Oxygen Therapy and Supplemental Oxygen Guide

Oxygen Therapy and Supplemental Oxygen Guide

If you or a loved one has recently received a prescription for oxygen therapy, you’re probably realizing there’s a lot of information to learn. New technologies for concentrating and delivering supplemental oxygen now allow for more freedom of movement than ever before!

Before you start, we’ve found it’s helpful to master a few basic concepts before choosing an oxygen system. This page will help make beginning your oxygen therapy as easy and straightforward as possible. Let’s get started!

Jump to a Topic:

What is Oxygen Therapy?

Oxygen therapy is a method of enriching the air you breathe so that each breath you take effectively supplies oxygen throughout your body. Oxygen therapy is needed when lungs are not able to absorb the amount of oxygen they need from the natural air around you. Oxygen therapy helps by delivering the exact amount of medical grade oxygen you need to keep you healthy and on the go!

Roughly 1 in 7 Americans require oxygen therapy at least once in their lives and with more than 20 distinct diseases that can interfere with the body’s ability to absorb oxygen, it’s no surprise. Luckily, today there are many tips, guidelines, and innovations in technology that make living with oxygen therapy an easy and positive experience. Oxygen therapy is a unique and extraordinary opportunity to achieve significant improvement in your physical condition and improve your overall quality of life!

Your Oxygen Supplementation Needs

When your doctor first discusses oxygen therapy with you, he or she will also address how often you will need this supplemental or additional oxygen. The amount of supplemental oxygen you need can vary depending on your condition, location, and lifestyle. This decision should be made by your doctor as a result of your medical condition, various oxygen related tests, and the altitude and climate at which you are living.

Once you know how often you will need supplemental oxygen, you can begin evaluating your machine options. Most users, that only require oxygen at night, meet their oxygen needs with a relatively inexpensive “home” or “stationary” oxygen machine/concentrator (This device will be explained in detail later in this document ). For the person who requires 24 hour supplemental oxygen, the traditional solution has been an oxygen tank. While this solution is still the most common, there are many new solutions that allow patients to maintain an active and involved lifestyle while still receiving the oxygen therapy they require. These new portable systems run on batteries, are lightweight, and allow patients to remain mobile and active.

What is Supplemental Oxygen Therapy?

All About Breathing

The air around us contains a blend of nitrogen, oxygen, and other trace gases. Oxygen itself is colorless, odorless, and tasteless. Our bodies use oxygen to convert the food we eat into energy and heat in order to sustain life. Just as a fire needs oxygen to burn fuel, our bodies need oxygen to burn calories.

Clean dry air at sea level is made up of approximately 78% nitrogen, 21% oxygen, 0.9% argon, 0.03% carbon dioxide, and a combination of 12 other elements in minute traces. Supplemental oxygen, as we’ve learned, increases the percentage of oxygen in each breath. Instead of inhaling 21% oxygen, you will be adding a supplement of 87% to 95% oxygen to each breath you take.

Medical Grade Oxygen

If you have worked in welding or other industries that use oxygen tanks, you know that oxygen comes in various grades. These grades are: Welding, Aviation, Research, and Medical. To a large extent, this grading system depends on the way in which oxygen tanks are filled. Oxygen is typically only considered medical grade when it is above 85% pure.

How Your Body Uses Oxygen

Our bodies need a certain amount of oxygen molecules circulating in the bloodstream at all times. When all internal organs are functioning correctly, the oxygen that you inhale passes from the tiny alveoli or air sacs of your lungs into the bloodstream, and the pumping action of your heart delivers this oxygenated blood to all parts of your body. The other 79% of each breath is simply exhaled without being absorbed by your lungs.

If your lungs aren’t working at their full capacity, they are likely unable to take in the full amount of oxygen that each breath would normally supply. Insufficient oxygen can result in a condition called “hypoxia” or “hypoxemia.”

Your doctor, if they haven’t already, will likely measure your blood oxygen levels using an oximeter or by taking a blood sample. A blood sample is most common in first-time oxygen users as this test measures more than just dissolved oxygen, it also provides a reading on the level of carbon dioxide in your blood as well as your blood’s PH level. These additional indicators provide your doctor with a more complete picture of your body’s overall oxygen supply and health.

