A Clinician’s Guide
Think They All Deliver the Same Amount of Oxygen…Think Again
What to Know Before You Order a “POC”
Portable Oxygen Concentrators (POCs) manufacture oxygen; they do not store oxygen.
Portable oxygen concentrators produce enough oxygen per minute to provide an acceptable dose of oxygen with every inhalation.
Portable concentrators that weigh 3 to 8 pounds only deliver oxygen on demand pulse flow.
Manufacturers of these devices place arbitrary numbers such as 1–3 or 1–6 to refer to the size of the pulse flow of oxygen. These settings are considered liter flow equivalents and are not
the same as liter flow.
These devices do not deliver the same amount of oxygen on the same setting. Example:
Setting 3 on AirSep FreeStyle = 24 mL at 20 Bpm
Inogen One G3 = 31 mL at 20 Bpm
SeQual eQuinox = 48 mL at 20 Bpm
3 LPM Continuous = 50 mL at 20 Bpm
What to Know Before You Order a “POC”
All POC oxygen users need to be titrated by your staff, if possible, or by a respiratory therapist at an accredited retailer.
The prescription should be written:
“Lightweight Portable Concentrator Titration Target SPO2 92% or Greater With a 30-Day Trial Period”
NOTE: Most local suppliers carry one brand and will not bill Medicare because of the low reimbursement.
Why Self-Monitoring is Important
Over 96% of oxygen users currently have a Home Oxygen Concentrator that produces continuous flow at 1 to 5 liters per minute and a Portable Tank System that delivers oxygen on demand (“pulse flow”) at settings 1 to 5.
The pulse settings on Portable Tank Systems and POCs are not equivalent to continuous flow.
Manufactures arbitrarily assign these settings and they differ from one POC to another and one manufacture to another. POCs converse battery time by use pulse flow, a tank system conserves oxygen via pulse flow.
Note: The common setting of 2 liters continuous flow delivers 30 to 33 milliliters per breath at 18 to 20 breaths per minute, compared to a Portable Tank Systems or Portable Oxygen Concentrators on the setting of 2 pulse flow, which deliver 20 to 23 mL at 18 to 20 BPM, or 1/3 less oxygen per breath compared to continuous flow.
Note: 90% of all oxygen users prefer carry POCs
It is becoming more common for oxygen users to replace their Portable Tank System with a POC because they are more convenient; they are lighter, will run on battery power and on DC car outlets, and never run out of oxygen. You will also find your patients to be more active when using a POC: and if your patient likes to travel, airlines only accept POCs onboard.
Why do oxygen users purchase POCs?
We are finding that oxygen users are purchasing POCs out-of-pocket because Medicare will not reimburse for the purchase of oxygen equipment and homecare dealers will not provide these products due to a low monthly reimbursement from Medicare. The cost of portable concentrators ranges from ($2250-$3500).
There are two types of POCs to choose from:
- Carryable mini portable concentrators, weighing 2 to 5 pounds that provide on demand “pulse flow only” settings 1 to 3 or 1 to 5
- Cart portables, weighing 10 to 20 pounds delivering pulse flow settings 1 to 6 and continuous 1 to 3 liters/min
POCs have become a consumer product:
The majority of POCs are purchased from internet companies that are not accredited nor licensed by local state pharmacy agencies and, like all consumer products, can be misrepresented.
We at OxiMedical Respiratory, an accredited and state pharmacy registered provider, feel obligated to explain what occurs in the marketplace, via homecare provider or internet reseller, once you hand your patient a signed prescription that fails to protect their right to return an inadequate product.
Note: POCs are regulated by the FDA and by law, your patient is protected from companies that will not give your patient adequate time to be tested on these portable concentrators.
“POC 2 to 3 Liters as needed”
Few words lead to broad applications and patient vulnerability.
By writing a prescription that requires a 10-day no-risk trial period, you are giving your patient the opportunity to be titrated at your office or a pulmonary rehab facility. This will protect your patient by saving them a restocking fee of 20% to 25%, ($600-$800), or their full investment of ($2250 to $3500) from companies that claim this product cannot be returned because of “one patient use”.
“POC 1 to 6 pulse, titrated to 90% or 92% SPO2 or greater 10-day trial money-back guarantee”
From the Management of OxiMedical Respiratory we appreciate your time in addressing these concerns that affect your patients. If you are in need of more information about POCs please schedule an online inservice for your staff on the pros and cons of POCs.