Homecare

Oxygen therapy at home, and in particular solutions that give the patient greater mobility, has very high priority in the Linde Healthcare development programme. Our objective is to provide quality of life, safety and simplicity for patients who are cared for at home.
We wish to develop the market for home medical care by focusing on therapeutic services that raise quality of life for these patients. Linde Healthcare offers safe complete solutions that cover everything from pharmaceutical gases to service and maintenance.

The HemLOX® system includes a large stationary container that Linde Healthcare supplies to the patient's home and replaces regularly with a re-filled container. The container holds 20 or 30 litres of liquid oxygen, which is equivalent to 80 and 120 one-litre gas cylinders. The stationary container is supplemented by small portable lightweight containers filled from the home container. These can be carried on the shoulders or in a specially adapted rucksack and give the patient very substantial freedom of movement. Linde Healthcare provides three different portable lightweight containers: Stroller 1.2, Helios Plus 300 and Spirit 300.

The oxygen concentrator is the most common of all the systems used in home medical care. It is an electrical device that separates the oxygen from the ambient air. The principal benefits of the system are that it is economical, requires very little maintenance and continuously provides the patient with oxygen.
The concentrator weighs 15-25 kg and is stationary as it must be connected to an electrical power source to work. The oxygen concentrator is therefore almost always used in combination with some mobile system with oxygen in a cylinder.

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Chronic obstructive pulmonary disease can be treated with oxygen.Mbr> Chronic obstructive pulmonary disease or COPD is a combination of bronchitis and emphysema. Chronic obstruction develops slowly and leads to impaired lung function that cannot be restored. However, continued development of symptoms can often be prevented by smoking cessation.
The World Health Organisation (WHO) estimates that COPD is the fourth largest cause of death after heart disease, cancer and stroke. Despite this, it is unfortunately an under-diagnosed and under-treated disease.
The characteristic symptoms are cough, shortness of breath and mucus production. Common risk factors are long-term smoking, pollutants from industry, allergies and repeated episodes of pneumonia.
Studies of oxygen therapy point to prolonged survival by several years and increased physical capacity.

Treatment methods -long-term therapy with oxygen is the established standard treatment for patients with advanced COPD. There are three different methods for oxygen therapy in the home:

• ● Liquid oxygen
• ● Gaseous oxygen in cylinders
• ● Oxygen concentrators

The doctor recommends a suitable system.
Smoking is strongly associated with COPD (around 90%). To be able to benefit from the oxygen therapy, the patient must stop smoking. This is also important for safety reasons as smoking poses an increased risk of fire in the use of oxygen.
Always and only dispense oxygen according to the doctor's instructions. If you suspect that your equipment is not working properly, contact the healthcare professionals.

Severe intense headache that can be treated with oxygen.
Cluster headache (Horton's headache) is an uncommon disease that affects more men than women. It is manifested as a very intense headache usually located around one eye. The headaches continue for a period and return with attacks occurring over a period a few weeks or months.
The headaches come suddenly and can last from 15 minutes to a few hours. The number of attacks is generally one or two per day but there can be up to eight per day. Common symptoms while an attack is in progress are that the eye often becomes red and runny, the pupil is small and the eyelid droops. Nasal congestion and nose drips may occur. Small amounts of alcohol often trigger an attack for the person who is in a headache period. Medicines that dilate the blood vessels, such as nitroglycerine, can also trigger the symptoms.

Treatment with oxygen -the attacks can often be curtailed and or alleviated within 10-15 minutes by treatment with oxygen. The treatment of an ongoing attack often consists in inhalation of 100% oxygen.

Sleep apnea is a very common but still largely under-diagnosed condition.
When you are asleep, the muscles in the upper airways (nose, mouth, throat and trachea) relax. If they relax too much, the airways can become constricted. This means that many people begin to snore. Sometimes it can even become difficult to breathe. If the airways are blocked completely, breathing is temporarily stopped (apnoea).
Obstructive sleep apnea is the most common symptom of sleep apnea, and means that breathing stops repeatedly during sleep. In some cases breathing can halt several hundred times every night. Obstructive sleep apnea syndrome (OSAS) is due to episodes of airway obstruction during the night that produce symptoms during daytime due to lack of sleep. The apnea attacks lead to oxygen deficiency which in the long term can lead to an increased risk of high blood pressure, myocardial infarction and stroke.
Sleep apnea is a very common but still largely under-diagnosed condition. The typical OSAS patient is a greatly overweight man over the age of 40, but anyone can be affected. The treatment includes weight reduction where justified, avoidance of alcohol and sleeping tablets and where appropriate use of what is known as a mandibular advancement splint. The next step in treatment is the use of a CPAP appliance that creates continuous overpressure in the airways so that they cannot collapse, or a bi-level device that forces air into the airways at different pressures depending on whether the patient breathes in or out.
Symptoms - the most common symptoms of sleep apnea are:

• ● Snoring
• ● Pauses in breathing during sleep
• ● Abnormal tiredness during the day

Research shows that sleep apnea in the long term can lead to diseases such as high blood pressure, heart disease, stroke and diabetes. The patient also becomes more susceptible to stress.