Here at American Medical Sales and Rentals “AMSR” the Oxygen Concentrator Store, we recommend keeping a medical grade pulse oximeter handy at all times. A pulse oximeter is a small device that clips onto the tip of your finger and uses a beam of light to check your blood oxygen levels. Your oxygen saturation should be around 95 - 100%. If you have your finger nails painted this could affect your oximeter reading. If you’re struggling to get an accurate reading or your blood oxygen saturation is less than 85% we suggest seeking a physicians assistance.

Benefits of Supplemental Oxygen

When the symptoms of insufficient oxygen are relieved and your body is getting the therapy it requires, you may feel an increase in physical energy. Additionally, due to the fact that oxygen affects brain cell function, you will likely notice an improvement in your overall brain health and functions.

The benefits of your oxygen therapy will quickly become obvious as soon as you use your concentrator. Although wearing a cannula may not seem ideal, new technology has allowed for ultra-soft cannula tubing and even discreet cannula laden eyeglasses. Regaining your ability to be physically active will have positive effects on every aspect of your overall health. Furthermore, once you experience the personal freedom of going to work, traveling, and visiting people you care about, you’ll find it easy to get used to your concentrator and cannula.

Are There any Down-Sides to Oxygen Therapy?

Although it is tempting to think you can get by without oxygen, research shows using oxygen can significantly improve your quality of life. A common misconception is that by using supplemental oxygen you will become more dependent upon it and subsequently weaken your natural ability to process oxygen. Contrary to this comment, using supplemental oxygen will allow the natural processes in your body to work more efficiently, decrease excess strain, and increasing your overall health.

Another possible downside to oxygen therapy is that some people experience a bit of dryness in their nose or sinuses from receiving oxygen. You may find you need to experiment with several types of cannulas or skin gels in order to achieve an arrangement that is most comfortable for you. Luckily, today, innovations in cannula technology allow for a softer, cushioned, and more comfortable fit than ever before.

Oxygen Therapy Systems

How Oxygen Flow is Measured

Oxygen is a gas and the flow is measured in liters per minute. If you require oxygen therapy, your doctor will prescribe you a given oxygen flow rate such as 2 liters per minute. An oxygen flow rate of 2 LPM means the patient will have 2 liters of oxygen flowing into their nostrils over a period of 1 minute. Oxygen prescriptions generally run from 1 liter per minute to 10 liters per minute with 70% of those patients being prescribed 2 liters or less.

Types of Oxygen Delivery Systems

Oxygen can be delivered via several different types of delivery systems. In most situations, people new to oxygen will have a system delivered to them from a local provider contracted with either their insurance provider or Medicare. While the system provided will likely cover your basic medical needs, it may or may not provide the user with the flexibility and freedom to maintain the lifestyle they prefer.

It is always recommended that a patient understand the options available and find a solution that will best match their medical condition, lifestyle, and budget. This section will provide you with a general overview of all types of oxygen systems. Understanding your oxygen needs and being aware of what type of systems are available to you is a great start to taking back control of your health!

Oxygen Tanks - Compressed Gas

Oxygen Tanks - Compressed GasAn Oxygen Tank is currently the most common form of oxygen therapy provided for patients who need oxygen during the day. Tanks of compressed oxygen gas (of various sizes) are provided to the patient. These tanks will allow the patient to leave the home; however, you will only be able to travel short distances. A patient is limited in travel depending upon the size of the tank and their prescribed setting (the higher the setting, the faster the tank will run out). It is difficult for patients with tanks to travel as it would require loading multiple tanks of compressed gas into a car. It is also important to note it is against FAA regulations to travel on an airplane with a compressed gas tank.

The mechanical device that distributes oxygen from a tank is called a regulator. Tank life can be extended with the addition of a “conserving regulator.” This device allows the oxygen to be dispersed in small doses when the patient breathes in. The technical term for this small dose is a bolus. This device can also be called a “puffer” because of the “puffing” sound that is made when the oxygen is dispersed.

Liquid Oxygen System

Believe it or not, the human body absorbs oxygen as a gas, however, oxygen can also be stored in a liquid form. A Liquid Oxygen System consists of a stationary reservoir that stores liquid oxygen and an ambulatory tank that stores the liquid oxygen and converts it to a gaseous form before delivering it to the patient. This system has the benefit of providing a light-weight (less than 5 lbs) ambulatory canister for the patient. It is the most expensive solution available because a commercial truck is required to deliver the refills and reservoirs on a regular basis.

It is also important to note that liquid oxygen is very cold and evaporates very quickly. The other disadvantage of this solution is limited travel. The ambulatory canisters provide for a relatively short duration of oxygen (approximately 2 – 6 hours depending upon the prescribed flow rate and specific device) and can not be used on an airplane.

