Traveling With Oxygen

Portable Oxygen: A User's Perspective

You are here because you or a loved one is on oxygen therapy. At some point a physician tested you to see if your body organs were getting enough oxygen. But, you didn't need to be tested. You already knew that something was wrong. You found yourself out of breath after doing simple tasks. Your coughs were productive with yellow sputum. You got lung infections that required hospitalization. One of two things happened next: 

• A nurse walked you around with a thing on your finger, which the both of you watched display the digits 91, 90, 89, and finally, 88--the "magic" number, or

• The nurse took blood from an artery in your wrist and had it analyzed.

Whichever occurred, you sat there as your doctor wrote a prescription for oxygen. The moment you reached home you found an oxygen provider at your door, delivering the equipment and tubing, and providing you with verbal instruction. Surrounded by equipment and with a new instruction manual in hand, you watch in bewilderment as the driver backed out of your driveway and disappeared.

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Oxygen on a Cruise

8/8/2004
from the New York Times

Q. I have chronic obstructive pulmonary disease and use an oxygen concentrator when I sleep. Will I be able to travel on a cruise that originates and ends in New York and goes to Nova Scotia and several New England ports? -- Peggy Lambeth, Greensboro, N.C.

A. Although the requirements of cruise lines vary, they typically call for having you or your travel agent get in touch with them in advance; sometimes a note from a doctor is required. Oxygen concentrators, which are about the size of an under-the-counter refrigerator (depending on the model), seem to be the easiest for cruise lines to deal with. But since concentrators rely on electricity, it is prudent for users to have accessible a nonelectrical source of oxygen -- such as an E-type cylinder -- should there be a power failure. The concentrator in dealing with the lung disease you mention -- which generally involves emphysema and chronic bronchitis either alone or together -- makes up for the decreased ability of the lungs to take in oxygen. Here's a look at the policies and sailings of some major cruise lines that run trips including the ports you mention and focusing on those leaving in September and October, when fall foliage is a popular attraction. Carnival Cruise Lines, www.carnivalcruiselines.com, (800) 227-6482, has no limits on the form of oxygen used, but asks that passengers contact its guest access services department at (305) 599-2600, extension 70025, before the cruise. It also requires that oxygen be delivered only by medical supply companies. Weeklong cruises on the Carnival Victory depart weekly from Sept. 11 to Oct. 2. Celebrity Cruises, (800) 437-3111, www.celebrity.com, imposes no limits on the kind of oxygen passengers can take aboard. If the supplier is a company other than CruiseShipAssist, Celebrity asks for the name of the person who will be delivering oxygen to the passenger's cabin and picking it up so that it can do a background check. The Constellation departs Sept. 20 for 11 days, Oct. 1 for 10 days and Oct. 11 for 13 days. The Cunard Line, www.cunard.com, (305) 463-3000, allows oxygen concentrators without advance notice. The Queen Mary 2 departs on 12-day cruises Sept. 17 and 29. Holland America Line, (877) 724-5425, www.hollandamerica.com, allows passengers to take their own oxygen concentrators aboard. But oxygen can be delivered to a ship only through one of Holland America's vendors, Advanced Aeromedical and CruiseShipAssist (see details below). The Rotterdam departs on Oct. 20 for 10 days. Princess Cruises, www.princesscruises.com, (800) 774-6237, asks that passengers fill out a health questionnaire in advance and that the passenger or agent arrange for delivery of equipment. The Grand Princess departs between Sept. 12 and Oct. 24 for seven-day cruises. Silversea Cruises, www.silversea.com, (800) 722-9955 or (954) 522-4477, requests that passengers provide a doctor's letter and get in touch with the line's special service department, which handles passenger needs case by case. The Silver Whisper departs Sept. 30 for eight days. The provider you now use may be a source for oxygen, assuming the line you are using has no objection. Among the other sources for renting an oxygen concentrator for a cruise starting and ending in New York -- including delivery to the ship and pickup -- are these:

Advanced Aeromedical, (800) 346-3556, www.aeromedic.com, has focused on oxygen and mobility equipment for 12 years. Cost: $412.50 for one week, $440 for two weeks. An E-cylinder setup -- including cart, cylinder, cannula (or tubing) and regulator -- is an extra $75.

