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Travel Assistance Tips

Mobility - a very important kind of freedom for almost everyone, but especially for the COPD (Chronic Obstructive Pulmonary Disease) patient. The therapeutic benefit that is now made possible is the main reason for having LINCARE Portable System. With the mobility this system provides, many COPD patients can go freely about their daily routine, take long trips, but most importantly can medically benefit from the prescribed exercise that the Oxygen Portable permits.

It must always be understood that carrying oxygen equipment in vehicles presents some problems and potential hazards. You can travel safely with liquid oxygen units, however you must do it properly.

In preparing to travel, two of the most important considerations are: how long can you personally travel between Portable refills; and how can refills be accomplished?

An important point to remember: you must think of all ventures in terms of your personal time between refills. Once you determine your own travel range, you can apply this to your intended means of travel to plan your trip.

Advance planning is the key to the success of your trip whether you plan to use public transportation, personal auto, camper or motor home. Each mode of transportation requires slightly different arrangements, but all require careful planning to ensure you are always able to renew your oxygen supply.

It is essential that you and your local LINCARE center work out the time you can safely expect to travel between Portable refills. This time will depend on your prescribed flow rate and should also include a 25 percent safety margin to allow for unforeseen delays during travel.

The Portable alone will typically supply a patient's needs for 4 to 8 hours. If your travel will take longer, some means of Portable refill must be arranged.

This is where the staff of your local LINCARE center comes in. They can make arrangements to have your oxygen supply requirements met by an Oxygen Portable supplier at your destination. If your travel plan is flexible or you wish to make arrangements yourself, a nationwide Oxygen Portable Service Directory is available from LINCARE.

If you are going to an area with a vastly different altitude, your prescription may need to be adjusted for this change. Consult your doctor on this point specifically.

Before you attempt to take your oxygen system out of your home and onto the road, please read this booklet carefully, then talk over your plans with your physician or therapist and your LINCARE center; they can help make your travels easier and safer.

Planning Checklist:

1. Check with your doctor.
2. Read and understand the safety precautions required for traveling with Oxygen Portable equipment.
3. Check with your insurance company (be prepared to pay for refills and equipment with cash, and submit your insurance claim when you return home.)
4. Check with the Oxygen Portable dealers where you will be getting refills. A Service Directory provided by your LINCARE center with help here.

Safety Considerations

The safety precautions required for traveling with Oxygen Portable equipment include those which are covered in the Instruction Literature for your specific units. These instructions should be read and understood by all members of your traveling party. They are available from your LINCARE center.

Rules for Handling and Transporting Liquid Oxygen Units

Your LINCARE Service Representative can help you prepare to transport these units. If you attempt to move the unit yourself, it is absolutely essential that you observe the following safety rules.

Keep the unit upright at all times. Do not store in the trunk of a car. Laying a Portable or Reservoir on its side will cause rapid release of oxygen through the unit's pressure relief valve. This results in very high oxygen concentrations near the unit and greatly increases the chance of fire. Slight tipping of the larger units during loading and unloading from a vehicle is not dangerous. This booklet will suggest proper methods to use to secure each unit during transit.

Disconnect therapy equipment before handling/transporting Liquid Oxygen System. Remove all flowmeter or humidifier equipment and cap the outlet fitting before attempting to move these units. If oxygen equipment is dropped or knocked over when these accessories are in place, they could be broken off, causing rapid release of oxygen. This could result in possible personal injury or damage to property.

Maintain adequate ventilation. All liquid oxygen containers release small amounts of gas periodically. Use, storage, or filling of oxygen equipment in a confined area could enrich the area with more oxygen than normal. Oxygen enriched air doesn't burn by itself, but it does cause fire to burn much more rapidly than normal. For this reason, adequate ventilation must always be provided as a precaution against fire. In the interior of a car for example, the air may become enriched if all the windows are closed. When using oxygen in a car, always keep a window partially open regardless of the weather.

There is one instance when more oxygen than normal is released from an Oxygen Portable unit: The process of filling a Portable from a reservoir will release more oxygen than any other operation. Remove all oxygen containers from your vehicle to an open, well-ventilated area before filling.

Warning Others. In all modes of travel you will be in contact with people who may not understand the safety precautions necessary when using oxygen equipment. Do not hesitate to inform those around you. No Smoking signs are available from your LINCARE center for the purpose of warning others when oxygen is in use.

Using Portable Oxygen when Traveling by Private Vehicle

Short trips by auto. When you travel with the Portable you must secure your Portable unit in the vehicle to keep it upright.

