Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.

If you have a condition such as chronic obstructive pulmonary disease (COPD) and are planning to travel, you may need to take supplemental oxygen with you. When you are traveling on an airplane, by train, or on a bus, or staying in a hotel, you need to be aware of considerations and possible restrictions.

As you prepare for a trip with supplemental oxygen, check that your equipment and devices are permitted for use during your travel and at your destination. Be sure to ask whether you will have space and be afforded accommodations to use your device.

Prepare for your travels by bringing batteries or chargers to power your equipment. Keep in mind that international destinations and cruise ships may have power outlet configurations that do not match the ones you are used to.

When you are traveling with oxygen, it is important to plan ahead. It is a good idea to schedule a pre-trip medical examination, especially if you will be traveling on an airplane, hiking, staying at a high elevation (such as on a mountain), leaving the country, or going away for a long period of time.

Obtain a letter of medical necessity from your healthcare provider during your pre-trip medical exam. Most airlines require that this letter include your healthcare provider's contact information, a statement about your specific condition, healthcare provider approval for air travel, and confirmation that you require supplemental oxygen, as well as the flow rate and duration of use. You may need to present it when you go through airport security, board your plane, go through customs, and/or at your hotel if you need to stay in a specially accommodated room.

Don't forget to pack all of your regular medications in your carry-on luggage and, if needed, to bring an adequate supply of COPD rescue inhalers with you throughout your trip.

It's always a good idea to keep any medications in their original containers so that you will get the right treatment in case of an emergency.

A high altitude may change the oxygen pressure around you—essentially increasing your oxygen requirement. This doesn't have a significant effect on most people, but if you have a pulmonary disease, a slight change in oxygen pressure can make you feel short of breath.

Your healthcare provider may change your prescription for oxygen supplementation if you are staying at a high elevation or flying during your travels. In fact, some people who do not regularly need to use supplemental oxygen might need to use it only in these circumstances.

When making an airline reservation, be sure to ask about specific regulations and restrictions that may apply when carrying oxygen onboard your flight. 

According to the U.S. Department of Transportation Nondiscrimination on the Basis of Disability in Air Travel Act, oxygen-dependent passengers may now carry their own Federal Aviation Administration (FAA)-approved, battery-powered portable oxygen concentrators (POCs) onboard U.S. domestic and international flights with 19 or more passenger seats, beginning or ending in the United States.

Assistive devices do not count against any limit on the number of pieces of carry-on baggage, and they have priority over other items for storage in the baggage compartment.

In addition to POCs, respiratory assistive devices also include nebulizers, respirators, and continuous positive airway pressure (CPAP) machines. Liquids associated with a nebulizer are exempt from the 3-1-1 liquids rule.

Compressed oxygen tanks and liquid oxygen are not allowed on airplanes.

POCs are permitted on flights only if they are approved by the FAA. Consider renting your POC from an oxygen supply company if you don't typically need oxygen, or if the device you regularly use is not FAA-approved.

According to the FAA, the following devices are approved to carry on board your flight:

For more information about FAA requirements for traveling with oxygen by airplane, visit the FAA website. 

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European Federation of Allergy and Airways Diseases Patients Associations. Enabling air travel with oxygen in Europe: an EFA booklet for patients with chronic respiratory disease.

Federal Aviation Administration. Acceptance criteria for portable oxygen concentrators.

Stoller JK. Patient education: supplemental oxygen on commercial airlines (Beyond the Basics).

Transporation Security Administration. Disabilities and medical conditions: respiratory equipment. 

US Department of Transportation. Passengers with disabilities: about the Air Carrier Access Act.

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