Air Liquide Paediatric, Руководство пользователя

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Patient Declaration
As a home oxygen user it is important that you understand what equipment is in your home and how
to use it safely.
After completing your initial installation and after each risk assessment your technician will ask you
to sign the following statement. This will be saved to your patient record.
I confirm that I have been trained in the safe use of the equipment provided and have
received important safety information.
I am satisfied with my installation and understand:
l
All oxygen equipment provided is the
property of Air Liquide, which is on loan to
the NHS
l
The local Fire and Rescue Service may visit
me to carry out a home safety check. In
addition, Air Liquide will visit my home on a
regular basis to service the equipment and
carry out a risk assessment
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The dangers of smoking and that I must not
smoke or let anyone smoke near me whilst
using the oxygen equipment. This includes
both cigarettes and e-cigarettes
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I should never use or store oxygen
equipment within 3 metres (10 feet) of open
fires or naked flames such as cigarettes,
e-cigarettes, matches, lighters, boilers,
gas cookers, open gas fires, candles, or
machinery which could create sparks
l
I should never use or store oxygen
equipment within 1.5 metres (5 feet) of
heat sources (e.g. a radiator) and electrical
appliances such as, televisions, hair dryers,
and toasters
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The oxygen equipment must be kept clean
and dry
l
I should only use water- based products
when using my oxygen equipment and that
I should never use petroleum jelly or other
oil- based products
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The airflow to the oxygen equipment must
not be obstructed and that I must allow
adequate ventilation
l
The items attached to the oxygen
equipment or within the tubing have
been provided as an integral part and for
my safety and must not be removed or
tampered with
l
The fire breaks must not be removed
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The oxygen installation must not be
altered without prior consultation and with
agreement from Air Liquide
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Not to use any oxygen equipment that
has not been requested by a healthcare
professional and provided by Air Liquide
l
How to order replenishments and/or
contact Air Liquide if there is a problem with
my equipment
I accept responsibility to keep the
equipment in a safe condition and location
as instructed by Air Liquide and to return it
to Air Liquide when it is no longer required.
I understand that failure to return the
equipment to Air Liquide may result in
prosecution.
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Paediatric Home Oxygen User Guide