Check The Oxygen Equipment

As the dependence for oxygen grows, it becomes more and more important that the equipment is working properly.  This is not something that should be taken lightly.  I can speak from experience.

I must be clear, this is not a license to point fingers at each other as you are caring for someone with COPD.  It is a horrible feeling to know that something you may have done (or not done) could have caused someone harm.  It is equally as unnerving when it is an equipment malfunction because there is still a very real sense of how dependent they are on the oxygen.

In the early stages of the disease, the effects may not be as noticeable or last as long.  For example, if someone is on 1L or less of pulse flow, as needed, it would not be as noticeable to them as it would be for a patient using 2L continuous flow.  If a continuous flow is missing, it is noticed.

One of the first times that I know of this happening to mom was at my wedding.  She was on 2L, pulse flow at that time.  However, her oxygen ran out, and none of us thought to make sure that there were spare tanks in the car.  (This was before the liquid oxygen option was given to her, and it was before portable concentrators.)  Her oxygen ran out before the ceremony.  She knew that it ran out, but she did not want to trouble anyone to go back to the hotel to get a tank.  The chapel was not close to the hotel, and the amount of traffic would have caused anyone going back to retrieve a tank to miss the ceremony.

During the reception I could tell that she wasn’t as active as I thought she might have been, and she didn’t seem to be looking as comfortable.  We cut the cake, had our first dance, and tossed the bouquet while mom sat to the side, watching with her sweet smile.  Then mom and dad decided that it was time to go.  It was still early, but she looked like she did not feel well.

We followed them out to the car.  Mom was sitting in the car trying so hard not to show how incredibly short of breath that she was.  I could see the sweat on her face and that twinge of fear in her eyes.  This was very early in the end stage, so we had not dealt with this very much at this point.  She kept trying to reassure me that she was okay, but I knew better.  Then just before they left she told me that her oxygen had run out.  She told me so that I wouldn’t worry as much, and I would know that when they got back to the hotel, she would be better.

My incredibly awesome husband helped me pack everything up at the end of the reception, and we went to the hotel to check on her.  He knew I would not be happy until I could see her for myself and know that she was okay.  When I saw her, she was recovering.  She was pale, but I could tell that she would be okay.  Even at that stage, it was not as easy thing to watch.

It happened several more times through the years.  By the end, mom was on 2L of continuous flow, 24 hours a day.  I know of a handful of times that she encountered severe shortness of breath due to either the oxygen not being on or something malfunctioning.  Most times, she would make light of it as best as she could, but it would literally take her a couple of days to recuperate.

If you encounter times that the one you are caring for is short of breath, but there is really no extra reason for it, check the equipment. Dials and switches can get bumped.  On switches can be forgotten, and portable oxygen can freeze up or become empty.  The oxygen equipment should be the first thing that you check.  If it is not on or somehow disconnected, get it on quickly, and help your patient relax as much as possible.  You may have to bump up the flow for a very short time to help them get the oxygen level back up in their system.

It is important that you do not beat yourself up about this.  It is also important that you do not beat up your co-caregivers as well.  If they have made a mistake, I am sure that they need your grace more than hurtful words.  Find ways to help each other remember to double check the equipment.  It is also important that you do not take any actions to help you remember, personal.  Don’t let this become a fighting point.  Let this be a time that you all lean on each other.