Thursday, October 29, 2009

Traveling with Portable Oxygen: Carefully Prepare in Advance

I just found out how complicated it can be to travel with portable oxygen. My friend Mr. D. asked me to accompany him as a medical companion on a trip by air across country. In advance of our departure, the organization we were traveling with arranged everything at no cost to Mr. D.  Included was the delivery of a portable oxygen concentrator from the local medical supply store (this machine provides a high concentration of oxygen mechanically, without a metal oxygen cannister). Meanwhile, I had already consulted Mr. D's doctor to obtain a prescription for oxygen to cover his use of the device while on this trip.

The group we were part of, a local chapter of the Honor Flight Network, had dealt with oxygen issues before, but on a different airline. Still, everything seemed to be in perfect order.  Our portable oxygen concentrator was clearly marked as appropriate for airline use. I had the complete manufacturer’s manual for the concentrator in hand, along with Mr. D’s current doctor’s prescription for the use of supplemental oxygen. Mr. D’s respiratory condition is quite stable; he is often "fine" on room air, but he does need some extra support from time to time (especially if he is exerting himself too much or in case of anxiety.) The battery on our concentrator was fully charged, and we had a portable (cigarette lighter) charger with us as well. Mr. D hasn’t flown for quite some time, and we honestly didn’t know whether or not he would need the extra oxygen while in-flight, but we wanted to be sure to have it on hand for our very active day in Washington D.C.

At our departure security screening, the TSA representatives x-rayed our portable oxygen concentrator and took it away briefly to perform further routine safety tests. They returned it without comment and we were on our way. The concentrator went into the cabin with us, neither the gate attendants nor the flight attendants commented on it at all, and we would have used it in flight, but Mr. D. didn’t need it. Fortunately, during our day trip in the nation’s capital, no member of our group (consisting of mid-80 to mid-90-year old veterans and their younger traveling companions) required any supplemental oxygen. When we departed late that evening for the trip back home on the same airline, the TSA portion of the boarding process was identical to that morning. However, the airline gate attendants informed us as we boarded the plane that while the oxygen concentrator could go with us in the cabin, it could NOT be used in flight, because we were lacking some very specific documentation that their airline requires.

Fortunately, Mr. D. was once again just fine without extra oxygen. However, this experience informed me that other travelers using supplemental oxygen might not be so lucky. In doing a bit of research it appears that various airlines have significantly different rules and regulations for the use of on-board oxygen. Individuals who are using several airline carriers for connecting flights are obviously particularly vulnerable to travel delays (or worse) if they are not adequately prepared in advance of their trip.

Oxygen Freedom a website that includes links to many major airline’s travel oxygen policies.  Be sure to read exactly what your carrier requires well in advance of your trip. (Their site also offers links to major transportation providers useful for those who are going to travel by bus, cruise ship, or train.)

Hightlighted below are direct quotes from the Transportation Safety Administration's (TSA) website which offer the low-down on air travel with oxygen in the U.S. from the TSA's point of view:

Medical Oxygen and Respiratory-Related Equipment. Supplemental personal medical oxygen and other respiratory-related equipment and devices (e.g. nebulizer, respirator) are permitted through the screening checkpoint once they have undergone screening. Any respiratory equipment that cannot be cleared during the inspection process will not be permitted beyond the screening checkpoint.

Persons connected to oxygen. Inform the Security Officer if your oxygen supply or other respiratory-related equipment cannot be safely disconnected. Only you can disconnect yourself to allow for your oxygen canister/system to be X-rayed. Check with your Doctor prior to coming to the checkpoint to ensure disconnection can be done safely. If your Doctor has indicated that you cannot be disconnected or if you are concerned, ask the Security Officer for an alternate inspection process while you remain connected to your oxygen source. Infants will remain connected to their apnea monitors throughout the screening process. Apnea monitors will be screened while remaining connected to the infant. Oxygen equipment will either undergo X-ray screening (only disconnected oxygen equipment) or physical inspection, and explosive trace detection inspection.

Oxygen suppliers or persons carrying oxygen supply. An oxygen supplier or personal assistant may accompany you to the gate or meet you at the gate once they have obtained a valid gate pass from the appropriate aircraft operator. Persons carrying his/her supply must have a valid boarding pass or valid gate pass to proceed through the security checkpoint. Oxygen being carried by the supplier or person will either undergo X-ray screening and explosive trace detection sampling.