Oxygen Concentrator Systems

“Buying a portable concentrator was such a great decision! Tanks are too heavy and awkward to handle when going out. Having to call for refills is annoying.” —Nancy M.
The vast remainder of this guide will cover Oxygen Concentrator Systems. As you will learn, these systems extract oxygen out of the air, concentrate it, and deliver it in a pure form to the user. Since they are continually drawing oxygen from the ambient air, a patient never needs to worry about running out of oxygen. Their only worry is that the device does require access to a source of power. These are by far the most commonly used oxygen solution systems for patients either new to oxygen or only using oxygen nocturnally.

How Oxygen Concentrators Work

Regardless of size, all oxygen concentrators fundamentally operate the same. First, the concentrator draws in the air around it through the filter to remove any airborne particles and ambient air pollution. The filtered air then passes through a molecular sieve chamber which then sorts the oxygen from the nitrogen and other gases. The unit will then release the nitrogen and other gases while keeping the pure oxygen molecules.

The oxygen is then concentrated to the medical grade level. The medical grade oxygen that is created is then immediately delivered to the patient via nasal cannula. When a concentrator is running you’ll be able to hear a distinctive intake and purge cycle.

Diagram of How an Oxygen Concentrator Works

Stationary vs. Portable Oxygen Concentrators

As we begin our deep dive into oxygen concentrator systems, one early distinction is between a stationary (“home”) oxygen concentrator and a portable oxygen concentrator. We will discuss each of these systems in detail but the primary difference is one of size and portability. Home concentrators are typically larger and are designed to be used in the home. A portable oxygen concentrator is by definition – portable. They operate the same as a home concentrator but they are able to run on “portable” power sources such as batteries and with the cigarette lighter (DC power) in your car. These portable oxygen concentrators are designed to replace tanks and provide patients with increased flexibility and mobility.

Before the invention of small battery-powered portable systems, all oxygen concentrators were stationary. What makes them stationary is the fact that they need to be plugged into a regular electrical outlet in the wall. They also tend to be heavier, since they have larger oxygen capacities and their internal compressors, sieve beds, and so forth are larger. The most typical home oxygen concentrators range in weight from roughly 30 – 50 pounds. They are relatively large devices and while most of them have wheels, they often are too heavy to move frequently and a patient would need to maneuver around their home with long (upwards of 50 feet) tubing connected to their cannula. The older home concentrator models are typically noisy and high energy consumers. An electric bill for running a older model of home concentrator can run as high as $20 - $40 / month.

Stationary vs. Portable Oxygen Concentrators

Newer models have made significant improvements in both noise and energy efficiency. Energy efficiency improvements have reduced the wattage required from over 500 watts to less than 200 watts. Similarly, the newer and quieter models of home concentrators have reduced the decibel level from over 80 decibels to under 45 decibels. 45 Decibel is similar to the sound of a standard refrigerator running.

Home concentrators are very robust and with routine maintenance will often run efficiently for 20,000 to 30,000 hours. Routine maintenance includes keeping the air intake clean and periodically cleaning and/or replacing the filters.

The oxygen generating capacity (liters per minute of oxygen flow) of a home concentrator is most typically 5 liters per minute. The vast majority of oxygen users are prescribed dosages between 1 and 5 liters per minute. The largest commercially available home concentrator delivers 10 liters per minute. Although it is fairly rare, patients needing over 10 liters per minute can bundle units together for increased oxygen delivery.

Relatively new to the market are super small (around 10 lb) home concentrators. These units will run on AC (wall outlet) or DC (cigarette lighter) power and are so light that it is easy to move them from room to room or put them in the car for travel. They currently only support oxygen flow rates up to 2 liters per minute.

The medical grade oxygen produced from a home concentrator is delivered in what was earlier described as continuous flow. This means that the oxygen is continuously flowing through the cannula to the patient’s nostrils. Most doctors recommend and prescribe continuously flowing oxygen for nocturnal (night time) use.

The settings on a stationary concentrator are very self-explanatory. Other than the power button the primary adjustment on most units is a flow tube with a knob on the bottom. This knob adjusts the liter flow per minute. For more updated stationary units, you’ll be able to adjust the settings via “+” and “-” buttons. Plus to increase settings and the minus to decrease.

It is not uncommon for a patient with sleep apnea to also be on oxygen therapy. Patients using a CPAP or BiPAP and on oxygen therapy connect their sleep apnea device to the home concentrator on continuous flow.

