Keene Medical Products, Inc.

The administration of oxygen at concentrations greater than room air with the intent of treating or preventing the symptoms and manifestations of hypoxia

Oxygen therapy can be used short term for people recovering from acute lung disorders (e.g. Pneumonia), or conditions that temporarily benefit from increased oxygen levels

Oxygen therapy is also for long-term use for people with chronic lung disorders such as Chronic Obstructive Pulmonary Disease (COPD) or Emphysema

KEENE MEDICAL PRODUCTS, INC.

The discharge plan is the mechanism that allows for the successful transfer of the respiratory care patient from the health care facility to home, extended care facility or an alternate site of care

The discharge plan details the type of respiratory care and equipment required, length of treatments, established flow rates, aerosol meds and/or treatments for sleep disordered breathing, patient demographics, etc.

KEENE MEDICAL PRODUCTS, INC.

The setup process includes the following:

• Site assessment for environmental limitations, inadequate lighting, poor temperature control, potential fire hazards or other safety hazards, possible physical hazards, unsecured cylinders, ungrounded outlets, poor accessibility to back up systems. Site should be free of fire, health and safety hazards

• Patient and Caregiver training including instruction on the use and care of the equipment and must demonstrate an appropriate level of skill

• Detailed safety and maintenance instruction

• Contact information for supplies or emergency situations

KEENE MEDICAL PRODUCTS, INC.

The patient’s physician has the primary responsibility for monitoring the patient’s condition and success of prescribed therapies

The physician may request the services of the health care provider, respiratory therapist, to perform certain diagnostic tests to monitor the patient’s condition such as oximetry and titration testing to confirm sufficient flow rates under varying conditions in the patient’s environment

KEENE MEDICAL PRODUCTS, INC.

A severe lung disease such as COPD, diffuse interstitial lung disease, whether of known or unknown etiology; cystic fibrosis, bronchiectasis; widespread pulmonary neoplasm

Hypoxia related symptoms or findings that might be expected to improve with oxygen therapy. Examples of these symptoms and findings are pulmonary hypertension, recurring congestive heart failure due to chronic cor-pulmonale, erythrocytosis, impairment of the cognitive process and morning headache

KEENE MEDICAL PRODUCTS, INC.

Coverage may be granted if the patient has a PO2 at or below 55 mm Hg and/or an oxygen saturation at or below 88 percent

These values should be taken at rest, breathing room air. If oxygen therapy is ordered while the patient is in the hospital, these values must be taken within 48 hours of discharge

If prescription is for MORE than 4 LPM, testing must be conducted while patient is on oxygen at 4 LPM. PO2 levels or O2 saturation must be within base criteria guidelines

In the event testing is conducted for situations other than at rest, additional documentation is required. Exercise – Test on room air – Test during exercise – Test during exercise on oxygen

KEENE MEDICAL PRODUCTS, INC.

Coverage may be granted if the patient has a PO2 between 56 and 59 mm Hg and/or an oxygen saturation of 89 percent if there is evidence of any of the following conditions:

• Patients in this category must be retested between the 61st and 90th day of therapy

• Dependent edema suggesting congestive heart failure

• “P” Pulmonale on EKG (P wave greater than 3 mm in standard leads II, III or AVF)

• Erythrocythemia with a hematocrit greater than 56 percent

• Oxygen is rarely considered medically necessary when

PO2 is > 55 mm Hg and/or saturation is > 89 percent

KEENE MEDICAL PRODUCTS, INC.

Coverage of a portable oxygen system

alone or to compliment a stationary

oxygen system may be allowed if the

patient is mobile within the home and

needs to ambulate at least 50 feet

beyond the stationary system

The same base oxygen criteria will apply

to portable oxygen systems

KEENE MEDICAL PRODUCTS, INC.

Primarily used for low liter flow and low volume

Oxygen is compressed into different sized cylinders

Smaller cylinders are used for portability

Cylinders must be exchanged and refilled as necessary

Portable systems average weight 6-8 pounds

Cylinder sizes –

KEENE MEDICAL PRODUCTS, INC.