The carrying strap and the auto seat belt may be convenient aids in fastening the Portable unit. The following illustration shows a suggested method of using the carrying strap to attach the Portable to a bucket-type seat of a passenger car. In this instance the unit must be equipped with additional cannula tubing to allow you freedom of movement within the vehicle while the Portable is in one place.

Another method that may be used to secure the Portable is to loop the carrying strap around the headrest of a bench-type seat. As the illustration below suggests, it may be positioned on the floor in the rear seat area and secured by looping the carrying strap through the arm rest. Here again additional cannula tubing will be required. The important thing is to secure the Portable so that it cannot tip in case of a sudden stop.

It may be that none of these methods is practical in your automobile. If this is the case, contact your LINCARE center for advice as to the best way to secure the Portable.

Anytime that filled oxygen equipment is inside an automobile, a window must be left open. Although newer cars have some form of flow-thru ventilation, the amount depends on the type and model of car. So, roll a window down at least part-way to be certain the interior of your vehicle does not become oxygen enriched.

Longer trips. There may be times when you would like to travel for a longer period of time than a single filling of the Oxygen Portable will allow. Such activities might include anything from an overnight visit to nearby relatives, to an extended vacation far from home. The thought is probably, "How can I take the Reservoir along so I will have plenty of oxygen?"

Up to this point we have discussed carrying only the Portable in a private automobile. This is for a very good reason - few automobiles are large enough to safely carry a filled reservoir. This unit must not be stored in the trunk and must be kept upright at all times.

Your LINCARE center can offer alternatives to transporting your own unit. If your destination is nearby, LINCARE might arrange to move your reservoir or deliver another unit so that it will be waiting for you when you arrive. For longer trips, LINCARE can provide a national directory of all suppliers of your Oxygen System which will permit you to make arrangements for resupply when out of your immediate area.

Campers & Motor Homes. If you plan to travel by camper or motor home, the large interior space of these vehicles may allow a reservoir to be secured to a permanent part of the vehicle. Select a location near a door or window where ventilation is best. Be careful not to confine the unit in any small space. For a reservoir, the location near a door is important so that the door may be opened to provide extra ventilation during a Portable filling operation. A window or overhead camper vent must always be left open while filled equipment is inside.

Many camper vehicles introduce potential hazards that are different from those found in your home. Gas heat or cooking appliances that use an open flame are two examples. Be aware that these changes from your normal surroundings do exist and check for these hazards before using such appliances in a vehicle where oxygen is present. Check out the installation of your oxygen equipment with your LINCARE center prior to use.

Some tips to remember in relation to use of the Reservoir while traveling include:

• Use a Rotary Flow Control Valve for setting your unit's output. Flowmeter accuracy is affected by the motion of a vehicle, while the rotary flow control is not. This makes the Rotary Flow Control Valve a better choice for travel.
• Try to minimize the handling of a filled Reservoir. With the weight of oxygen inside, these units are more sensitive to handling damage or shock.

Use of the Portable on Public Transportation

Making arrangements for travel on public transportation with oxygen equipment may be difficult. You may be asking a ticket agent or reservation clerk to provide services that he/she is unfamiliar with. If you encounter difficulty ask to speak to a supervisor or someone of higher authority. Be persistent! Remain courteous and explain your situation carefully.

In all types of public transportation the carrying of filled Reservoir must be considered impractical. Trips must be carefully planned to provide Portable refills at stopover points where, by pre-arrangement, an oxygen supplier can provide your oxygen needs.

Rail Travel

The Amtrak railway passenger system is making progress toward removing barriers from intercity train travel to give everyone access to this mode of travel. A booklet entitled "ACCESS AMTRAK" is available free of charge from Amtrak. This booklet does not deal specifically with travel while using oxygen, but it does contain other helpful information concerning travel for handicapped passengers.

Amtrak has no hesitancy in allowing patients on board Amtrak trains with their Oxygen Portable equipment in either coach or sleeping car accommodations.

Amtrak requests that a patient planning to travel with Oxygen equipment make them aware of the situation in advance so that they may assist in any way they can to make a trip more comfortable and enjoyable. To alert Amtrak, tell the reservations clerk or travel agent.

The call you make to the reservation number is the key to a successful trip. Here you can find out exactly what Amtrak has to offer and what problems you can expect to encounter. In addition, it permits Amtrak to make any special arrangements which might be required.