Portable Oxygen Concentrators

As mentioned earlier, the primary difference between the home concentrator described above and a portable oxygen concentrator is the mobility of the device. The two type of concentrator functions, for the most part, are exactly the same. The ability to run a concentrator using these additional power sources gives a patient significantly increased flexibility. The patient then no longer has to worry about their tank running out of oxygen and instead only needs to ensure they have access to a power source.

Pulse vs. Continuous Flow

The performance of portable oxygen machine is divided into two categories – either pulse dose only or pulse and continuous flow.”Pulse dose is a method of dispersing oxygen that was originally developed to extend the oxygen supply stored in a tank. Pulse means that instead of delivering oxygen with a flow that is continuously flowing to the patient’s nostrils, it is delivered in short spurts of oxygen called a bolus when the patient inhales. Pulse dose in a portable concentrator allows the machine to have a lighter and smaller compressor (because the machine does not need to work as hard) and also helps to extend the battery life for the same reason.

The second category is a unit that is both pulse and continuous flow. These units can toggle between pulse dose and continuous flow at the press of a button. This feature can be very beneficial to patients because it allows them to use pulse dose when they want to conserve battery life and then allows them to switch to the more energy consuming continuous flow when they are on AC power or for night time use.

Many research articles have been published on the trade-offs between pulse and continuous flow concentrators. We would always recommend talking to your doctor about which type of unit is best for your individual medical condition and lifestyle. In general, however, most doctors are still recommending continuous flow concentrators for patients using oxygen nocturnally (at night). This recommendation stems from the following reasons:
  1. Many people breathe through their mouth at night and subsequently may or may not effectively trigger the pulse dose delivery system. If a patient does not effectively trigger the pulse dose, they will not get the correct amount of oxygen and not awaken as rested and their oxygen saturation will decrease. Note: This is still true even though many concentrator manufacturers advertise “sleep” and “night time” sensitive triggering mechanisms in their units.
  2. Many people find the “psht” noise made by a pulse dose unit to be disruptive to their sleep.
  3. If a patient is a sleep apnea patient (on a CPAP or BiPap), it will not function properly if connected to a pulse only machine due to the breathing irregularities.
There are also studies that report increased saturation from a pulse only device. The logic behind these studies is that the pulse trigger mechanism directs the medical grade oxygen more effectively into the patients respiratory system. These studies report that continuous flow is analogous to someone sticking their head out the window of a moving car where most of the air just “flows” by and is not easily inhaled by the passenger in the car.

The trigger mechanism on pulse dose concentrator systems is what allows them to deliver the bolus of oxygen at exactly the moment you begin to inhale. These trigger mechanisms are at the center of recent technological developments by manufacturers of portable devices.

The importance of a reliable trigger mechanism cannot be overstated. Your breathing doesn’t occur at exactly equal intervals, and a pulse-dose oxygen delivery system has to be able to sense the very moment that you start to take a breath. Furthermore, the mechanism has to be sensitive enough to recognize your breathing pattern even during sleep when breaths can be very shallow. Each manufacturer has a proprietary trigger mechanism. Although most people can’t tell a difference, there are some people have preferences between the delivery types.

The technology of these trigger mechanisms has evolved rapidly within the last several years and your doctor may not be aware of the new options offered by current portable concentrators. You may be told that only stationary continuous flow models are appropriate for sleep, because that was indeed true a decade ago. The ultimate test of which system is best for a given patient can only be determined with pulse oximetry tests that will verify the oxygen saturation with both systems.

Settings on the Machine

Unlike continuous flow systems, on which you can simply set the number of liters per minute of oxygen, pulse dose concentrators have settings that are a bit less obvious. Once you become familiar with your very own machine, it will become as straightforward as working your TV remote -- but you may have a few questions at first.

Here’s a short introduction:
Setting an Oxygen Concentrator Pulse dose machines have numerical settings – such as 1, 2, 3, etc. Unfortunately there are no standardization of settings across manufacturers. The settings on a machine typically (not always) correlates to the volume of the bolus of oxygen being delivered (i.e. setting 1 is smaller than setting 2 etc). The volume of a bolus on setting 1 on a particular machine is not the same as the bolus volume setting 1 on different machine. Most manufacturers recommend as a rule of thumb that a setting of 1 on a pulse dose machine is ROUGHLY equivalent to 1 liter per minute continuous flow. We would recommend patients to work with their doctors and check their oxygen saturation statistics to determine the appropriate setting for their needs.

