Patient leaflet - Liquid Medical Oxygen

1. WHAT IS LIQUID MEDICAL OXYGEN AND WHAT IS IT USED FOR

Liquid Medical Oxygen is supplied and stored as a liquid at very low temperatures, in vessels and storage tanks. It is converted to Medical Oxygen, a gas at normal temperatures, for you to breathe when required. In hospitals, the converted Medical Oxygen is supplied via a medical gas pipeline system.

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

2. THINGS TO CONSIDER BEFORE USE

Medical 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.

Take special care when using Medical Oxygen if:

your baby requires extra oxygen and is premature.
Only give the amount of Medical Oxygen advised by your healthcare professional
you are suffering from chronic lung disease, such
as bronchitis or emphysema. The amount of Medical Oxygen used must be carefully controlled to the flow rate you have been advised to use by your healthcare professional
you have accidentally taken Paraquat (a type of weed
killer), advise your healthcare professional before using Medical Oxygen, as there is a possibility of toxic effects to the lungs
you have raised carbon dioxide levels in your blood. In
extreme cases this may lead to loss of consciousness.

As Liquid Medical Oxygen is stored as a very cold liquid under pressure, rapid opening of the outlet valve will either cause very cold gas or liquid to be discharged. If this gas or liquid comes in contact with the skin it will cause cold burns. Parts of the vessel can also become very cold, when in use. This will be evident by ice forming on the cold sections and care should be taken not to touch these areas.

If you have received a cold burn intense pain may be experienced when the skin starts to thaw. To treat cold burns:

loosen any clothing restricting blood flow and get medical
help immediately
- do not apply any direct heat to the affected area
- place the affected area(s) in lukewarm water
- use sterile, dry dressings to protect the damaged skin.

Your clothing could become saturated with oxygen if either liquid or excessive gas comes in contact with it. If your clothing becomes saturated you should walk around in a well-ventilated area for 15 minutes, keeping well away from naked flames and sources of ignition.

Taking other medicines

If you have been taking or prescribed Bleomycin (to treat cancer),Amiodarone (to treat an irregular heartbeat) or Nitrofurantoin and similar antibiotics (to treat infection), advise your healthcare professional before using Medical Oxygen, as there is a possibility of toxic effects to the lungs.

Tell your healthcare professional if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Pregnancy and breast feeding

Medical Oxygen will not affect you or your baby if used during pregnancy or whilst breast feeding.

Driving and using machines

You may drive and use machines after using Medical Oxygen providing that your healthcare professional considers that you are both fit and capable.

3. HOW TO USE LIQUID MEDICAL OXYGEN

Instructions for use

Liquid Medical Oxygen is only given to you after it has been converted into Medical Oxygen gas at room temperature. In a hospital or clinic Medical Oxygen will be given to you by a healthcare professional. They will ensure that your Medical Oxygen supply is suitable for your use and that the equipment has been set up correctly so that you receive the right amount of oxygen.

To breathe your oxygen you will either be given a face mask or a nasal cannula. The prongs on the cannula are inserted into your nostrils and the tubing is placed over your ears and adjusted under your neck for comfort. The face mask or nasal cannula is connected to your oxygen system with the tubing provided.

If you are using a Liquid Medical Oxygen vessel at home you will be given full training on the use of your vessel and equipment when you receive your first supply.

When using your Liquid Medical Oxygen at home directly from your vessel, you must:

ensure the vessel is stood upright on a flat surface and
supported so that it will not fall over. Liquid Medical Oxygen vessels should only be used in the vertical position with the valve uppermost, to prevent liquid from being spilt
ensure that all equipment is kept free from oil and
grease
check the contents gauge on the vessel before you start
to make sure there is enough gas available for your use
check that the tubing is correctly fitted to the outlet
open the valve slowly
select the flow prescribed by your healthcare
professional
if a leak occurs, this will be evident by a hissing noise.
When using your Liquid Medical Oxygen vessel at home to fill a portable cylinder, you must:
- ensure the vessel is stood upright on a flat surface and supported so that it will not fall over. Liquid Medical Oxygen vessels should only be used in the vertical position with the valve uppermost, to prevent liquid from being spilt
- ensure that all equipment is kept free from oil and grease.
- check the contents gauge on the vessel before you start to make sure there is enough gas available for your use
- follow the instructions provided for the portable cylinder
- never store your portable cylinder in engaged position on the vessel.

