Flying with medical oxygen. A respiratory
therapist from a Vancouver hospital recently called us with the following question. We have an elderly patient with newly diagnosed CHF and COPD who is ready for discharge.
The family wants to transport her back to India, but she’ll need oxygen throughout the long trip. How can we ensure that she’ll continue receiving uninterrupted oxygen supplementation until she reaches her home in India?”
Why do families struggle to arrange medical oxygen for an international trip?
Usually, patients who need medical oxygen at home after being discharged from the hospital will find a suitable solution, even in smaller communities. Whoever is tasked with the discharge coordination will have the contact details of an oxygen supplier. Be it a respiratory therapist, a nurse case manager, or a hospital social worker, they will have a local network to consult.
Options for medical oxygen at home include purchasing equipment or short-term/long-term rentals. Large oxygen bottles are standard, or more recently, electric oxygen concentrators that can take oxygen out of the ambient air and channel it to the patient’s airways.
These home solutions are not very helpful for patients who, instead of going home after discharge, go to an airport to start a 20+ hour journey: regular medical oxygen tanks won’t be allowed onboard, and a typical oxygen concentrator for home use is too heavy and too bulky to be taken on a commercial flight.
Besides, who brings the equipment back after using it? Air travel, and particularly international air travel for that matter, asks for a different approach.
What options are available to supply oxygen onboard on a flight?
In short, portable oxygen cylinders or portable oxygen concentrators. But that sounds way
simpler than it is. The airline will supply specific aviation oxygen bottles pre-approved for commercial aircraft use, starting with oxygen cylinders.
Compressed gaseous medical oxygen is considered a hazardous material, and it can only be brought onboard passenger aircraft if there is a program for inspection and maintenance of the equipment.
The cabin crew will follow strict safety protocols for storing and handling the bottles in flight. The cost of airline-supplied oxygen on a commercial flight can vary substantially. Some airlines don’t charge oxygen, while others charge a flat fee or an amount based on the flight length or the number of oxygen bottles needed. Oxygen alone can cost as much as 1,500 dollars, independent of booked seats!
Portable oxygen concentrators, or POC for short, are smaller battery-operated devices designed for mobile patients on oxygen. They are a different ball game when it comes to air travel.
POCs can be owned by the patient, provided by an aeromedical transport company, or rented from a supplier that works with the airline. A different set of rules and conditions apply to using a POC onboard commercial aircraft.
Travelling with a POC also comes with unique challenges: enough battery packs must be carried in the hand luggage, and some POCs and battery packs are allowed, while others aren’t.
Where do you start when you need oxygen on a flight?
Airlines typically publish their requirements for medical oxygen onboard on their website. Start there. Then, ask the patient’s healthcare providers for more information on what the patient needs. Is the patient fit for travel? Can the care needs be managed while travelling?
Families often think the process is as simple as downloading the airline’s medical form, having it completed by a doctor, and sending it back to the airline. However, various factors can make medical oxygen onboard a complex undertaking. If not handled by professionals, the airline approval process can become a frustrating and lengthy experience.
While the doctors, nurses, and respiratory therapists on the ground know the patient best, it is often beneficial to involve an aeromedical company as well. They know the airlines best and transport patients daily onboard commercial flights.
Because these aeromedical transport companies specialize in transporting patients onboard commercial flights, they are experts in solving transport problems like in-flight oxygen. They are familiar with the process behind airline medical clearance and the conditions different airlines impose before accepting a passenger who needs oxygen onboard the flight.
Why is a medical escort recommended when flying with oxygen?
The need for medical oxygen on a commercial flight typically goes hand in hand with other care needs: wheelchair assistance, mobility, medication, toileting, and considerations to avoid overexertion and prevent the patient’s condition from worsening.
The flight environment is challenging for patients who suffer from respiratory illness: they’ll work harder to breathe at a high altitude, especially on a long flight, and they might need extra medication, vital signs monitoring, close observation, and adjustments of the oxygen flow at times based on changes in the patient’s condition.
There is always the risk of a medical emergency; a medical escort can intervene and prevent smaller problems from escalating. Sometimes, the airline will only transport a patient if a medical escort is hired.
But even if it is not a hard requirement, it can be comforting for the patient and the family to know that a medically-trained professional is taking responsibility for patient care for as long as the journey takes.
The alternative would be to rely on the judgment and intervention of untrained family members, cabin crew, or random bystanders.
Other than a medical kit, medical escorts also carry company-provided POCs that are lightweight, compact, and pre-approved for travel with airlines at no extra cost for the patient, resolving the problem of organizing medical oxygen for the trip.
Conclusion
In the patient’s case in Vancouver, the respiratory therapist put the family in contact with Jet Companion to organize the transport to India. The family left dealing with the airline approvals to our case managers.
A few days later, all the paperwork was in place, and one of our flight nurses arrived at the bedside. The long journey to India was uneventful, and all the family had to do was rent medical oxygen equipment for long-term use from a local supplier at home in India. Contact us today and see how we can help you.