The overall capability of any machine can be measured by the total oxygen output. This metric is the total volume of oxygen that can be delivered in 1 minute. For a pulse dose machine, this is computed by summing the volume of boluses that can be delivered on each setting. To understand this a little better, the smallest portable on the market has a total oxygen output capacity of 350 milliliters per minute and the largest units have almost 10 times that capacity at 3000 milliliters per minute (or 3 liters per minute) total capacity.

Using a Dual Mode System

Some portable systems have settings that allow you to choose either continuous flow or pulse flow on the same machine. These pulse and continuous flow units weigh more than pulse-only units. This is because dual systems requires a bigger pump/motor assembly, more electronics and larger molecular sieves. They generally weigh less than 20 pounds, and (similar to a carry-on airline bag) they all include wheels and a retractable handle.

In some cases, people opt for a pulse-dose delivery during the day and then switch to a continuous dose system at night. The reason for this choice is that at night, your breaths are shallower and some physicians are concerned that the trigger mechanism on the pulse dose machines may not be activated by this shallow breathing. If you are interested in testing whether your particular sleep style calls for continuous flow oxygen, you can ask your doctor if you would be a candidate for an overnight oximetry test.

Weight

Portable oxy concentrators are also considerably lighter in weight than a home concentrator. The lightest units on the market are a mere 2 pounds with the more powerful units weighing in at between 15 – 20 pounds. The big variation in weight is largely correlated to performance. The smaller units are all “pulse only” machines and typically have fewer settings. Units weighing over 8 pounds typically include a wheeled travel cart. Most patients cannot tell the difference between an 8 pound unit and a 15 pound unit when rolling it with its easy wheeled travel cart.

Battery Life

Concentrator Battery Life Battery life varies significantly across units, batteries, and settings. In general, the harder the machine is working the shorter amount of time the battery will last. For instance, a unit works harder on continuous flow than on pulse dose because it is continuously producing oxygen. Similarly, the unit works harder on a higher setting than on a lower setting. You can think of it a little like gas mileage - the faster you drive, the more gas that is consumed. For a portable oxygen concentrator, a battery will last the longest on a lower setting on pulse dose and last the shortest on continuous flow at a high setting.

Most portable concentrators now use lithium ion batteries. This is similar to most computer batteries which are robust and have long lives. Batteries will, of course degrade over time. Most battery manufacturers suggest a lithium ion battery can be recharged approximately 300 times without significant degradation. You can extend the life of a battery by periodically cycling it and keeping it out of temperature extremes.

The Portable Oxygen Concentrator Revolution

The POC Revolution

Portable oxygen concentrator (POC) technology has solved the problem posed by many an oxygen user’s desire to remain mobile. In the past, anyone who needed supplemental oxygen was either tethered to a long tube and cannula in their home or was required to carry heavy flammable oxygen tanks around on a wheeled cart.

The ability to concentrate oxygen continuously out of the surrounding air has been profoundly liberating, because it has freed people with COPD and other physical conditions to once again be able to resume work, socialize, travel via airplane, and much more! The positive outcome of this technology cannot be overstated.

Consider the following examples:
“The freedom of having my own unit and not constantly fighting with Medicare as to my needs was important to me.” —Howard
  1. Mrs. Jones is out shopping with her friends and has shopped a little longer than expected. With an oxygen tank, she would be worried that she could potentially run out of oxygen. Alternatively, with a portable concentrator, Mrs. Jones would simply be able to switch out her batteries. Additionally, Mrs. Jones could simply head to an establishment that has wall chargers available. We generally suggest a place where you can comfortably sit down at while your unit charges such as a restaurant, coffee shop, or book shop. The third solution for Mrs. Jones would be for her to head to her car and operate her unit with her DC power available in her cars cigarette lighter.

    Mrs. Jones is no longer constrained by her tanks running out of oxygen.
  2. Mrs. Smith would like to visit her new grandson several hundred miles away. To make this trip, she would have to load her 50 pound home concentrator in the car as well as roughly 10 oxygen tanks so she has enough oxygen for the weekend. With a portable oxygen concentrator, Mrs. Smith can easily lift and maneuver the unit with ease and the unit can easily meet her needs 24 hours a day.

