Oxygen at Home and Power Cuts: A Backup Plan

Start with the doctor's answer

Ask your doctor in advance:

• If oxygen is interrupted, what could happen to my parent, and how quickly?
• How many hours a day is oxygen essential, and at what flow?
• Is there a safe interval without oxygen, for example a few minutes while switching to backup, and what symptoms should prompt immediate action?
• What oxygen level and symptoms should lead to calling 112?
• How long should our backup last?

Some people tolerate short breaks, and others become unwell within minutes. Do not guess. Write the doctor's answer on the first page of the care plan; see keeping a health record at home.

Backup options

1. A backup cylinder. A full cylinder with a regulator, set up and ready, is the simplest and most reliable backup because it needs no power. It must be kept secure and upright, away from flames. See oxygen cylinder safety at home and oxygen cylinder or concentrator: which suits home use?.

2. A portable concentrator with a charged battery. It can bridge a power cut if the battery lasts at your parent's setting and is fully charged. It does not always replicate continuous flow, so the setting must be tested. See portable oxygen concentrators: travel and daily use.

3. An inverter or UPS for the concentrator. A battery-and-inverter system can keep a home concentrator running during a cut. It must be sized for the machine's wattage, not just its label; concentrators draw a few hundred watts and can have a starting surge. Ask the supplier for the exact power draw and the inverter size and type recommended (many concentrators work best with a pure sine wave output). Check how long the battery bank will last at that load, remembering that batteries age and deliver less than the label claims. Test the system by switching off the mains while the machine is running.

4. A generator. Can be used for long outages, but a generator must never be run indoors, in a garage or near windows, because carbon monoxide can kill. Fuel is a fire hazard near oxygen. Keep both well away from the oxygen equipment. Many apartments do not allow them.

5. A neighbour, relative or hospital nearby. Know who has power or backup, and the quickest route to the hospital. This is a last resort, not a plan.

Most families combine a cylinder (always ready) with an inverter or portable concentrator (for longer cuts).

Sizing the backup

Work out the numbers with the supplier:

• Cylinder time: volume of gas divided by the prescribed flow in litres per minute; for example, 1,500 litres at 2 litres per minute lasts roughly 12 hours. At 4 litres per minute, it lasts about half as long. The gauge shows what remains. Treat the estimate with caution.
• Longest likely outage: ask neighbours and the electricity board how long cuts typically last, and add safety margin for storms and holidays.
• Time to get replacements: how long does the supplier take to deliver at night?
• Inverter runtime: battery capacity divided by the load, with a margin.

Aim for a backup that lasts longer than the longest plausible gap plus the time to get help.

Preparing the home

• Place the concentrator on a hard floor, near a safe earthed socket, and plug it directly into the wall; avoid long extension leads.
• Label the inverter socket for the concentrator only and keep other appliances off that circuit.
• Keep a backup cylinder ready, with the regulator attached and tested, tubing and a spare cannula next to it, and the flow dial set to zero.
• Write the prescribed flow on a card beside each device, plus the doctor's number, the supplier's helpline and 112.
• Keep torches and charged phones by the bed, because lights go out. A head torch frees the hands.
• Keep a spare cannula and tubing in a labelled bag.
• Keep an oximeter with spare batteries near the bed; see pulse oximeters: how they work and how to use one.
• Teach at least two people to switch to backup oxygen: family members and the household helper if they are involved in care.
• Keep a printed one-page checklist by the machine.
• Think about heat and fans: a power cut in summer may leave the person hot and breathless. Keep a battery fan or a safe way to cool the room. Do not use candles or open flames for light or mosquito repellents near oxygen. See temperature and ventilation at home and power cuts and older adults.

What to do when the power fails

1. Stay calm and help your parent sit upright. 2. Check the alarm. Many concentrators sound a power failure alarm. Silence it only after you have switched to backup. 3. Switch to backup oxygen at once: move the cannula to the backup cylinder or portable unit, check gas flows at the right setting, and put the cannula back on. 4. Check the person: breathing, colour, alertness and, if you have one, the oximeter. 5. Check whether the power cut is local: a tripped switch, an unplugged cord or a loose connection. Fix only if it is safe and you know how. 6. Keep light safe: use a torch or battery lamp, not a candle or a diya. 7. Call the electricity helpline if the outage is unusual, and tell them a patient on life-supporting equipment lives at the address. Some utilities keep a register for priority restoration; ask your local office. 8. Call the supplier if the cylinder will not last or the inverter fails. 9. Call the doctor if breathlessness increases or oxygen levels are below the target. 10. Call 112 if your parent is struggling to breathe, has blue lips, chest pain, confusion or collapse, or if backup has failed.

Do not turn up the flow beyond the prescribed rate because of worry. See oxygen flow rates and prescriptions: what families should know.

Fire and safety during outages

Outages make fire hazards more likely because families turn to candles, kerosene lamps, diyas and generators.

• No candles, lamps or matches in the room with oxygen. Use battery torches.
• No smoking.
• Never run a generator indoors or near doors and windows.
• Do not refuel a generator near oxygen equipment or while it runs.
• Keep cylinders away from inverters and batteries, which can spark or heat.
• Keep cables tidy and avoid trips in the dark.
• Keep the tubing from tangling around chairs and doors.

See safe use of oxygen and electrical equipment and smoke and gas safety for older adults.

Practise the drill

Once, in daylight, with the doctor's agreement and when your parent is well, do a dry run: switch off the mains, switch to the cylinder, and time how long it takes. Note what went wrong: a regulator that was hard to open, a missing tube, a torch with a flat battery. Fix and repeat. Practise again every few months and after any change in equipment. Have each family member do the changeover once.

Maintenance of backup systems

• Check the cylinder gauge weekly and swap it before it falls to the low zone.
• Charge the portable concentrator battery fully and keep it on charge as the maker advises. Check battery health; batteries lose capacity.
• Test the inverter monthly under load and replace the battery when it no longer holds charge; see safety device batteries and checks.
• Check the expiry or test dates on cylinders.
• Replace spare cannulas as they age.
• Update phone numbers on the card.

During disasters and long outages

In floods, storms or heat waves that last days, plan to move early: contact the hospital or a relative with power before supplies run low. Keep the discharge summary and medicines ready; see emergency bag for a hospital visit. Know that suppliers may be overwhelmed. Order cylinders early at the first warning. Check that your phone is charged and a power bank is ready.

When to ask a professional

Ask the doctor how long your parent can safely be without oxygen and what to watch for. Ask the supplier for the exact wattage of your concentrator and advice on inverters, batteries and cylinder backup. Ask an electrician to check the wiring and earthing and to fit a dedicated socket. Ask a nurse to show family members how to switch to backup. Call the doctor if breathlessness worsens during or after an outage. Call 112 for severe breathlessness, blue lips, confusion, chest pain, collapse or a fire.