Treatment - there are several ways of treating sleep apnea. The patient may, for example, try to improve his or her condition. The following simple lifestyle rules are recommended:

• ● Have regular sleeping times
• ● Introduce a routine you always follow when going to bed
• ● Make sure that you have a comfortable bed
• ● Air the bedroom every day
• ● Avoid large meals in the evening and do not go to bed on an empty stomach either
• ● Do not take a hot bath before going to bed
• ● Do not fall asleep in front of the television
• ● Do not drink alcoholic beverages before going to bed

The choice of treatment is governed by the severity of the disease, age, other diseases and any physical abnormalities in the nose and throat. Common treatments are:

• ● CPAP (Continuous Positive Airway Pressure)
• ● Mandibular advancement device (in mild cases)
• ● Surgical interventions (now increasingly avoided but may be necessary in the case of physical obstructions)

CPAP
The most common and most effective treatment for sleep apnea is CPAP (Continuous Positive Airway Pressure). CPAP blows ordinary room air into the patient's airways through a mask. The improvement in the patient's own quality of sleep and quality of life is often experienced quickly. However, CPAP treatment requires a thorough sleep investigation.

As asthma symptoms are caused by blocked airways, it is best to treat the lungs as directly as possible.
Asthma is a chronic disease characterised by breathing difficulties due to inflammation and obstruction of the airways. With modern treatment, many asthmatics are free of symptoms between the attacks. During an acute asthma attack a sudden deterioration in the condition can lead to more severe symptoms. During an attack the airflow may be completely obstructed and the attack may consequently become life-threatening.
Asthma produces various symptoms such as coughing, wheezing, a sensation of tightness in the chest, shortness of breath and thick mucus.
As asthma symptoms are caused by blocked airways, it is best to treat the lungs as directly as possible. Inhalation therapy is suitable for this purpose. Various inhalers are used to administer medicines (steroids and bronchodilators) in many respiratory diseases such as asthma and COPD.
Common symptoms

• ● Cough
• ● Wheezing
• ● Sensation of tightness in the chest
• ● Dyspnoea
• ● Shortness of breath
• ● The severity of the symptoms vary from patient to patient.

Asthma is diagnosed on the basis of medical history and physical examination. The doctor investigates the patient's symptoms, how often they occur and how severe they are. A significant factor is whether there is a family history of asthma and allergies. Lung function tests are performed in the diagnosis of asthma.
PEF measurement is used to diagnose and monitor asthma. A PEF meter measures how much air the patient can exhale. It is easy to use and patients can perform the measurement on their own.
In addition to these examinations, a prick test or blood tests may be of benefit in diagnosing any allergies. If necessary, a more extensive investigation of lung function can be done by what is known as spirometry. This is done in hospital or at a clinic.
Treatment
The first step is always to avoid the risk factors. Medicines that prevent or alleviate attacks and symptoms can be given orally or injected, but in most cases inhalation is used.
As well as the right medication, some simple rules (according to the American Lung Association) can help asthma patients to control the disease:

• ● Start keeping an asthma diary to try to find out what triggers the asthma symptoms.
• ● If you suspect that something can act as a triggering factor, you should as far as possible avoid exposing yourself to this.
• ● Air conditioning in the home may be useful if you react to pollen or spores.
• ● Many asthma patients are sensitive to tobacco smoke.
• ● Indoor mould should also be avoided: a dehumidifier may be beneficial.
• ● House-dust mites are a common triggering factor. Avoid vacuum-cleaning in general, or least poor-quality vacuum cleaners that stir up dust and allergens.
• ●It is a common to have asthma for the whole of one's life. The asthma may, however, vary in severity over various periods. Regardless of how well you feel at the time, you should always follow your doctor's advice. If you do, the chances of your symptoms of asthma decreasing in the long term will increase.

Nitrous oxide is the most common method of pain relief in connection with childbirth. Nitrous oxide is the most common method of pain relief in connection with childbirth. It is rapidly effective, without limiting the mother's mobility during delivery and quickly disappears from the body. Nitrous oxide can be combined with all other forms of pain relief.
There are no known adverse effects on breathing, circulation, labour or other bodily functions. Nor are there any known adverse effects for the child. Nitrous oxide is, furthermore, the only medication-based method of pain relief over which the woman herself has control.
Childbirth pain is different from other types of pain. It gives a positive signal that delivery is progressing and that the baby is on its way. The pain does not come suddenly. It comes gradually, increases in intensity and fades away. The rhythm of labour helps the women to become accustomed to the pain, to learn how to cope with it on her own.

