Why is medical oxygen a challenge for people travelling by air?

Abstract

There are currently 3.5 million people in Europe who require medical oxygen, and as life expectancies increase, this figure is likely to grow. At the same time, air travel is becoming more accessible to a wider range of people, as costs of flights fall, and airlines and airports make improvements to the accessibility of their services.People who need medical oxygen to fly experience a wide range of difficulties when planning to travel by plane, and sometimes during or after the flight.A European Commission Regulation (EC No 1107/2006) sets the standard for airlines when it comes to making air travel accessible, but healthcare professionals and oxygen providers can both help patients to navigate the various requirements for using medical oxygen when travelling.In this review, we discuss the journey of the patient planning to travel by air, from initial consultation and fit-to-fly test, through to planning their air travel and oxygen supply, travelling, and arriving at their destination. We also highlight some common problems at each stage and suggest points for healthcare professionals to discuss with patients.Key pointsPatients who require medical oxygen for air travel should begin planning their trip as far in advance as possible.It is very advantageous for healthcare professionals to be able to advise patients on travelling with oxygen and what they need to do.Requirements and policies can vary greatly between airlines, causing problems for patients who are trying to book their flights.Patients or their carers need to be confident operating their oxygen equipment, as the stress of travel and lack of medical assistance on an airplane can put them at risk.Careful arrangements need to be made by the patient to make sure that they have the correct oxygen therapy at their destination, and can access support if they need it.Educational aimsTo understand the process and potential challenges for a patient who requires oxygen to travel by plane.To be confident in discussing air travel with patients who are affected by lung disease.

2022 Brazilian Thoracic Association recommendations for long-term home oxygen therapy

“…(151) É importante salientar que essas recomendações se baseiam principalmente em estudos realizados em pacientes com diagnóstico de DPOC e são extrapolados para outras doenças respiratórias. (152,153) Após uma avaliação, o médico assistente deve preencher a autorização de voo com a prescrição do fluxo de oxigênio e de outras medidas necessárias no documento conhecido como Medical Information Form (formulário de informações médicas), que é fornecido pelas empresas aéreas. O preenchimento deve ocorrer pelo menos 72 h antes do voo para que haja tempo hábil de apreciação pela empresa.…”

PH Professional Network: Up, Up, and Away: Clinical Considerations for Altitude-Related Travel and Pulmonary Hypertension

“…11 Some airlines can directly provide the patient with oxygen for the flight, either free of charge or for a cost; patients can check with their airline if these services are available. 12 Some airlines do permit portable oxygen concentrators (POCs). Before travel, patients should check whether their oxygen company can provide a POC that is FAA approved and inquire about airline-specific policies regarding oxygen and batteries, including the process for boarding and disembarking, and required paperwork.…”

“…Before travel, patients should check whether their oxygen company can provide a POC that is FAA approved and inquire about airline-specific policies regarding oxygen and batteries, including the process for boarding and disembarking, and required paperwork. 12,13 Due to the limited battery life of POCs, the patient may need to bring multiple charged batteries to last the duration of the flight. The general recommendation from the Pulmonary Hypertension Association (PHA) is to bring enough batteries to last 150% of the predicted length of the flight.…”

“…Typically, a physician statement detailing the patient's medical need for oxygen is sufficient; however, some airlines will require specific forms to be completed for bringing medical equipment such as oxygen onto the flight. 12 Most airlines require notification of need for oxygen in flight at least 48 hours in advance. Allow adequate time to confirm documentation needs and submit completed forms.…”

Oxygen

“…The authors conclude that heliox and oxygen administrated during rehabilitative exercise might result in greater functional and clinical benefits compared with exercise conducted while breathing room air if an increased training intensity is achieved, but not if the training intensity remains unchanged. The European Lung Foundation and the European Industrial Gases Association AISBL collaborated on an article that provides practical tips on air travel for people requiring oxygen therapy [4]. Furthermore, we hear from a patient about what it means to live with medical oxygen and how life can still be lived to the fullest despite disease- and treatment-related limitations [5].…”