All referrals for oxygen therapy and respiratory support should be submitted using the updated SHA-0556 form. This standardized provincial document replaces previous versions to ensure more efficient processing and consistent patient care across the Saskatchewan Health Authority (SHA). Lung Sask will continue to accept other referral forms in the interim so to not impact any patient care.

Submission Instructions: please ensure to send completed forms via fax to 306-766-6049 or email provincialcopdreferral@saskhealthauthority.ca.

Completeness: Confirm that all applicable boxes are checked off, patient information is complete, and the patient's postal code is verified.

Why the Change? The SHA is transitioning to this unified referral system to reduce wait times and ensure patients are directed to the appropriate specialists or services correctly and to their preferred/closest location. Please discontinue the use of any older respiratory referral templates and ask your local medical clinics to update to this form in EMR's. The link provided below will always host the most up-to-date form.

For clients who may need nocturnal testing rurally, please ensure Lung Sask has also received the order. 

1. SAIL Criteria
To qualify for SAIL-funded nocturnal home oxygen, overnight oximetry results must be assessed by a SHA employee and demonstrate:

• A room air test at least 3-4 hours in length must show a SpO₂ below 88% for at least 30% of the night, and show significant improvement in SpO₂ while wearing oxygen on a second night of testing. Patients must not have been hospitalized for a cardiorespiratory event or had an exacerbation or change of treatment in the 30 days prior to testing

2. NIHB Criteria
NIHB criteria differ from SAIL requirements. Home oxygen may be considered for coverage by the NIHB program once the client's condition is stabilized and treatment regimen is optimized. Clients must be assessed by a RT, RN, LPN, or RPN (SHA or non-SHA) and meet both of the following:

• Room air testing demonstrating nocturnal desaturation below 89% for at least 30% of the night, AND
• Sleep-disordered breathing must be ruled out.

3. Appropriate Oxygen Equipment for Testing
Portable oxygen concentrators are not appropriate for overnight oxygen testing because they typically provide pulse-dose only on inspiration.

Acceptable oxygen sources for testing include:

• Stationary concentrators
• Wall oxygen
• Oxygen cylinders/tanks
  

4. Clients Using CPAP or BiPAP
If a client uses CPAP or BiPAP, the device must be worn during testing. This is still considered a room air test. If testing with oxygen, an adaptor is required, reach out to the client's home oxygen company or Lung Sask if one is needed.

Low overnight SpO₂ while using CPAP/BiPAP may indicate:

• The need for CPAP mask adjustments
• The need for pressure adjustments
• The possible need for supplemental oxygen

5. Cost
There is no cost to the patient for nocturnal testing through Lung Sask or your local tester. Return shipping of oximeters to Lung Sask is paid by the SHA/local testing site i.e. home care, First Nations band etc. 

6. Sleep Apnea Testing
Nocturnal oximetry is NOT a replacement for sleep apnea studies. Patients cannot access CPAP therapy with oximetry testing. Sleep testing must be completed by a sleep disorders centre OR private sleep apnea company. Nocturnal oximetry may be ordered for CPAP follow-up to ensure therapy is adequate or assess if oxygen is required. 

Lung Saskatchewan is proud to celebrate two leaders in respiratory health who have been recognized nationally for their contributions to patient care, research, and professional leadership.

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