Traveling with Oxygen
Tips for Safe Travel with Medical Oxygen

Updated May 26, 2009
by Angela Morrow, RN, About.com Guide

Traveling with oxygen may seem intimidating. With a little planning, however, it can be easily -– and safely -- done.

Before you begin to plan any kind of travel with oxygen, you'll first need to get clearance from you physician for travel. You'll want to have his support and expertise to help with your travel plans. You may also need him to sign a letter for the airline, train, bus, or cruise line you'll be traveling with.

After you've obtained a physician's clearance for travel, you'll need to know the regulations and restrictions of traveling with oxygen. Whether your traveling by car, bus, or plane there will be some rules to follow and practical things you can do to make traveling with oxygen as easy as possible.
Traveling with Oxygen by Car

If you are traveling by car and your vehicle is large enough to transport your oxygen concentrator, you can bring it along with you and use it when and wherever you have electrical outlets. You can carry portable oxygen, which has become quite light and easy to use, for use while in the car and wherever you don't have access to electricity.

Talk with your oxygen supplier about how much back-up oxygen you'll need. They can also help you arrange for oxygen pick-up from another source at your destination if you can't bring your concentrator along. You'll also want the number of an oxygen supplier at your destination anyway in the event you have a malfunction or other oxygen emergency.

It's important to store your oxygen out of direct sunlight and away from any heat sources. Of course, no one should smoke in the car while it's transporting oxygen.

Airline Travel and Portable Oxygen
The Federal Aviation Administration (FAA) requires that any person traveling with oxygen submit a letter from their physician stating their need. The FAA has approved two types of portable medical oxygen devices and allows airline passengers to carry them on the airplane. The two oxygen devices, manufactured by AirSep Corporation and Inogen, Inc., work by filtering nitrogen from the air and delivering concentrated oxygen to the user. Because the devices do not carry compressed oxygen, they aren't considered hazardous to flight safety.

If you're traveling by plane, check with your oxygen supply company to see if they carry one of the two portable oxygen devices. You will need a doctor's order for portable oxygen so be sure to bring this up when you are discussing your travel plans with your physician.

Some airlines may not allow passengers to carry on the FAA approved devices and require, instead, that passengers use the airline's on-board oxygen. Others may allow passengers to use their own oxygen on the runway but switch to the plane's oxygen once on board. Be sure to check with your airline well in advance of your flight to see what their rules are and to make necessary arrangements.

More airline safety tips from About.com's Guide to Air Travel.

Traveling by Bus or Train
Bus and trains lines vary in their rules and regulations. Most bus lines will allow carrying on portable oxygen but you'll need to check with them in advance of your trip. Some train lines may permit you to bring oxygen on board but require you use your own generator for power. Always call the bus or train line you're planning to use as far in advance of your trip so you can plan accordingly.

Oxygen on Cruise Lines
If you're feeling adventurous enough to try a cruise, you might be surprised to find how easy most cruise lines make traveling with oxygen. Many cruise lines will provide oxygen while others will allow you to bring your own. If your bringing your own, you'll want to work with your oxygen supply company to calculate how much back up oxygen you'll need to bring.

Work with the travel agent who is helping you plan your cruise to arrange your oxygen needs. She can help you arrange for oxygen pick up at various ports if you can't bring enough on the cruise line with you to last the duration of the trip.

More medical tips for Traveling on a Cruise

Have Fun!
Once you've done your homework and advance planning, you can feel confident that your oxygen needs will be met. Now it's time to enjoy the fruits of your labor and have a great vacation!