    With her DC charger, she can run her unit for the entire drive; she can also use the AC, or wall outlet charger, when she arrives at her grandson’s home. If they end up leaving the house to run errands, visit family/friends, or more she can simply use her batteries.
  3. Mr. Walters loves to travel. Unfortunately, the FAA will not allow any air travel with oxygen tanks. Almost all portable oxygen units are FAA approved and Mr. Walters only needs to coordinate with the airline ahead of time and ensure he has sufficient battery life to navigate the travel between his home, the airport, flight, and his destination itself. Portable oxygen concentrators have given thousands of oxygen users the freedom to travel again.

Traveling with Oxygen

Portable oxygen technology has opened up the world of travel to patients on supplemental oxygen. Before traveling, talk with your doctor about your plans. If you will be visiting a location with a different altitude, temperature extremes, or a dusty/damp environment you’ll want to discuss the way in which it will effect your equipment and oxygen delivery.

Automobile Travel

Portable oxygen concentrators work great for automobile travel. Here are a few reminders to keep in mind:
  1. Due to the variations in a cars electrical system, even though the owner’s manuals may state that the unit’s battery will trickle charge or charge slowly, we have found that it is a good idea to check that your individual unit will specifically charge with your brand, model, and year of car before you make any travel plans. If you are unsure, we recommend you remove the battery from the unit and run the unit solely on the DC power. This maintains the charge in your battery for when you want to be mobile.
  2. It is also a good idea to periodically roll down a window in order to let the excess nonoxygen molecules and gases from your concentrator escape.
  3. Always make sure the intake port, where the air goes into your concentrator, is open. If your unit can not easily access new air, it will overheat trying to create oxygen.
  4. It is strongly recommended that passengers in the car do not smoke as it can create a severe safety hazard.
  5. Never store any of your equipment in the trunk where it can become overheated.

Airplane Travel

“The freedom this has allowed me has made me so happy. It’s like having my life back again after having been told I had severe COPD. I now have the freedom to continue the things I love doing, like golfing, gardening and traveling!” —Mike D.
Oxygen is highly flammable and old-fashioned oxygen tanks can present a fire hazard. For this reason, the FAA does not permit people with traditional oxygen tanks to fly on airplanes. Oxygen concentrators, however, are considered safe by the FAA who has now approved more than 10 portable models. If you travel by air, it is important to contact the airline you are traveling with several weeks in advance of your trip. Most airlines require additional paperwork such as a letter from your physician and documentation of your need to travel with oxygen.

When planning your trip, it is important to recognize the complete amount of battery time that will be required.

Most airlines require patients to have enough battery life to cover a minimum of 150% of flight time and a minimum of two batteries. This means if your flight from point A to point B is scheduled to take 2 hours; the airline will verify that you have a minimum of two batteries and they will last a minimum of 3 hours. This requirement is to ensure the passenger on the plane has enough battery life should there be any delays in the flight. We strongly recommend you also take into account how you will travel to the airport. Specifically, will you need to use your batteries or will you be able to use DC power in your car? If you will need to travel to the airport on batteries, you would want to make sure you have additional battery life available for the actual flight. Incrementally, we recommend planning about 2 hours in the airport before you board your plane. Some airports are smaller and you can go more quickly from the car to your airport gate but we recommend being conservative. Once you are at the gate waiting for your plane, we recommend plugging your unit into AC power. This will allow your batteries to begin to recharge (it takes about 4 hours on average to fully recharge a concentrator battery), and more importantly if you are on AC power, you are no longer draining your batteries. If you’re unable to find an electrical outlet, don’t hesitate to ask the airport personnel for assistance.

Supplemental Oxygen Airplane Travel

Choose direct flights when possible, so that you don’t have to deal with the extra stress and exertion of repeated loading and unloading of your oxygen system in cramped airline cabins. We also recommend boarding early and getting yourself settled. Remembering to take your time and follow good respiratory breathing practices is very important during the stresses of travel.

If possible, use the pulse dose setting on your oxygen concentrator while you are sitting at the airport. You will conserve oxygen more effectively when your system is running on a pulse dose setting.

Oxygen Safety

Safety precautions center on the fact that oxygen is flammable. Keep your equipment at least 2 to 3 yards away from any source of open flames. This includes gas stoves, fireplaces, candles, barbecues, and so on. Avoid potential sources of sparks, such as hair dryers and electric razors. It’s a good idea to post signs in the rooms in which oxygen is in use, to remind everyone that no smoking is allowed.

Fire extinguishers should be placed in easy-to reach spots in your home. It’s also important to keep your home smoke detectors working properly and check their batteries on a routine schedule.