Oxygen and Arrangements. Passengers are responsible for making the arrangements with: (1) The airline(s) for supplemental Oxygen onboard the aircraft, and (2) Local providers for oxygen use during any layover stop(s) and at the final destination, (3) The airline, friends, relatives or a local supplier for removal of the canister from the originating airport's gate area immediately after you leave the gate area to board the aircraft. You must make similar arrangements for your return trip. Please, check the procedures outlined below for details. More information on airline accommodations for oxygen users can be found at the National Home Oxygen Patient's Association  web site. You can also download the "Airline Travel with Oxygen" brochure. This publication provides valuable information on traveling with oxygen, including airlines that do and do not provide in-flight supplemental oxygen.

When You Make Your Reservation. Arranging for Supplemental Oxygen (O2) Aboard the Aircraft. Neither the Air Carrier Access Act nor the Americans with Disabilities Act require airlines to provide oxygen service. Consequently, airline policies, procedures and services on accommodating passengers who use supplemental oxygen vary widely. Notify the carrier when you make your reservation that you will need to use supplemental oxygen aboard the aircraft(s). Ask about the airline's policies on the use of supplemental oxygen onboard. Federal regulations prohibit airlines from allowing passengers to bring their own oxygen canisters aboard to use during the flight. Passengers who use oxygen canisters must purchase canisters from the airline for use during the flight. However, some airlines do permit passengers to bring aboard oxygen concentrators, which do not contain oxygen, and use them during the flight. Policies vary from carrier to carrier, so be sure to check with your airline well in advance.

Keep in mind that not all airlines offer supplemental oxygen service, or may not offer it aboard all their aircraft. Inquire whether: 1) the airline provides oxygen service, 2) it is available on the flights you wish to take, and 3) you must provide a doctor's letter, or permit them to contact your doctor directly to verify your medical need.

Arranging for Supplemental Oxygen during Layovers or at Your Destination.  Notify the carrier(s) you are traveling with that you will need oxygen at the airport(s). Let them know that your oxygen supplier will be meeting you at the gate with an oxygen canister. Ask about their policy for allowing oxygen suppliers to meet you at the layover airports and/or at your destination gate. Contact your oxygen supplier and request that they make arrangements for your oxygen at the city or cities you'll require. The supplier will need to know the airline(s) you'll be using, departure and arrival dates and time, departure and arrival gates, flight number(s), arrival time(s), and the equipment you will need. Make all these arrangements as soon as possible. If a representative from the oxygen-providing company is going to meet your flight with an oxygen canister, arrange for your flight(s) to arrive during the supplier's normal business hours, if possible. Also, have a local phone number and a contact person in the event of any unforeseen situation(s), such as if their representative is not at the arrival gate when you get there.”

What I Should Have Known in Advance

We flew with Southwest Airlines.  Their website provides specific guidelines about the use of oxygen on their planes.  The prescription I obtained for Mr. D. is nowhere near meeting the three specific criteria that their policy requires. 

In fact, Southwest's policy requires that specific details about the passenger's portable oxygen concentrator be provided when the initial reservation is made.  Further, the passenger must have a letter from his/her physician on letterhead with an issue-date of no more than one year prior to flight departure date.  (This document will only be accepted if it is printed on the physician’s letterhead, a basic template for physicians to follow is available here for download.) The doctor's letter MUST include three specific details: (1) Whether the user is able to operate the device and recognize and respond appropriately to its alarms, and if not, that the user is traveling with a companion who is able to perform these functions, (2) The phases of the flight (taxi, takeoff, cruise, landing) during which use of the device is medically necessary, and (3) The maximum flow rate corresponding to the pressure in the cabin under normal operating conditions. (Cabins are pressurized to an altitude of 8,000 feet.)

Travel Tip:  Have at least two nasal cannulas on-hand.  Mr. D. brought his own tubing/cannula sets.  It was a good thing, because the medical supply company had forgotten to include tubing with they delivered the concentrator.  By the time we actually received the device, it was much too late for us to get tubing from them.

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justin said...

Thank you for that information. I am going to send this article to my grandpa. He is going to be visiting me soon, and I know he had expressed some concerns traveling with his I think that Portable Oxygen. I am glad that the FAA finally cleared portable oxygen concentrators for travel.

Yashwant Naik said...

nice one thank you for sharing...

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