how often you can get replacements. Some of the timing depends on your insurance. If your insurance or the equipment provider doesn’t cover nasal cannulas (or doesn’t provide enough), you can purchase them online.

- How do I replace the nasal cannula? – While your baby is still in the NICU, ask an RT to show you show to replace the nasal cannula. Find out if the prongs should go up or down, if you need to trim the prongs, etc. If possible, have them help you change your baby’s cannula so you know how to do it.

- Keeping the cannula on your baby’s face is a challenging part about having your baby on oxygen. There are different techniques to keeping the cannula on. Some of it depends on your child. Does he/she try and take the cannula out? Is his/her head big enough that the cannula doesn’t slip off easily once you tighten it?
- Duoderm and tape – this is a popular way to keep the cannula on. It’s pretty sturdy however it is hard to adjust the tube once you have taped it on. Some people cut the duoderm and tape into hearts which is quite cute and works just as well as standard rectangles.
- TenderGrips – these are often used in the hospital. They are easy to put on and you can adjust the tubing if need be. You do have to replace them every couple of days so make sure you have a good supply on hand.

Tubing
The oxygen tube can be one of the most frustrating parts of having your baby on oxygen. It can be tripped on, stepped on, pinched, etc.

- Long vs. short cord – depending on the liter flow that your baby is on, you may get to choose between a long or short cord. Find out what your options are as well as what length cord you need. We originally had a 50 ft. cord for our daughter however we quickly realized that we could make do with a 25 ft. cord. It took up less space and made it easier to move around because we weren’t dragging a huge amount of cord behind us.

- If you have other children, make sure they understand that they can’t step on or block the cord. It can take some getting used to but with continued reminders, your other kids will soon move past the cord without even thinking about it

- Visitors – the cord can easily trip people up so make sure you remind visitors to watch their step. Try and move it out of the walking path if possible.

Traveling
Taking your baby places while he/she is on oxygen can make things a bit challenging but with a bit of planning, it can be pretty easy.

- Before you go somewhere, determine how long you will be out and how many tanks you will need.

- If you are going somewhere where you can take a stroller, take one! It makes it much easier to get around. Use a stroller with a big basket so that your tank and any other necessities can fit underneath.

- If you’re child is older and walking, make sure they know to stay close enough to you that the cord doesn’t get stretched or pulled out off of the tank.
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If you are going on a longer trip (overnight or more), make sure you bring an extra nasal cannula and adhesive for attaching it to your baby’s face. You don’t want to be stuck in case you need to make a change.