Frequently Asked Questions

Supplemental oxygen is a medical treatment that manages and provides extra oxygen for people with hypoxemia (shortness of breath) and breathing difficulties.

When is the right time to start talking with your physician about Supplemental Oxygen?

• • If you are regularly feeling shortness of breath while doing simple tasks. For example: Climbing stairs or walking up an incline
  • Experiencing fatigue, irritability, confusion, morning headaches
  • Some patients may not experience specific symptoms even when without sufficient oxygen.

What are the potential benefits of using supplemental oxygen?

• • Reduces breathlessness
  • Increases one’s ability to stay in an active lifestyle
  • Reduces stress on other organs

Oxygen levels:

• Your physician will test your need by measuring your oxygen saturation level while you are at rest, walking or exercising, and/or during sleep.

6-minute walk test:

This test is commonly used to determine whether you need supplemental oxygen when you are active. During this test, performed at a physician’s office, you will walk 6 minutes while your oxygen levels are monitored with an oximeter.

• Your oxygen level and blood pressure will be taken before you start the walk.
• Readings on oxygen levels are recorded throughout the test and when the walk is completed.
• Supplemental oxygen is generally needed when a patient’s saturation falls under 88 on a pulse oximeter.

• It is important to maintain communication with your physician, letting them know of any symptoms you are experiencing to identify potential supplemental oxygen needs more easily. Make sure you talk with your physician about your lifestyle to decide which equipment will suit you best.
• Your physician will order the appropriate tests. Be sure to look at what your insurance covers and have this discussion with your physician prior to testing.
• Your physician will provide you with a prescription and will typically contact a company that takes your insurance. The referral is often general, so a discussion with your provider on your specific needs, including travel, would be helpful. Oxygen companies can differ in what they are able to accommodate, so choosing the right one up front is important.

Oxygen suppliers and insurance companies are to provide:

• The recommended oxygen system, including equipment and disposable supplies ( ie., nasal cannulas, tubing, and/or oxygen concentrator humidifier bottle).
•  24-hour emergency service for equipment malfunctions or power outages.
• Education on the proper and safe use of your equipment. When they come to your home ask them to show you how to work the equipment.
• The oxygen supplier will verify your insurance and bill your insurance provider.

When equipment is delivered, ask the delivery setup person to talk you through the basics of maintaining equipment and how to use. They are supposed to check equipment function periodically.

Pulse vs. Continuous Flow

Pulse flow delivers oxygen based on the wearer’s inhalation, but it does not provide oxygen for every breath, meaning the actual amount received may be less than expected. Additionally, pulse settings do not equate to liters per minute, and oxygen delivery is not instantaneous. In contrast, continuous flow provides a steady, uninterrupted supply of oxygen.

Oxygen Systems

There are two types of oxygen systems: In-home stationary unit and a portable system for travel outside the home.

Stationary Unit / Home Concentrators

• Pulls oxygen from the air in the room to produce concentrated oxygen delivered through the oxygen tubing.
• Equipment typically stays in the room where it is set up. The concentrator puts out heat and loud noise.  The long tubing provided by the supplier will allow you to move around your home.
• The cost of electricity to run an oxygen concentrator is not covered by insurance. This expense is tax deductible in some situations (ask a tax professional to determine your situation).
• All stationary units are continuous flow units. They are up to 5 liters/minute continuous or up to 10 liters/minute continuous.

