Written by: Amanda Lundberg BSN, RN
Posted with permission by RN MEDFLIGHTS
Travel opportunities for people with severe medical conditions have improved. This includes those with lung diseases who may need supplemental oxygen while traveling at high elevations, such as during air travel.
Although the Federal Aviation Administration (FAA) has regulations that cover oxygen use in commercial air carriers, the airlines also have policies that regulate how oxygen can be used in flight. These differences can confuse travelers when they fall within FAA regulations but differ from airline to airline.
Using Supplemental Oxygen During A Flight
In an airplane, the air pressure drops within the cabin as the plane ascends to a greater altitude. While commercial airplanes have pressurized cabin limits that allow the plane to travel at altitudes of up to 40,000 ft, this can place added stress on those who require supplemental oxygen.
The increased altitude also affects gasses within the body. As the plane rises and atmospheric pressure drops, this trapped air expands, which explains why your ears pop. The lower air pressure also decreases the oxygen available to the body. This effect is generally not noticeable for healthy travelers, but individuals with lung disease may experience significant symptoms. In this case, a person may require a portable oxygen concentrator, which is a medical device used to provide oxygen by extracting it from the air.
Oxygen concentrators are safe, convenient, and cost-effective to use. They do not require refilling and can be used for extended periods without needing to be replaced. They also do not pose a risk of explosion or fire in flight since they do not contain compressed oxygen.
What Are the Federal Aviation Administration (FAA) Rules?
The FAA does not allow passengers to bring a compressed gas cylinder or canister of oxygen since they are hazardous and pose a risk of explosion or fire. They maintain a list of portable oxygen concentrators that meet specifications for in-flight use.
Individuals who depend on a portable oxygen concentrator must carry sufficient batteries for the duration of the flight, and the spare batteries must be protected against damage. Currently, the FAA has approved over 20 portable oxygen units, including the Freestyle Comfort, Inogen One G5, SeQual Eclipse 5, Respironics SimplyGo Mini, and Respironics SimplyGo.
The Transportation Security Administration (TSA), which is a part of the Department of Homeland Security and is responsible for security on commercial airlines, allows portable oxygen concentrators that meet FAA specifications for in-flight use to be brought onboard a commercial airline.
Airlines Have Specific Regulations
In addition to the FAA rules, each airline has specific passenger regulations. Before flying, it’s crucial to check with your healthcare provider to be sure it’s safe to fly with your specific oxygen needs.
When you choose your portable oxygen concentrator, it’s important to know how long the battery will last and bring additional batteries to last for the duration of the flight. When traveling with a portable oxygen concentrator, extra time at the airport is necessary. You will also want to set up a pulse oximeter and adjust your oxygen as needed during the flight.
Whether you are on a domestic or international flight, you must call the airline to ensure that you satisfy their rules and are using a portable oxygen concentrator they have approved. If you fail to follow the airline rules, they may make an emergency landing and charge you for it. These are the requirements for the top five U.S. airlines.
United Airlines United Airlines will provide onboard medical oxygen on flights between Guam and Honolulu, Manila, Palau, and within Micronesia and the Marshall Islands. Passengers are allowed to bring a portable oxygen concentrator that meets FAA specifications. The airline may request documentation from a licensed physician to confirm your ability to fly without medical oxygen. Liquid oxygen is not allowed, and passengers must give the airline a minimum of 48 hours advance notice they will bring a portable oxygen concentrator on board. View more: Tips for Flying with Oxygen on United Airlines.
Southwest Airlines Southwest Airlines allows portable oxygen concentrators but not compressed or liquid medical oxygen. The oxygen machine can only be used in battery mode, and passengers can only use concentrators that have been FAA approved for use in flight. The airline must be notified in advance when booking the ticket and check with a customer service agent to verify the device at the airport. Once on board the aircraft, the concentrator must be stowed under the seat in front of the customer and cannot be placed in an overhead bin. View more: Tips for Flying with Oxygen on United Airlines.
Delta Airlines Delta Airlines classifies a portable oxygen concentrator as an assistant device and no longer provides compressed medical oxygen. You are allowed to use an FAA-approved portable oxygen concentrator with a battery in-flight. The passengers must complete an approval request that is faxed or emailed to the airline’s oxygen provider at least 48 hours before departure. Passengers using a concentrator cannot be seated in an exit row or bulkhead. While it does not count toward your carry-on baggage limit, the batteries must be removed if they are not in use. Passengers will receive telephone confirmation their concentrator has been approved, and they must bring the completed approval request form to the airport. View more: Tips for Flying with Oxygen on Delta Airlines.