Cylinder Liters per minute

Oxygen without conserver

Oxygen with pulse dose conserver

Approximate Weight (Pounds)

Capacity (Cubic feet)

Capacity (Liters)

E 2 5.6 Hours 17 Hours 8 24 680

D 2 3.3 Hours 10.5 Hours 5.5 15 425

B (M-6) 2 1.4 Hours 4 Hours 2.5 6 164

Small compressor that extracts oxygen from the air

and stores it for constant use

Always accompanied by a back up system

Runs continuously if properly maintained

Easy to operate and move

Requires electricity

Flow rates from 1-10 LPM

Most commonly used modality

Portable concentrators for traveling clients

Specialty units available for powering respiratory

devices

KEENE MEDICAL PRODUCTS, INC.

Systems includes concentrator, compressor

system with table and 2 portable cylinders

with attached conservation devices

Portables refilled off the concentrator

2 portables allows up to 10 hours on 2 LPM

Portable weight under 5 pounds

Approximately 90 minutes to fill

KEENE MEDICAL PRODUCTS, INC.

Sequal Eclipse

• 17.9 lbs

• AC or DC operation

• Can operate on conservation mode or 3 LPM continuous flow

• Wheeled cart for ease of use

• Extra batteries available

• FAA approved

Airsep FreeStyle

• 4.4 lbs

• AC and DC operation

• Provides three pulse settings equivalent to 1-3 LPM oxygen

• Carrying case available for ease of use

• Optional AirBelt for 3 hours of more battery

• FAA approved

Airsep Focus

• Under 2 lbs

• AC or DC operation

• Provides a 2 pulse setting equivalent to 2 LPM

• Carrying case available for ease of use

• Extra batteries available

• FAA approved

KEENE MEDICAL PRODUCTS, INC.

Airsep FreeStyle Airsep Focus

Sequal Eclipse 3

Excess of portable cylinders or frequent deliveries

Tolerates a portable conservation device (Doctor prescribed)

Ability to handle and fill portables

Active, “on the go” clientele

3 LPM maximum for Home Fill and Eclipse

Conservation mode only for Focus and Freestyle

Improve quality of life

KEENE MEDICAL PRODUCTS, INC.

Nasal cannula delivered by nose only low flow systems

Nasal masks delivered over nose and mouth medium and high flow systems 5 LPM or greater

Extension tubing of various lengths is connected between the delivery system and mask or cannula

Humidification systems as required and prescribed

KEENE MEDICAL PRODUCTS, INC.

Extends the oxygen use time of portable cylinders

Senses inhalation and instantly releases a programmed pulse of oxygen at a predetermined flow rate

Active portable O2 users

Must be prescribed by physician

KEENE MEDICAL PRODUCTS, INC.

Initial Education/Critical Pathway

PIC (Product Information for Customers) Sheets

Infection Control

Proper Changing of Disposable Supplies

KMP Routes and Delivery Cycles

Patient Responsibilities for Maintaining Equipment (Pre-filters, etc.)

Review Client Bill of Rights and HIPAA Privacy Policies

KEENE MEDICAL PRODUCTS, INC.

Demonstrated by Technician

Patient performs return demonstration

KEENE MEDICAL PRODUCTS, INC.

Phone Sticker

Delivery Cycle

Serviced according to MFG guidelines

KEENE MEDICAL PRODUCTS, INC.

Review of PIC Sheet

Oxygen Safety Tips

No Smoking Signs

Storage/Handling

KEENE MEDICAL PRODUCTS, INC.

Prescription from Doctor

Call for Pick-up

KEENE MEDICAL PRODUCTS, INC.

7-10 Day in person follow up to review setup instructions, safety, maintenance, etc.

Review of equipment options for best fit

6-month follow up

RT follow up as required by Physician approved Plan of Treatment

Concentrator Maintenance Schedules

KEENE MEDICAL PRODUCTS, INC.