Crystal Cruise Lines

Medical Services:
Medical staff are on call 24-hours a day. The professional services of this staff, as well as certain medications, are available on board at reasonable costs. Guests requiring ongoing medication, or having specific dietary needs, are advised to bring an ample supply of medication or dietary supplements with them in their carry-on luggage.

Portable oxygen tanks and concentrators may be used on board, provided Crystal Cruises is notified in writing, in advance, that a guest is bringing his or her own oxygen equipment, and has made direct arrangements with an independent medical contractor who has agreed to undertake all required arrangements without involving the ship's onboard Medical Center and its personnel. The oxygen-dependent guest must travel with a companion who is also completely familiar with the operation of the concentrator.

Oxygen-dependent guests are limited to those cruises on which they can be properly supported by equipment vendors and which have itineraries that will easily allow medical disembarkation if it should be required. The number of oxygen-dependent guests using portable equipment is very limited on any cruise. Requests for oxygen equipment for a specific cruise will be processed in the order of date received.

10 Travel Tips for Patients
Traveling with a Serious Illness

Updated May 18, 2009
by Angela Morrow, RN, About.com Guide

Being a palliative care or hospice patient doesn’t necessarily exclude you from traveling. This could be the perfect time to take that vacation you’ve always put off or travel to see special friends or relatives. If you’re considering taking a trip, there are some important things to consider to make sure it's as safe and pleasant as possible. Here are 10 travel tips to get you started.

1. Clear travel plans with your doctor.

   It’s important to work closely with your physician to plan your vacation. You’ll first want to get his clearance that travel is safe and feasible for you. He can help you devise a travel plan that will take into consideration your special needs and prepare for any unseen emergencies that could arise.

   Inform your physician that you wish to travel, where you’ll be going, and how you’ll get there. Review the rest of the travel tips below with him to make sure your travel plans are as safe and comprehensive as possible.

2. Find a local hospice or palliative care physician at your destination.

   If you are a hospice patient and will be taking an extended vacation, you may want to consider transferring hospices for the time you’ll be away. Finding a hospice in the area that you’ll be staying in and enrolling in their program for the time you’ll be there can ensure that there is no interruption of your care. You’ll still have nurses to check in on you and someone to call in the event of an emergency. You’ll also feel confident that you can easily get medication refills or new prescriptions for any symptoms that arise.

   If you’re not a hospice patient but under the care of a palliative care physician, you can work with your doctor to find a physician in the area where you’ll be going. Your current physician can speak to the new one and send her any information she may need in case she needs to take over your care while you're there. Again, this is a way for you to feel confident that you’ll get the care you need when you need it most.

3. Find a local pharmacy where you’ll be traveling.

   Have the name and number of a local, preferably 24 hour, pharmacy where you’ll be staying. If your vacation is relatively short (one week or less), this may be sufficient to make sure your needs are met. Give the name and phone number of the pharmacy to your hospice agency or palliative care physician. This way, if you have any new symptoms or need emergency refills of existing medications, they will have the information to call in a prescription for you.

   If your traveling out of state, a prescription from you physician may not be valid. This is another good reason to find a hospice or palliative care physician where you'll be staying.

4. Stock up on important medications.

   The best way to make sure you won’t need to use a new pharmacy is to have plenty of medication with you when you travel. Ask your physician for refills if you need them and make sure you have at least one weeks worth of medication longer than you’ll be staying. For example, if your vacation is expected to last one week, you’ll want at least two weeks worth of medication. Having an extra supply on hand will ensure that you’re covered if your vacation needs to be extended or if your dose needs to be increased while you are away.

5. Travel safely with medications.

   The safest way to travel with medications is to make sure it is with you at all times. If you are flying or taking a train or bus, don’t leave your medications in your luggage; carry them in a bag that you keep with you at all times. Keep all your medications in their original bottles to avoid any medication errors.

