For Congress,
the FDA & Medicare
·
Return Liquid Oxygen to Fee Schedule Payment
ATS 01 (ama-assn.org)
-
https://www.ama-assn.org/system/files/2019-05/a19-119.pdf
·
The FDA Needs to Regulate Portable Oxygen Concentrator Settings so They
Are Equivalent to LPM
POC’s oxygen
pulse-dose settings do not correspond to continuous ‘liters/minute’
flow rates prescribed by most providers.
https://www.thoracic.org/patients/patient-resources/resources/portable-concentrators-garvey.pdf
You need to be
tested on your selected portable oxygen concentrator to confirm it
is meeting your oxygen needs.
https://www.nationaljewish.org/education/patient-education/print-multimedia/materials-printer?nodeId=c0a1fa54-bf43-4748-814f-f81e6fe4865d&partnerId=MS
·
Liquid Oxygen Needs to be Widely Available for Those Who Require 3 LPM of
Ambulatory Oxygen
In patients with
chronic lung disease who are mobile outside of the home and require
continuous oxygen flow rates of >3 L/min during exertion, we suggest
prescribing portable liquid oxygen.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667898/pdf/rccm.202009-3608ST.pdf
·
For Individuals
With COPD But No History of Type 2
Respiratory Failure A Target Sp02 of 88% to 92% Is Not
Necessary for All and I Believe Has Negative Health Consequences.
Oxygen therapy and inpatient mortality
in COPD exacerbation
One-year mortality
Mortality at 1-year post discharge in
those treated with supplemental oxygen
In patients who received supplemental
oxygen on admission and survived to discharge, the risk of death at
1year was 28%. The 12-month mortality rates, excluding inpatient
deaths, were: 87% or less=32%, 88%–92%=31%, 93%–96%=23%and
97%–100%=28% (including inpatient deaths these figures were 43%,
37%, 32% and 40%) (figure 3). The 93%–96%group had a significantly
lower risk of death than the 88%–92%group, and overall (online
supplemental table 5 includes further information relating to 1-year
mortality).
·
Using Horse Sense, More Research and Better Education On Blood Oxygen
Levels Is Needed for All Who Respiratory Diseases Touch.
Congress, Medicare, the FDA, Pulmonologists, Doctors and
Respiratory Therapists Should Pay Attention to the Horse Sense Part.
I have a better understanding of what I am
discussing if horse sense is used.
Using Medical terms often leaves me wondering what was said
or meant. It could also
be regurgation of rote learning
which I am sure, “all with COPD should keep their Sp02
between 88% and 92%” is.
--------------------------
Medicare needs to:
·
Regulate POC and conserving
devices settings so they are equivalent to LPM.
·
Require a high and low LPM on
prescriptions.
POC manufacturers
and salespeople encourage people to believe that POC setting are
equivalent to LPM without actually saying it or hiding it deep
in the manual or instructions that come with the POC.
Misleading statements from POC manufacturers and sales
organizations
https://hors-sens.com/oxygen/needed_changes/settings.html
--------------------------
Arnold et al. BMC Pulmonary Medicine 2011,
11:9
http://www.biomedcentral.com/1471-2466/11/9
Ambulatory oxygen: why do COPD patients not
use their portable systems as prescribed? A qualitative study
https://bmcpulmmed.biomedcentral.com/counter/pdf/10.1186/1471-2466-11-9.pdf
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THIS PAGE IS A WORK IN PROGRESS
UNDER CONSTRUCTION
______________
These are my thoughts and
experiences, not medical advice.
Gerald(Skip) Miller