Methods of pain relief - methods of pain relief are usually divided into natural and medical methods. The natural ones mean that the body's own pain-relieving systems are utilised. The body is stimulated to produce various pain-relieving substances, including endorphins (the body's own morphine). The pain can also be inhibited by other nerve impulses being stimulated, for example through heat, small electrical impulses (TENS) or injections (sterile water). The natural pain relief methods generally provide the best relief at the start of the dilation stage.

Nitrous oxide -Nitrous oxide is one of the generally acting methods of pain relief, but unlike morphine-like products the supply is controlled by the woman herself. A mixture of nitrous oxide and oxygen is inhaled through a face mask, nasal cannula or mouthpiece. A common concentration is 50-70% nitrous oxide in oxygen, but the concentration can be regulated according to need. Linde Healthcare's equipment VENTYO®, for example, is intended for this purpose.
The nitrous oxide is taken up in the blood on inhalation. The gas is carried with the blood circulation to the organs of the body that receive and pass on pain impulses and exercise their effect there. The pain-relieving effect is felt after just five to six breaths. It decreases rapidly when breathing in the mask stops.

Children's pain is often under-estimated in the health service and they consequently often receive inadequate pain relief. Procedural pain is the term used today to describe the pain that occurs in connection with diagnostic and/or therapeutic procedures. It is often short-term and of moderate intensity.
Children's pain is often under-estimated in the health service and they consequently often receive inadequate pain relief. In addition, procedures such as needle insertion, injections, application of dressings on wounds can be experienced as more frightening than for adults as they do not always understand the benefit.

Nitrous oxide has a calming and pain-relieving effect
Nitrous oxide is a well proven and documented pain-killing gas. The gas has been used for many years for pain relief in childbirth, in dental care and in emergency and ambulance care. Nitrous oxide has properties and effects that are desirable in a medicinal product in the treatment of procedural pain in children. It is both calming and pain-relieving. In addition, no needle is required to deliver nitrous oxide, and administration is easy to control. The pain-killing effect arrives within about a minute, and the effects fade rapidly after administration has ended. The side-effects are mild, the most common being nausea, dizziness and "loss of control". But these side-effects usually disappear quickly when administration of nitrous oxide ends. The child can leave the hospital within about half an hour after the procedure has ended.

Hypoxic respiratory failure is the general term used to describe organs of breathing not being capable of maintaining effective gas exchange in the lungs.

Hypoxic respiratory failure is the general term used to describe organs of breathing not being capable of maintaining effective gas exchange in the lungs. Blood gas tests are used to ascertain whether respiratory failure is present.
In infants with hypoxic respiratory failure the blood vessels in the lungs are constricted. This limits the blood flow from the heart to the lungs and means that when the blood low in oxygen returns to the heart, it is conveyed past the lungs through ducts that remain from the fetal period and flows back out into the body. Many infants with hypoxic respiratory failure have a sporadic lung disease which means that the air flow (and therefore oxygenation) is good in some areas of the lungs and less good or non-existent in other areas.
When nitric oxide is inhaled, the constricted blood vessels in the lungs relax, so that the blood flow from the heart to the lungs increases, and the quantity of blood that goes outside the lungs decreases. The blood flow increases in those areas of the lungs where the air flow is greatest and where the best gas exchange can take place.

HBO is an accepted treatment for decompression sickness. HBO (hyperbaric oxygen therapy or hyperbaric pressure therapy) is an accepted treatment for decompression sickness.

HBO means that the patient is given pure oxygen at an air pressure that is increased to 2 to 3 times normal air pressure. This treatment is given in hyperbaric chambers which are available at a number of special clinics. By giving such treatment, it is possible to increase oxygenation out in the tissues to around 10 times higher values than when air is breathed at normal air pressure.
The treatment is used in various conditions when good oxygenation is to be achieved out in the tissues and can also be used to get rid of carbon monoxide from the blood more quickly in carbon monoxide poisoning and in decompression sickness when too rapid ascent has led to nitrogen being dissolved in the body and needing to be eliminated.
HBO is also used in a number of other conditions with sometimes good results. Mention can be made of severe infections of soft tissues, carbon monoxide poisoning, and chronic ulcers caused by poor blood circulation.

Devices for sleep therapy provided by Linde Healthcare consists of maintanence, patient support and CPAP-masks.

Obstructive sleep apnoea is a chronic disorder in which intermittent and repeated upper-airway collapse during sleep leads to irregular breathing and repeated awakening at night. It is a serious condition since the resulting daytime sleepiness impairs judgement and increases the risk of accidents. There is also evidence that obstructive sleep apnoea increases the likelihood of high blood pressure, which in turn raises a person’s risk of heart attack or stroke¹.
Our product portfolio includes a broad range of comfortable, easy-to-use, and reliable equipment for sleep therapy. 1 Rowley. Obstructive sleep apnea-hypnoea syndrome. Emedicine 2009.http://emedicine.medscape.com