Getting oxygen shouldn't be so hard

03-05-2006

By some estimates, more than 1 million Americans who suffer from pulmonary and respiratory problems depend on supplementary oxygen to sustain their quality of life. Accompanied by a tank supply of the compressed gas, many have found the freedom to move around town and even travel away from home.

Long trips clearly present logistical challenges for oxygen-dependent passengers, who must ensure they'll have an adequate supply both during the trip and once they arrive. Patients who use a regular oxygen supplier should be able to arrange for services at their destination, but canisters of compressed gas are generally not permitted on commercial air planes. Over the years major carriers have developed procedures to accommodate these passengers, at least on their larger jet craft. (Oxygen services are generally not available on smaller commuter express flights.)

Carriers offering in-flight oxygen services include American, Continental, Delta, Northwest and United. The costs, procedures and equipment varies from airline to airline. Some supply their own tanks for a fee of about $75 for each leg of the flight; others recommend a designated oxygen supplier. But all require a minimum of 48 hours' advance notice to make arrangements, along with a doctor's order specifying the oxygen need, both in liter flow per minute and whether it's continuous or as-needed.

Oxygen-dependent passengers also are asked to board planes early. They're generally put in window seats, but not in rows by compartment bulkheads or emergency exits. Bringing oxygen tanks also involves special procedures at Transportation Security Administration checkpoints.

However citing insurance issues and the risks of mishap, a number of other airlines never allow passengers to carry oxygen tanks onboard, notably Southwest, ATA, Jet Blue, and, since its merger last fall with America West, US Airways.

This policy once meant that oxygen-dependent travelers were not able to fly on these airlines, but recent developments are changing the situation.

Last August, the Federal Aviation Administration approved two brands of portable oxygen concentrators for use on commercial aircraft. Rather than relying on tanked supplies of compressed gas, these electric devices create a supply of nearly pure oxygen from the surrounding atmosphere by filtering out nitrogen and other elements and particulates.

Home oxygen concentrators have been available for several years, but they were too bulky to be mobile. Medical equipment manufacturers have been working to develop more portable models, and two brands of portable oxygen concentrators, Inogen One and AirSep Lifestyle have now been approved for in-flight use.

Weighing about 10 pounds, these devices provide a reliable, intermittent flow of supplemental oxygen, quietly running on AC current or rechargeable batteries that can provide power for between one and three hours.

Although use of these devices still requires the passenger to obtain a doctor's certificate and to notify the airline in advance, they do simplify some logistical issues involved with getting supplemental oxygen, even if they do mean having enough battery back-ups to last the whole trip.

The biggest problem is their price. While home oxygen concentrators cost under $1,000, the portable units now run between $5,000 and $7,500, a hefty investment for occasional use. Some regular medical oxygen suppliers have portable units they can lend to their regular customers, but not for renting to noncustomers.

Airlines could simplify the problem by making their own portable oxygen concentrators available to passengers. There are professional models that fit under seats, and cash-strapped carriers could certainly charge an extra fee for their in-flight use.

Passengers would still have to make other arrangements for before and after the flight, as well as during any connections, but it would be a big improvement for any travelers who need a little extra oxygen in their lives.

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