Ambulatory Oxygen Assessment

Ambulatory Oxygen Assessment

Patient Information

Community Respiratory Team

• Author ID:             AD
• Leaflet Number:     CM 321
• Version:                1 
• Name of Leaflet:    Ambulatory Oxygen Assessment
• Date Produced:     July 2024
• Review Date:         July 2026

What is ambulatory oxygen?

Ambulatory oxygen is a portable treatment to be used for activities such as walking, gardening, housework or exercising, and is usually delivered via a small cylinder which can be either carried in a backpack or pulled on a trolley. Ambulatory oxygen provides the body with extra oxygen during activity if the lungs cannot provide enough when you are working harder, because they are damaged. Oxygen is safe if used correctly, but as it aids combustion, and can accelerate a fire rapidly, we do not provide oxygen to those who smoke or use e-cigarettes, and this includes smoking in the home by members of your household.

The ambulatory oxygen cylinder is attached to a nasal cannula, which delivers oxygen into your nose and as you walk. The need for ambulatory oxygen is assessed in clinic or in the home in certain circumstances.

What do I need to do?

Before your appointment, you need to be well and stable, which means no chest infections within the last 6 to 8 weeks, not feeling too unwell to do a walking test, no dizziness, and no regular chest pains (unstable angina). If you are not sure, contact the respiratory team before you attend clinic on 0300 707 1170 to speak to someone or arrange a call back.

If your blood oxygen levels are always less than 92% after resting for 30 minutes, you will need to have a long-term oxygen assessment first. Please let your GP know if you are not already using oxygen treatment and think this may apply to you. Your GP will make the decision to refer you if they think it is needed and safe to use. 

On the day, make sure you bring a list of your medications, inhalers and GTN spray if you have one, any walking aids you normally use and wear comfortable clothes and walking shoes (not high heels or flip flops!!).

What will happen at the assessment?

On arrival, we will look at medical history, medications, and observations such as blood pressure, heart rate and oxygen levels, to make sure your treatment is optimised. 

We may make recommendations to your GP to make sure you are on the correct treatment if we have concerns.

We will also ask about your breathlessness and how far you can normally walk as part of the test, to see if it will be beneficial. If you are not using oxygen, you will do the walk test on room air, but if you have long-term oxygen in place, we will do this on the flow rate you are normally prescribed.

The walking test will last for six minutes and is done at your own pace. We will use a stopwatch to see how far you can walk in this time. You can stop and rest during the test if needed, and we will be recording your heart rate and oxygen levels. If at any time you do not feel you can continue, just tell us and we will stop. We will demonstrate what to do before we begin the walk, and you can have a short practice before the test. When the test is over, we will continue to monitor your recovery and ask again about your breathlessness, using a scoring tool during the test and after. 

If the test shows your oxygen levels are dropping and oxygen should be used, we will repeat the test after 15 to 20 minutes with oxygen.

What are we assessing on the test with oxygen?

On the second assessment, we will look for any improvements in your oxygen levels, but also, there needs to be improvements in walking distance and/or less breathlessness, to show that having oxygen has a benefit. This walk also gives you the opportunity to see how the equipment works, how it feels to use it, and to ask any questions after the test.

In some patients needing higher flow rates, we may need to bring you back to increase oxygen further if needed and get the right flow rate for you. 

What will happen next?

If you need ambulatory oxygen, we will make sure you and/or your family or carer are able to use the equipment and understand when to use the oxygen provided to meet your medical needs. We will complete forms with you, including a consent form and a brief safety check list to make sure there are no concerns. We will also provide oxygen safety information and provide a leaflet detailing the information you will need. The oxygen will be ordered online for delivery within 3 working days, and you can specify a morning or afternoon delivery with any instructions needed. 

The engineer will also show you how to use the equipment when delivered and will do a home safety check.

If longer term support is required, this will be arranged. 

What equipment will I receive?

Initially, you will be provided with cylinders, but we can adjust any equipment needed depending on how you use it, and this is reported to us by the oxygen supply company.

If you do not use the equipment, it will be removed; it is not provided ‘just in case,’ as it is meant to enhance your independence outside the home.

What follow-up will I receive?

As oxygen use needs to be monitored to keep you and everyone else safe, you will be seen in the home for a home safety check within 4 weeks of receiving the equipment, to check there are no risks, such as from fire or tripping. The oxygen supply company will also show you how to use the equipment, they will leave you with an information pack, and they are available via a 24-hour helpline for advice if you have any queries about your equipment.

A follow-up appointment will be booked 2 months later to repeat the walk on oxygen and to see how you are managing with the equipment. After 6 months, we will check usage and do an equipment and safety check; then, after 12 months, we will repeat the walk test, and these are repeated every year. 

When you are seen in your home, we will call in the morning of the appointment to check we can still come, and we will try to give a morning or afternoon approx. time. We apologise in advance for any times we are not able to come to see you, as sometimes we are asked to see urgent cases within 24 hours, and this can affect our caseload. We will always try to see you before your appointment if you have any concerns. Please report any new early morning headaches, drowsiness, or problems with excessive daytime sleepiness to the respiratory team as a matter of urgency. 

Contact Details

To contact a community respiratory nurse call Boston House Respiratory Team on:

0300 707 1170 from 9am until 5pm Mon-Fri and/or leave a message.

Or email wwl-tr.commrespiratory@nhs.net  

This will be monitored by admin staff who will ask someone to call you back. Although we try to contact you within 24 working hours, please be aware this may not be on the same day, and we do not currently have a weekend service

COPD unit in the hospital: Monday to Friday 9am to 5pm telephone: 01942 822231

Although we try to contact you within 24 working hours, please be aware this may not be on the same day, and we do not currently have a weekend service.

For medical emergencies, you must call either NHS 111 or if urgent, 999 if you have chest or severe pain, severe breathlessness at rest, that is not relieved by your medication, or a cough, or vomiting up any blood.