6. Prepare to travel with oxygen.

   If you will be traveling with oxygen, it’s important to research the applicable rules and regulations. Airlines are the strictest about traveling with oxygen and each airline has different rules. Be sure to ask the airline, bus, or train that you’ll be traveling on about their regulations and restrictions.

   Regardless of how you travel, the most important thing for you to do is arrange oxygen therapy where you’ll be staying. Find a local oxygen supply company and arrange delivery or pick up of an oxygen concentrator and for any refills needed for your portable tanks.

   For more in depth information about traveling with oxygen, see Tips for Traveling with Oxygen

7. Have a plan in place in case of emergency.

   What if your condition worsens while you’re traveling? What if you become too weak to travel back home? What if you need be hospitalized while you’re there?

   These aren’t easy scenarios to consider but there is no sure way of knowing that something like this won’t happen. It’s best to consider the worst case scenarios and have a plan in place should something go wrong.

8. Consider nutrition.

   Decreased appetite and weight loss are often unavoidable side effects of serious illness. If you’ve been struggling with this, you’ve probably already found a system that works for you, whether it’s frequent small meals of palatable foods or meal supplement shakes. Keep nutrition in mind when traveling to make sure you maintain optimal nutrition.

   Carry some meal supplement shakes with you in your luggage and find a store where you’ll be staying to replenish your supply. You may want to talk to friends or relatives your visiting to warn them of your food aversions or meal requirements. Ask them have plenty of your favorite foods on hand so you’ll always be able nourish yourself.

9. Make sure you have plenty of support.

   Vacationing in good health is often draining; traveling in poor health can be down right exhausting. Make sure that your travel companion is capable of helping and supporting you for the duration of your vacation. It’s also helpful to make any friends or relatives you’ll be visiting aware of your current physical state and any limitations you have. This will allow them to prepare whatever they need to fully support you during your stay.

10. Have a great time!

    You’ve gone through a lot of planning and preparation to get ready for this trip. You’ve covered all your bases and have a plan in place to make sure you’re as comfortable and safe as possible. Now you can sit back and reap the rewards. Enjoy your vacation and the company of your loved ones!

TSA (Information)

120-95 - Portable Oxygen Concentrators
Date Issued: October 23, 2007
Responsible Office: AFS-200
Description: This advisory circular (AC) summarizes Federal Aviation Administration Flight Standards Service (AFS) Safety and Enforcement Policy about the use of portable oxygen concentrators (POC) onboard aircraft: AC 120-95.pdf (PDF)

Question: Can I take a my own portable oxygen tank on the plane with me?

Answer: You may not bring a portable compressed oxygen tank on a commercial airline flight. Oxygen is considered a hazardous material. However, if the air carrier agrees, a passenger can provide their oxygen tank to the air carrier 48 hours ahead of the flight to examine and test the oxygen equipment to assess its integrity. If the air carrier agrees to test the oxygen equipment and determines it is safe for use, the air carrier will return the device to the passenger for the flight. No air carrier is willing to accept the safety and liability risks of permitting passengers to carry on and use their personal oxygen tanks during commercial flights without their approval.

Airlines may let you carry a portable oxygen concentrator approved for use by the Federal Aviatin Administration. These are not hazardous as they work by filtering nitrogen from the air and delivering oxygen in concentrated form.

Also, some airlines do provide oxygen to passengers at a charge, although they are not required to do so.

Please check with your airline before you purchase your ticket to ask if they will test your oxygen tank for safety, let you carry the specified oxygen concentrators, or if they will provide oxygen to you.

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:

* The airline(s) for supplemental Oxygen onboard the aircraft.
* Local providers for oxygen use during any layover stop(s) and at the final destination.
* 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 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 O² supplier will be meeting you at the gate with an O² canister.
* Ask about their policy for allowing O² suppliers to meet you at the layover airports and/or at your destination gate.
* Contact your O² supplier and request that they make arrangements for your O² 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 O² 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.