American Airlines Passengers flying on American Airlines with any type of medical or mobility device are offered pre-boarding, deplaning, and airport assistance. The airline maintains a list of approved portable oxygen concentrators for passengers to check before making reservations. Before boarding, an agent at the gate will confirm your device is approved for use in flight and may request a test that the unit operates and responds to alarms. The agent will explain the phases of the flight when a concentrator can be operated and will check your batteries to ensure that you have no less than 150% battery life for the duration of the flight. This means if the flight is 4 hours, you must have 6 hours of battery life. The device must fit underneath the seat in front of you, and in addition to being unable to use any exit row or bulkhead, there may be other seats that are unavailable. Gate agents will check to see if the concentrator is free of any petroleum products, is in good condition, and is free from damage. View more: Tips for Flying with Oxygen on American Airlines.
Frontier Airlines Frontier Airlines offer help making reservations for people who need extra services while flying, such as using a portable oxygen concentrator. As with other airlines, Frontier does not allow compressed oxygen or oxygen cylinders on the flight or in the baggage compartment. Frontier maintains a list of FAA-approved devices they allow in flight. Since the concentrator is considered an assistive device, it can be carried on board and used in the cabin. They recommend passengers carry fully charged batteries to last the journey and that any batteries transported in the luggage must be protected from physical damage and short circuits. Before traveling, passengers must complete a Frontier Portable Oxygen Concentrator Medical Authorization Form or have a medical statement from their physician addressing all the points on the Frontier form. This must be completed, signed, and presented at the airport. Flight crews and customer service representatives will ask to see the document. View more: Tips for Flying with Oxygen on Frontier Airlines.
Virgin Atlantic Virgin Atlantic Airlines classifies portable oxygen concentrators as medical equipment. They have specific guidelines passengers must follow in flight. The airline requires passengers to complete a POC Approval and Battery Approval Request Form that must be signed and faxed or emailed at least 48 hours before the flight. Virgin Atlantic notes that you may have booked a flight with them, but if the flight is operated by a partner airline, you must contact them directly for their policy about medical oxygen. Passengers cannot sit in an exit row or bulkhead seat, and if you plan on using it during the flight, it must have 150% of battery life for the duration of the flight. In other words, if you expect a 6-hour flight, the airline expects you to have 9 hours of battery power. When batteries are not in use, they must be removed and packaged separately. The airline reserves the right to ask for more information about your medical condition before the flight, so you must contact the airline in enough time to meet the requirements, or you may be unable to fly. View more: Tips for Flying with Oxygen on Virgin Atlantic Airlines.
Alaska Airlines Alaska Airlines maintains a list of acceptable oxygen-concentrating devices they allow on domestic and international flights. Your concentrator must have identifiable part numbers, model numbers, or kit numbers. Portable oxygen machines that are not on the FAA-approved list can be carried in the cabin unused, with the battery removed. The airline does not require advanced notice but strongly recommends passengers give 48 hours advance notice that they are carrying a concentrator. Passengers must check with a customer service agent prior to boarding the flight and carry an ample supply of fully charged batteries to last the duration of the flight. Passengers with a concentrator cannot sit in a bulkhead seat and may not use an emergency exit seat. View more: Tips for Flying with Oxygen on Alaska Airlines.
Hawaiian Airlines Hawaiian Airlines makes every effort to accommodate individuals who use portable oxygen concentrators. When traveling with a portable oxygen concentrator, you are required to notify the reservations department at least 48 hours before your flight and check in no later than one hour before the minimum check-in for your flight. If you require a safety assistant to travel with you, you are not charged for that person’s flight. However, the airline reserves the right to choose one of its employees to act as a safety assistant. The airline may help you from the terminal entrance to the airport gate, and assist you during boarding, deplaning, and making connections. All portable air oxygen concentrators must be FAA approved. Passengers must also carry a Portable Oxygen Concentrator Use form or written statement from your physician with the necessary information. This must be signed and dated within 10 days of your initial departure date. While in flight, you are limited to where you can sit, and the unit must be stowed under the seat in front of you during taxi, take off, and landing. View more: Tips for Flying with Oxygen on Hawaiian Airlines.
Allegiant Airlines Allegiant Airlines does not allow liquid or compressed oxygen in the cabin or as cargo. They also do not provide oxygen and encourage their passengers who require oxygen to use a portable oxygen concentrator that meets FAA specifications. Passengers must alert the reservations agent at the time reservations are made. If a portable unit is required after making reservations, passengers must add this to their reservation on the airline website or call the airline’s customer care team. A portable oxygen concentrator does not count toward carry-on baggage, and no additional fee will be charged to the passenger.