Always use your Liquid Medical Oxygen equipment exactly as your healthcare professional has shown you and at the correct flow rate. You should check with your healthcare professional if you are not sure.

DO NOT SMOKE or have a naked flame near your Liquid Medical Oxygen vessel. The oxygen will make a flame burn much more violently.

NEVER use oil based moisturising creams with your equipment.

If you use more Liquid 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.

05 1 /

4. POSSIBLE SIDE EFFECTS

Like all medicines, Medical Oxygen may cause side effects, although not everybody will get them.

The side effects that may occur whilst using Liquid 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%.
In patients with breathing disorders whose breathing is
triggered by a reduced oxygen level in the blood, the administration of oxygen may further reduce breathing effectiveness, and can result in an accumulation of carbon dioxide and excessive acid in the body (acidosis).

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.

5. HOW TO STORE LIQUID MEDICAL OXYGEN VESSELS

Expiry date

Do not use Liquid Medical Oxygen after the expiry date which is stated on the batch label.

Vessel storage

Store your Liquid Medical Oxygen vessels:

upright on a level surface so that they can not fall over
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 vessels, with empty and full vessels kept apart
out of sight and reach of children .

Handling vessels

Always handle your Liquid Medical Oxygen vessels with care, only moving if fully trained to do so. Liquid Medical Oxygen vessels should only be used in the vertical position.

Liquid Medical Oxygen medicnal gas, cryogenic

6. FURTHER INFORMATION

What Liquid Medical Oxygen Contains

Your Liquid Medical Oxygen vessel contains a minimum of 99.5% Oxygen.

There are no other ingredients.

Liquid Medical Oxygen vessels

Liquid Medical Oxygen is a supplied to the home in the following size vessels:

Vessel Size	Vessel Content (litres)
DLC 30	25,600
DLC 31	24, 900
DLC 37	31,400
DLC 41	33,500
DLC 45	38,300
DLC 46	37,600

Liquid Medical Oxygen is also supplied to storage vessels at healthcare facilities that range from 8440 litres to 486200 litres capacity.

Marketing Authorisation Holder and Manufacturer

BOC Limited

Forge

43 Church Street West

Woking

Surrey

GU21 6HT

Tel 0800 111333

This leaflet was last approved in

This is an uncontrolled document when printed

Active substance	Oxygen
Excipients	None.
Shelf life	6 months
Storage	Liquid Medical Oxygen vessels should be: preferably stored inside, kept dry and clean, and not subjected to extremes of heat and away from stocks of combustible material. stored separately from industrial and other non-medical gas containers. stored to maintain separation between full and empty vessels. used in strict rotation so that vessels with the earliest filling date are used first. stored separately from other medical gas containers within the store stored in a secure and upright position to avoid spilling of the liquid stored in a well ventilated area stored without a cover or material over the vessel Liquid Medical Oxygen bulk storage tanks should be sited at least 3 metres from boilers and other sources of naked lights, fuel stores, paint stores and other volatile flammable materials. Warning notices prohibiting smoking and naked lights must be posted clearly in the vessel storage area and the Emergency Services should be advised of the location of the vessel store. Care is needed when handling and using Liquid Medical Oxygen vessels.
Drug group (ATC)	V Various drug classes V03 All other therapeutic products V03A All other therapeutic products V03AN Medical gases V03AN01 oxygen
Marketing authorisation	PL 00735/0009 (first authorised 1 September 1972)
Marketing authorisation holder	BOC Ltd

Liquid Medical Oxygen – patient leaflet, side effects, dosage