Many patients on oxygen therapy notify their fire department and utility companies that oxygen equipment is in use in their home. This notification serves two purposes:
  • First, it lets the electrical and telephone companies know that you have a Priority Service Listing for times when there is an interruption in public power. Consumers with this type of listing are given special priority during outages.
  • Secondly, it lets firefighters know of the presence of a flammable gas in your home.
Occasionally, if you’re a user of stationary equipment, you may have long tubes that allow movement through the home. Be aware of these tubes as they can be a tripping hazard. To combat this we suggest wrapping the tube with brightly colored tape or purchasing our green tubing which is much more visible than the alternative clear tubing.

Accessories

  • AC Charger or Adapter – This connects your portable unit to AC power. This typically comes standard with the purchase of a unit. Replacement chargers are available.
  • DC Charger or Adapter – This connects your portable unit to DC power. This typically comes standard with the purchase of a unit. Replacement chargers are available.
  • Cannulas – A nasal cannula is the plastic tubing that delivers oxygen to the user. Tubing can be attached to the cannula which means you can move around within an area without having to move your concentrator every time. There are various models of cannulas available - the variation is in the type of cannula (for low or high flow) and the material (softness, flexibility)

    A nasal cannula is the plastic tubing that delivers oxygen to the user. Tubing can be attached to the cannula which means you can move around within an area without having to move your concentrator every time. There are various models of cannulas available - the variation is in the type of cannula (for low or high flow) and the material (softness, flexibility). If you are having trouble with your cannula, we recommend you speak to one of our specialists.
  • Tidy Tubing / Coiled Tubing – Tidy Tubing is a 14-inch long coiled piece of oxygen tubing that stretches up to 15 feet, allowing for mobility all around the home without the danger of tripping on 50 feet of hose that is lying on the floor. Tidy Tubing has a small clip on one end that attaches to clothing, and it’s possible to join up to 3 together for a total of 45’ of mobility. The coiled nature of the tubing makes it selfretracting, so there’s no need for the elusive oxygen tubing “reel” that so many O2 patients desire, but does not seem to exist.
  • Humidifiers – Most units (both stationary and portable) have humidifier kits designed to help provide moisture to compensate for dry nostrils. A humidifier kit typically consists of a water bottle, tubing and a holder (if required) . The medical grade oxygen passes over the water to absorb the moisture. A humidifier can not be used with a pulse dose machine.
  • Carry Bags – Many portable oxygen concentrators come with the option of speciallymade travel cases, protective covers, accessory bags and other highly useful carriers. It is important that you never put an operating concentrator in any bag other than the one specifically designed for it as it may limit air flow and subsequently the unit would not function properly or safely. These typically come standard with a portable unit. Replacement bags can be purchased separately.
  • Carts – Wheeled carts are available for those concentrators that are just a bit too heavy to comfortably be carried over your shoulder. These carts to make it easy for you to be mobile with your oxygen concentrator.
  • External Chargers – Also known as desktop chargers, these accessories are incredibly convenient especially if more than one battery is owned. The small size of the chargers allows them to be taken along with for travel and time on the move. These chargers can help cut your total charge time in half.
  • Batteries – Stocking up on an extra battery or two for portable devices can make all the difference in terms of your mobility.
  • Wheel Chair Packs – Several of our portable concentrators have custom designed carry bags that can easily be attached to the back of a wheel chair.

Renting vs. Buying Oxygen Solutions

Concentrators can be expensive and as such rentals are primarily intended to provide short-term oxygen for travel or special occasions. For example, if you have a family member coming to stay with you and they need supplemental oxygen during the night, you might find it easier to rent a device for their visit rather than having them pack up their non-FAA approved 50- lb oxygen concentrator as checked baggage on the airplane. Packing a concentrator in your luggage subjects it to possible rough handling by airline personale. We find it’s safest to travel with a FAA approved concentrator with you in the airline cabin, this way you can ensure its safety. Similarly, if you’re used to using a home oxygen concentrator and you have to travel abroad, you may simply want to rent a portable unit that meets the FAA requirement. Situations as such often occur when a patient is satisfied with their current solution and only need the oxygen for travel.

Buying an Oxygen Solution or Concentrator
Renting an Oxygen Solution or Concentrator

In other cases, patients find that the level of service and amount they pay out of pocket to insurance companies is not satisfactory. In such cases, patients often look to purchase their own solution. When patients pursue this option there are no longer any out of pocket charges on a monthly basis for their oxygen solution. In addition, the patient’s insurance company or provider no longer has any say in the patient’s use of their machine. When a cash purchase is made, the patient has the choice of which type of unit they wish to receive and whether they want a new or used unit.