When talking to the reservations clerk be sure to cover the following points:

• Describe your need to carry oxygen and your origin and destination points.
• Explain that scheduling is critical to you.
• Ask which kind of accommodations you will need, on the basis of your particular needs.
• If assistance is necessary, ask if stations are attended by Amtrak personnel and if they will be available to help you. Your travel request will be referred to a special service desk to find answers to your questions and that desk will coordinate your trip from beginning to end with Amtrak personnel. You should receive a call confirming your travel arrangements. If you do not, follow up the inquiry and confirm the arrangements yourself before your departure date.

Whether you are making a short trip or a long trip, it is best to call Amtrak a reasonable time before your trip to ensure that special accommodations can be arranged. Although most short-distance trains are unreserved, handicapped travelers may be granted a reserved seat by prearrangement.

Bus Travel

Travel by bus may be the least clearly defined of public transportation means. For local travel, check with your bus operator for regulations. If travel with oxygen is allowed, take the necessary steps to inform people around you that smoking may be a hazard. Most public vehicles now have a "No Smoking" section; insist on being seated there.

Under Department of Transportation regulations, bus operators may permit travel with oxygen equipment. Some operators, however, may be concerned if you show up with oxygen equipment without prior notice.

Check with your bus service in advance to prevent problems.

In this mode of travel, as in any other, planning is the key. Here again, it will not be possible to carry a filled Reservoir with you. Arrangements must be made to resupply you with oxygen at your destination.

General Air Travel

The use of Oxygen Portable equipment aboard commercial aircraft is not permitted. However, many airlines are prepared to provide oxygen for you while you are on board their aircraft. The policies of the various air carriers on providing supplemental oxygen service are not all alike. Virtually all airlines do require at least 24 hour advance notice and levy a charge for the oxygen service.

Typical airline requirements are:

1. Advance Notice: 24 hours to one week before boarding.
2. Prescription Required: quantity of oxygen and flow rate; most require flow rate adjusted for cabin pressure used by that airline.
3. Doctor's Release Required: should include diagnosis and release with approval for air travel; special forms may be necessary. Be sure to have several copies of completed forms with you.
4. Service Charges: typically $40 per flight; connecting flights usually involve charges for each ticket coupon. Some charge by number of cylinders used.
5. Some airlines require patient to be accompanied by friend or relative.
6. Most airlines permit carrying of empty personal oxygen equipment as baggage, some do not.

Be sure to check with the airline to verify their policies on each of these points. If the reservations operator or ticket agent cannot answer your questions, be patient and remember that such questions probably are not routine business. Ask for the telephone number of the airline's "Air Medical Department" or "Special Services" usually located at the airline's home office.

In addition to arranging for oxygen service aboard the aircraft, you will also need to arrange for supplying your oxygen needs before flight time, during any layover for connecting flights, and after arrival at your destination. Your LINCARE center can assist you with these details and may be able to meet you at the airport gate with a portable unit and also set up a reservoir at your lodging.

The following tips may be helpful:

• Discuss your travel plans with your physician. A prescription with the flow rate adjusted for cabin altitude will probably be required by the airline. A doctor's release and approval for air travel is generally needed. Take along several copies to be sure that you have enough for all flights and for the oxygen supplier at your destination.
• Your LINCARE center's staff can help you arrange for your oxygen supply at your destination. Ask for a copy of the "Oxygen Portable Service Directory," which lists dealer locations in the continental United States and Hawaii. Confirmed advance arrangements with the dealer at your destination are essential.
• If you plan to take your Oxygen Portable with you on the plane as baggage, confirm that the airline will accept it. If airport personnel are reluctant to accept the Portable as checked baggage, assure them that it is empty and use the contents indicator to demonstrate.
• Airlines can usually provide assistance if needed for boarding and deplaning passengers. Wheelchairs and golf carts at large airports can be requested when reservations are made.
• Travel with a companion. In most airports, the pace and the distances between ticket counters and boarding gates may be considerable. If problems develop, someone who knows your needs can be of great help.
• You may want to bring a cannula with you, as well as adapters and connectors.

Be at the airline at least 2 hours early because you must pay for the oxygen at the ticket counter at the time of the flight. There is usually a line and the transaction takes about 20 minutes to process. You will board the plane early.

Take all your prescription drugs on board with you.

Turn on the oxygen, relax and enjoy.

Remember, patience and thorough attention to detail are your most important assets in making the arrangements for air travel. Plan carefully, confirm all arrangements well in advance, and then enjoy your trip.

Specific Airline Requirement Links