Frequently Asked Questions

Supplemental Oxygen FAQ

What is supplemental oxygen?

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
What factors are used to determine if supplemental oxygen is needed?

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.
What is the physician’s role in my journey with supplemental oxygen?
  • 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.
What is the role of the oxygen supplier and insurance?

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.
How do I manage my equipment?

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.

What are the different types of oxygen equipment?

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.
  • When traveling, you can carry this with you, but it is very heavy, weighing between 30 and 50 lbs.

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.
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 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.
What do I need to know when flying with oxygen?

Only POCs meeting FAA Regulations Allowed

You can only use an FAA approved portable oxygen concentrator (POC) on an airplane.  No other form of supplemental oxygen is allowed.  While there is a list of POCs on the FAA’s website, it is an out dated list that was last updated in February 2021.  The FAA no longer “approves” POCs.  They have issued guidance as to what constitutes a POC that is allowed on a plane, leaving it to the manufacturers to say their POC is FAA approved.  All POCs listed on our comparison chart are currently manufactured POCs meeting FAA requirements.  Click here to see the FAA’s list of previously approved POCs and the criteria for new POCs to meet FAA regulations.

Newer POCs Must Be Labeled
POCs not on the FAA’s list that meet the FAA requirements must have a sticker in red with:
“The manufacturer of this POC has determined this device conforms to all applicable FAA acceptance criteria for POC carriage and use on board aircraft.”

Flying Requirements – Planning Ahead

​T​he FAA requires that you have 150% battery for your flight time.  This means if you have a 4 hour flight, you need to have at least 6 hours of batteries with you.  This is so you don’t run out of batteries if there’s a delay.

All extra batteries must be individually contained to avoid contacts that could start a fire.

All batteries must be carried on.  They cannot be checked.

Litium-ion Battery Regulations

Based on the watt hours (Wh) the regulations state:

0-100 watt hours – There is no limit to the number of batteries.

101-160 watt hours – Only three batteries are allowed, with the airlines permission. One attached to the POC and two extras.
Batteries over 160 watt hours are not allowed.

Current Issue with POC Double Batteries

For about a year now there have been scattered reports of airlines questioning the watt hours of double batteries.  More recently passengers with “FAA approved” POCs have run into issues and have been denied entry onto planes with these batteries.  There are two double batteries that are in question and one triple battery that is between 101 -160 watt hours.

While the FAA and TSA have guidance on lithium-ion batteries for some specific devices, to date there is no specific guidance on POC “double” batteries.  Running On Air is working on getting clear guidance so oxygen users won’t be surprised at the gate and denied entry onto planes.

Caire Sequal Eclipse
The most affected POC is Caire’s Sequal Eclipse.  This POC, in it’s various versions, has been listed as FAA approved.  There is only one battery for the Eclipse 5 and it is listed as having two 98.9 Wh batteries in the same casing.  Caire says the double battery, or power cartridge, contains two electrically isolated battery packs with isolated safety circuitry, thus complying with FAA regulations.  However, some airlines are saying these batteries are 197.8 Wh.  Unfortunately, this double battery is the only one available for the Eclipse.

Inogen G5, Rove 6 and OxyGo Next

Similarly, the Inogen G5 and Rove 6, and OxyGo Next are also affected, however, it is just their largest battery.  Their double, or extended, battery is presented in the same format as the Eclipse, as two 92.2 Wh.  Some airlines are saying these batteries are really 184.4 Wh.  The single batteries are fine as they are under 100 Wh.

Rhythm S3, S4 & Arya Mini

​Rhythm S3 and S4, and Arya Mini also have an issue with their largest battery in that you can only bring three of them with the carrier’s permission.  Their largest battery is over 101 and under 160 Wh.

Specific Airlines

While the FAA has its regulations, airlines can make their own policies on what’s required, including prior approval and documentation.  While we are providing the links to various airlines’ oxygen policies, it is important to note that as of April 11, 2025, none of their pages specifically say they don’t allow the double battery, even though some, like Delta, have a no double battery policy.  We strongly suggest you check with the airline EVERY time you fly, as their policies may change.

Delta requires approval of POC use through OxygenToGo.  As of April 11, 2025, Delta has a specific no-double-battery policy.
Links to More Information

Make sure to include enough batteries to get you from home, through the airport on both ends of your flight, and to your destination.  Using a wheelchair through the airports could help you save battery power.

Source: https://runningonair.net/flying

What safety precautions should I take when using oxygen equipment?
  • 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.
Where can I find other oxygen resources?

 

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