Portable Units

Compressed gas tanks

• Green and Silver (aluminum) tanks filled with compressed oxygen gas.
• Tanks can vary in size. Choose the size that will work best for your lifestyle.
• A regulator will be provided, which will attach to an oxygen tank, allowing the patient to set the desired flow rate while in use. Each regulator has a control knob to set the oxygen flow rate and a content gauge to show you how much oxygen remains in the cylinder.]
• Is your body able to handle a backpack or shoulder bag to be hands-free? Tip: Having a strong back and keeping up with exercise ensures your ability to carry.
• Larger E tanks that are pulled on carts are difficult to maneuver on uneven surfaces, difficult to load in your car, and don’t allow you to be hands-free.
• Some compressed gas tanks can be filled at home with a concentrator filling system. These are special tanks that only work with a home-fill concentrator system.
• If a supplier only provides a home-fill system, they provide limited tanks. Negotiate with the supplier to provide more tanks.
• If preferred, an oxygen-conserving device (OCD) regulator can be attached to an oxygen tank and can help patients conserve the amount of oxygen they are using in place of a traditional oxygen flow regulator. It optimizes oxygen delivery by releasing oxygen only during inhalation and prolongs the duration of the oxygen supply. A prescription is required to use an OCD.
• When traveling, you can carry this with you, but it is very heavy, weighing between 30 and 50 lbs.

Portable Oxygen Concentrators (POC)

Typical POC’s are pulse only (pulse flow delivers oxygen in short, intermittent bursts that are synchronized with the patient’s breaths). There are limited POC’s that have continuous flow as an option.

• POC’s run typically on rechargeable batteries. Battery life depends on the size. Generally, the smaller the unit, the lower the oxygen output and the shorter the battery life.
• POC’s can be recharged via a wall plug or car adapter.
• Most pulse POC’s are not cleared for sleeping.

Oxygen Cannulas

Oxygen cannulas come in different lengths (4’, 7’, 25’, and 50’) and provide different prong types (soft prongs, long prongs, and short prongs).

• Prong types are a matter of personal preference, allowing you to choose the option that best fits your nose, whether long or short. Soft prongs offer enhanced comfort and are less likely to cause irritation.
• Oxymizer Pendant: This device is optional. With a standard cannula, oxygen flows continuously during both inhalation and exhalation, resulting in wasted oxygen during exhalation. The Oxymizer Pendant, however, captures the oxygen released during exhalation in a reservoir disc and delivers it with the next breath. This provides a higher concentration of oxygen than the flow rate setting alone would indicate. As a result, users can achieve the same oxygenation at a lower flow rate, extending the duration of their oxygen supply.

• Portable Oxygen Concentrator (POC) is the accepted type of oxygen system that can be used on airplanes.
• You must contact the airline ahead of time to ensure you can bring your POC on the plane. Not all models are safe for air travel.
• Ensure your POC has a fully charged battery before traveling and take advantage of charging stations in airport terminals between flights.

There is a new FAA rule about flying with oxygen. Please check your battery and find out what the watt-hour rating is. It has to fall below the 160 maximum allowed by FAA, or your battery may be banned from the flight.

• The Inogen One G5 double (16 cell) battery is 188.8 watt hours. The Inogen One G5 single (8 cell) battery is 92.2 watt hours, which is under the new FAA limit. The Inogen One G4 double is 92.2, and the Inogen One G4 single is 46.1 watt hours.
• The SeQual Eclipse battery is 195 watt hours.
• Check the watt hours on your battery or call whoever provided your equipment to find out the watt hours of your battery. Click here for more information.

• Avoid flames, sparks, cigarettes, matches, lighters, gas stoves, etc.
• Secure oxygen tanks to prevent them from falling.
• Do not store tanks near heat sources or in direct sunlight.
• Do not use cracked or broken tanks.
• Place the stationary concentrator in a well-ventilated location.
• Do not store items on top of the concentrator.

• Running On Air– A Non-Profit organization that focuses on advocacy and education around supplemental oxygen and lung diseases.
• American Lung Association
• Pulmonary Fibrosis Foundation– Oxygen Therapy Information
• Medicare Patients’ Oxygen Rights
• American Thoracic Society
• SOAR Act– Advocacy: Oxygen Reform Bill to ensure supplemental oxygen is patient-centric, ensure access to liquid oxygen for patients whom it is medically necessary, creates a statutory service element to provide adequate reimbursement for respiratory therapists, and ensures predictable and adequate reimbursement and to protect against fraud and abuse.