Breathing disorders such as pulmonary fibrosis can affect the movement of oxygen from the lungs into the blood. This means that the oxygen level in the blood may drop, and the body’s organs, tissues and cells may not get the amount of oxygen they need. This can lead to you feeling tired and being less active.^1-3

Oxygen therapy keeps the level of oxygen in your blood above a certain level, which reduces breathlessness. It can, therefore, help people with pulmonary fibrosis to stay more active throughout their day.

Only your treatment team can guide you on when oxygen may be needed and what type of oxygen delivery should be used.

Getting ready for oxygen therapy

Oxygen therapy will change how you approach your day-to-day life. Getting around the house and going out may become more of a challenge.² However, with some advice and preparation, the transition can be made easier.

At first, you may only need oxygen to do physical activities, such as gardening or taking a walk. However, depending on your overall health, oxygen therapy may be needed throughout the day, even when you are resting.

As oxygen is considered a medicine, it must be prescribed by a doctor. Based on a series of tests, the prescription will provide details of how much oxygen you need and how often you will need it.

Your pulmonologist or respirologist, as part of your treatment team, will also discuss which type of oxygen and delivery system best suits you.

Types of oxygen delivery

Oxygen storage and transport

The right choice for you depends on several things, including how much oxygen you need, when you need it, where you live and your access to electricity.³

Although you may be prescribed extra oxygen over the long term,⁴ this doesn’t mean that you must limit your daily life. Often patients find that when a prescription of supplemental oxygen is made, it helps them to be more active.⁵

Oxygen at home

Because oxygen is stored in pressurised containers there are certain safety measures you will need to take when using oxygen at home. Try to follow these tips when using your oxygen to avoid any hazards.

There are four key considerations when using oxygen at home

Below are several hints and tips for using different types of supplementary oxygen. Although this list may appear overwhelming at first, using your oxygen system correctly and safely is very important to make sure that you avoid hazards and receive the full benefit of your oxygen therapy.

Take your time to understand this information. Not all will be relevant to you, but it should give you some useful tips for using your oxygen system safely and correctly.

Safety precautions to take when using oxygen cylinders⁶

Additional safety measures when using an oxygen cylinder delivery system:

• Store the cylinder in an upright position, using a cart, or strapped into place so that it will not fall over

• Keep your cylinder in a place where it is not likely to get knocked over

• Monitor your oxygen levels and plan ahead to ensure you don’t run short; always have back up tanks available

Safety precautions when using liquid oxygen⁶

Additional precautions when using liquid oxygen:

• Don’t turn the tank on its side, as this may cause the liquid oxygen to leak out

• Keep the tank at least 1.5 metres (5 feet) away from heaters, electric or gas heaters, steam pipes, furnaces, and radiators

Safety precautions when using oxygen concentrators⁶

Additional precautions when using an oxygen concentrator:

• Never use an extension cord to plug in your concentrator

• Don’t cover the unit and always keep it at least 15 centimetres (6 inches) away from the wall, curtains or anything else that might block the filter or prevent air circulation around it. This will prevent the unit overheating

• Consider buying a backup generator in the event of power outage

Travelling with oxygen therapy

If you are on oxygen therapy and you would like to travel, it is important to plan ahead.

Depending on how you are travelling you may need to make certain arrangements. For example, there may be forms to fill in, additional charges (e.g. from airlines), or special procedures for the storage and transport of your oxygen equipment.³

The following steps will help you prepare for travelling:³

1. Your first step should always be to speak to your treatment team about your plans, so they can discuss your fitness for travel

2. You will need to speak to your travel provider to guarantee that they can accommodate all your treatments, especially supplemental oxygen therapy

3. Contact a travel insurance provider to ensure you have an insurance policy in place to cover all eventualities, such as medical expenses, cancellations and personal equipment/belongings

4. Download our checklists for air, train and car travel to help guide you through your travel planning process

Altitude and elevation

At high altitudes you may find it harder to breathe due to the low oxygen levels in the air. If you are travelling to high altitudes, you may require supplemental oxygen. If you are already on oxygen therapy you may need to increase your oxygen flow.⁷

Depending on the severity of your condition, your treatment team may do pre-travel checks to determine whether you need oxygen therapy at your destination.⁷ If you have any plans to travel, make sure you inform your treatment team, so they can make sure you have all the treatments you need and have taken all the precautions needed to protect your health.

Flying with supplementary oxygen

In an aircraft, the air pressure is different when on ground level. If you need oxygen therapy at ground level, you will also need oxygen in-flight, and may need to increase the flow during the flight.⁸

Even if you are not currently on oxygen therapy, it’s a good idea to have your treatment team assess whether you will need in-flight oxygen if you are planning to fly.

If your treatment team recommends in-flight oxygen, there are a few tasks you need to do before your flight. Some of these tasks may need to be done months in advance and even before booking airline tickets. For example, you will need to contact the airline and complete forms to ensure that you are ready to travel. You will also need to check the airline’s requirements for in-flight oxygen. You must talk to your insurance provider about oxygen while travelling – you may need or benefit from additional insurance.³

Each airline has their own specific rules and policies regarding in-flight oxygen supply. The European Lung Foundation has a nicely organised “airline index” which lists all major airlines and their oxygen policies as well as contact information.

For full guidance on flying with oxygen therapy, download this flying with oxygen checklist to take to your treatment team.

Fit-to-fly assessments

If you have an underlying medical condition, some airlines require you to provide a statement from your treatment team proving you are “fit-to-fly”. In addition to the information in your medical record and your shared travel plans, your treatment team may perform a number of different assessments before issuing a letter to the airline.

One simple test you may need to perform is called a walking test. In this test, you’ll be asked to walk 50 metres (55 yards) or climb one flight of stairs. If you’re unable to complete the task due to breathlessness or any other respiratory symptoms, the treatment team will probably recommend the use of in-flight oxygen.⁸

There are also several other tests which your treatment team may use to assess your fitness to travel.

Today, even travelling long distances with extra oxygen is possible with proper planning. Learn more about travelling with pulmonary fibrosis and find some helpful information in our Travelling with pulmonary fibrosis section.

Key takeaways