Reduce oxygen flow/concentration or stop oxygen therapy if the patient is clinically stable and their peripheral oxygen saturations have been within the target range for two consecutive observations (O'Driscoll et al. [209]). Observe the patient 5 minutes after stopping or lowering the dose of oxygen therapy and document the observations. Repeat observations again after 1 hour; if saturations remain within the desired target range, oxygen therapy has been successfully weaned or stopped (O'Driscoll et al. [209]).

Patients should be observed for signs and symptoms of hypercapnia. These include anxiety, mild dyspnoea, headache, hypersomnolence, delirium, confusion, facial flushing, bounding pulse, tachycardia, warm peripheries, drowsiness and flapping tremor (Feller‐Kopman and Schwartzstein [78], Patel and Majmundar [215]). If hypercapnia is suspected, reduce the oxygen concentration down slowly. Do not stop oxygen completely as this may cause rebound hypoxia (Feller‐Kopman and Schwartzstein [78]).

Accurate documentation of patient observations and the oxygen device, flow and concentration administered will assist healthcare professionals in determining whether a patient is clinically improving or deteriorating, and help to guide future treatments. Clear documentation of the events that led up to a patient requiring oxygen therapy, in addition to any other relevant information, must be available for all healthcare professionals to review if required, as this will improve communication and reduce patient risk (NMC [198]).

Long‐term oxygen therapy at home may be required if the patient is chronically hypoxaemic and requires oxygen for more than 15 hours per day (Hardinge et al. [99]). Relevant conditions include COPD, cystic fibrosis, interstitial lung disease, neuromuscular and skeletal disorders, pulmonary hypertension, obstructive sleep apnoea and heart failure. Palliative oxygen therapy may also be required for patients with intractable breathlessness caused by their underlying lung disease (O'Driscoll et al. [209]). A full clinical assessment should be performed before a referral is made to the home oxygen assessment team.

The patient and their family should be formally educated and provided with written information on the hazards of oxygen use at home. Healthcare providers must be sure that the patient and their family members understand the dangers of smoking (including e‐cigarettes) in an oxygen‐enriched environment. An increased amount of oxygen in the environment increases the speed at which things burn once a fire starts. Oxygen can saturate clothing, fabric, hair and beards. Even flame‐retardant clothing can burn when oxygen content increases. It is important to keep all naked flames and heat sources away from oxygen systems. Patients should be advised never to smoke or light a match while using oxygen, or allow others in the same room to do so. The local fire brigade should be informed of any home with an oxygen system (Hardinge et al. [99]) and every home should have at least one working smoke detector on every level and near all bedrooms. When transported in a car, oxygen cylinders should be adequately secured, a warning triangle should be displayed and the car insurance company should be informed.

The oxygen supplier in the community has a responsibility to carry out a detailed risk assessment of the patient's home and ensure the environment is safe, as well as educate the patient and provide written information on the use of oxygen equipment. The patient should also be followed up by a specialist home oxygen assessment team at least 4 weeks after hospital discharge to ensure safe use and compliance with oxygen therapy (Hardinge et al. [99]). Oxygen may be supplied in cylinders or in an oxygen concentrator, which is more economical for patients requiring long‐term oxygen therapy. For more guidance see the British Thoracic Society's guidelines for home oxygen use in adults (Hardinge et al. [99]).