Portable Oxygen Concentrators: Travel and Daily Use

What a portable concentrator does

Like a home unit, a POC draws in room air and separates out most of the nitrogen to supply oxygen-enriched air. It is powered by a rechargeable battery, a mains adaptor and often a car or DC adaptor. It is lighter than a home concentrator, commonly a few kilograms, and has a carrying case or a trolley.

Most POCs have two modes or at least one:

• Pulse dose (demand) mode. A sensor detects when the person begins to breathe in and delivers a short pulse (a bolus) of oxygen. This saves oxygen and battery, so the machine can be smaller. Settings are numbered, such as 1 to 5, and a setting is not the same as a litre per minute flow.
• Continuous flow mode. Oxygen flows steadily, like a home concentrator. Only some models offer it, and often only up to a limited rate, with a shorter battery life.

Do you need a portable unit?

A portable concentrator suits someone who:

• Is prescribed oxygen on exertion or for daily activity and wants to leave home.
• Has a flow need that a portable model can meet.
• Is mobile enough to carry or wheel it.
• Travels for medical appointments, family events or holidays.

It is not a replacement for a home concentrator for night-time or continuous high-flow use. Many people need both. Some people whose prescriptions require higher continuous flows cannot use a portable unit at all. A cylinder may be a simpler choice for short outings; see oxygen cylinder or concentrator: which suits home use?.

Getting the setting right

Because pulse settings do not equal litres per minute, the doctor or a trained technician should test your parent on the portable unit to find the setting that keeps oxygen in the target range, at rest, walking and sleeping if relevant. Ask for:

• The recommended setting for each activity and mode.
• A written note of the setting equivalent to the home prescription.
• A walking test with an oximeter while using the portable unit.
• What to do if oxygen falls on the machine at the recommended setting.

Do not simply copy the number from the home concentrator. See oxygen flow rates and prescriptions: what families should know. Pulse devices rely on the person breathing in through the nose to trigger the pulse; mouth breathers and people with very shallow breathing may not trigger it reliably. In those cases, the doctor may suggest continuous flow or another source.

Choosing a model

• Maximum output: check the highest pulse setting and whether continuous flow is offered and at what level.
• Weight and carrying method: a very light unit is useful only if it meets the prescription. Consider a shoulder strap, backpack or small trolley.
• Battery life: the stated life usually applies to the lowest setting. At higher settings, it can fall sharply. Ask for the battery life at your parent's setting.
• Spare and extended batteries: many models take a second battery for longer outings. Check how long recharging takes.
• Alarms: low oxygen purity, low battery, no breath detected, high temperature.
• Noise: consider if it will be used in meetings, trains or at night.
• Cannula compatibility: use the cannula type the maker specifies; see nasal cannulas and oxygen masks: choosing and caring for them.
• Travel approvals: if flying, look for a model approved by the airline. See below.
• Service and warranty: local service, loan machine and a helpline are worth more than a few grams.
• Rental option: often sensible for a trial or a holiday. See renting breathing equipment: costs, checks and return.

Costs vary widely. Portable models generally cost much more than stationary ones, so test before committing. See oxygen concentrators: a buying and renting guide.

Using it day to day

1. Charge fully before every outing, and carry the charger and a spare battery. 2. Check the setting against the prescription, and write it on a label on the case. 3. Fit the cannula properly and breathe through the nose, which triggers pulse mode. 4. Carry it safely: keep it upright, with vents clear, not buried under coats, bags or blankets. Do not cover it. 5. Check oxygen levels with an oximeter during exertion when advised; see pulse oximeters: how they work and how to use one. 6. Rest when needed. Pace walking; see breathlessness: positions and breathing techniques that help. 7. Know the alarms and what to do: switch to the backup source if the machine alarms. 8. Clean the filter and wipe the case as per the manual; see a cleaning schedule for breathing equipment.

Backup

Never leave home with only a portable concentrator unless you have a plan for failure. A battery can die, an alarm can sound, or a car adaptor can fail. Carry:

• A charged spare battery.
• A small cylinder or other backup if the doctor recommends it.
• The prescription, doctor's letter, emergency numbers and a list of nearby hospitals.
• A mobile phone with a charged battery or power bank.

See oxygen at home and power cuts: a backup plan.

Travelling with a portable concentrator

Plan early, with your doctor and the carrier.

• Medical clearance. A doctor should confirm your parent is fit to travel and state the oxygen requirement for the journey, especially for flying, where cabin pressure lowers the oxygen level, and for hill stations at altitude.
• Airlines. Many airlines allow only approved models, require advance notice and a medical form or doctor's letter, and set limits on battery numbers and capacity. Rules vary and change, so contact the airline well before travel, and confirm in writing. Carry the machine in the cabin, not in checked luggage. Ask whether you may use it at the gate and during boarding. See travelling with oxygen: trains, flights and road trips and train, flight and airport assistance.
• Batteries. Lithium batteries have strict rules for carriage. Check the maximum watt-hour rating and number allowed by the airline and keep spares in carry-on baggage with terminals protected.
• Trains and buses. Ask the operator about use of a machine on board and charging points; do not assume that power sockets will be available or working. Carry enough charged batteries for the whole journey plus delays.
• Road trips. Use the car adaptor only as the maker instructs, keep the machine secured and ventilated, and do not leave it in a hot parked car, where heat can damage batteries and the machine.
• Hotels and relatives' homes. Check there is a safe power socket, and brief hosts about the fire safety rules.
• Insurance and contacts. Carry the supplier's helpline, and the contact of a doctor or hospital at the destination.

Fire and safety rules on the move

All oxygen fire rules apply outdoors and indoors:

• No smoking near the person, and avoid places where others smoke. Ask people nearby to stop.
• No open flames, including lamps in temples, pooja areas with diyas and incense, candles at celebrations, street food stoves, tandoors and barbecues. Keep well away.
• No oil or grease on the face and connections.
• Avoid hot vehicles and direct sun for the machine.
• Do not allow others to use the machine.
• Do not cover the machine with a shawl, coat or bag in a way that blocks air.

See safe use of oxygen and electrical equipment.

Care and maintenance

• Keep the battery contacts clean and dry.
• Follow the maker's advice on battery storage and replacement; batteries lose capacity with age.
• Clean or replace the particle filter as instructed.
• Have the unit serviced on schedule, and have its oxygen output tested if the maker advises.
• Keep it away from humidity, rain and dust. In the Indian monsoon, protect it from damp.
• Do not use if it is dropped or damaged until checked.

When a portable unit is not enough

If your parent needs more oxygen on exertion than the portable machine can deliver at a reasonable battery life, or their oxygen falls despite the correct setting, tell the doctor. Do not push on and do not raise the settings beyond the recommendation. Alternatives include a higher-capacity portable model with continuous flow, cylinder-based systems or avoiding certain activities.

When to ask a professional

Ask your chest doctor to test your parent on the portable unit and write the setting for rest, walking and travel. Ask the supplier to train family members and explain alarms. Ask the airline or railway for current rules, well in advance. Call the doctor if your parent becomes more breathless, drowsy or confused, or if readings fall below the target despite correct settings. Call 112 for severe breathlessness, blue lips, chest pain, collapse, or if the machine fails and there is no backup.