Homecare companies and insurance companies often provide oxygen users with equipment on a monthly rental basis (typically a co-pay of some sort). When entering into this arrangement it is good to be cognizant of all the costs. Specifically, it is not uncommon for an insurance co-pay to be large enough that a concentrator could be purchased outright in a matter of months. Also worth noting is many concentrators provided via this channel can be much older, meaning much louder and less energy efficient than the newer models, which can drive up electricity costs significantly.

Oxygen FAQs

  1. Oxygen isn’t a drug; why do you only sell your machines by prescription?
    The U.S. Food & Drug Administration (FDA) makes the rules about prescription sales. At this time, oxygen concentrators are one of the medical devices for which the FDA requires a prescription. This is to ensure proper care has been taken in selling you an oxygen concentrator that is appropriate for your needs, and a prescription is the only evidence we have of exactly what those needs are.
  2. Why do I need to carry my oxygen prescription around with me at all times?
    Your prescription is a formalized way of ensuring your safety. Like all crucial medical information, you want to be sure that in an emergency, the people helping you are aware of your exact physiological need for supplemental oxygen. If you plan an airplane flight, you should notify the airline ahead of time because they may want more than just your prescription; you may be required to give them some extra certification from your physician.
  3. I was just prescribed oxygen, what’s next?
    Most people are prescribed oxygen and then a homecare provider is contracted either by Medicare or an insurance company to provide patients with long term rentals of oxygen solutions. Most providers have a specific solution they promote. The most common solution is the delivery of a home concentrator and a supply of compressed gas tanks. An informed user should know that there are many alternatives available which may or may not be covered under Medicare and/or insurance. Home care providers are not required to carry all solutions and most do not.
  4. Do I have a choice of brands?
    Absolutely. We represent all the top manufacturers and we present their products to you in an impartial, informative manner. We carry concentrators made by Philips Respironics, AirSep, Invacare, SeQual, Inogen, Inova Labs and DeVilbiss.
  5. What is a stationary concentrator?
    Stationary concentrators are intended for people who need higher volumes of oxygen, and they tend to be larger, heavier and louder than the portable units. They deliver oxygen according to the “continuous flow” method and many people use them for night-time oxygen supplementation. Some of these home concentrators have wheels to allow easy movement and cannulas upwards of 50 feet long to make maneuvering around your home easier.
  6. How many hours a day will I need oxygen?
    The answer to this question depends on your activity level, physical health, and individual lifestyle -- so the exact prescription for oxygen therapy is different for each person. You and your doctor will discuss the level of your need for supplemental oxygen and will likely specify what flow rate and schedule will give you the optimum therapy.
  7. What is a portable concentrator?
    A portable concentrator is one that can be unplugged and run off batteries for an extended period of time. Like any cordless tool, portable concentrators enable you to move about freely and pursue your normal activities. Portable concentrators are generally smaller and lighter than home concentrators and tend to have somewhat lower oxygen capacity. They generally deliver oxygen to you on the “pulse dose” method, meaning that you get one puff of oxygen each time you start to inhale. Some portable concentrators include an option for receiving oxygen by the continuous flow method as well.
  8. What is a bolus?
    A bolus is a “shot” of oxygen; one single puff. In the pulse dose method of oxygen delivery (used by most portable concentrators), a single bolus of oxygen is released by the concentrator into your nasal cannula each time you start to take a breath. By delivering oxygen only at the moment you inhale, portable concentrators avoid oxygen waste and are able to meet your needs within a smaller format.
  9. What is a sieve bed?
    A sieve bed is the filter inside the oxygen concentrator which separates out the nitrogen from the oxygen in the air. This sieve bed uses a material called Zeolite to collect all the nitrogen in the air. Typically a concentrator has two of these sieve beds, one is always working to collect nitrogen and the other is being “purged” of the extra nitrogen it has collected. The two sieve beds switch jobs every few minutes automatically, in a completely sustainable ongoing process.
  10. What is the best concentrator on the market?
    We carry concentrators from the very best manufacturers in the country and have complete faith in each model. In the sense of quality, we feel that each one of them is the best on the market or we wouldn’t offer it to our customers! The more relevant question is: Which concentrator is the best one for you? Our oxygen specialists will discuss your needs with you, to make sure you have the best concentrator for your unique situation.


Updated: January 19, 2019