When should supplemental oxygen be used in flight?

For best protection, you are encouraged to use supplemental oxygen above 10,000 feet MSL. At night, because vision is particularly sensitive to diminished oxygen, a prudent rule is to use supplemental oxygen when flying above 6,000 feet MSL. So, when you fly at high altitudes, supplemental oxygen is the only solution.



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Others who do not require medical oxygen elsewhere may need to use it when travelling by plane. Conditions commonly associated with use of medical oxygen for air travel include chronic obstructive pulmonary disease (COPD), restrictive and interstitial lung diseases, bronchiectasis, cystic fibrosis and severe asthma.

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For best protection, you are encouraged to use supplemental oxygen above 10,000 feet MSL. At night, because vision is particularly sensitive to diminished oxygen, a prudent rule is to use supplemental oxygen when flying above 6,000 feet MSL. So, when you fly at high altitudes, supplemental oxygen is the only solution.

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Airlines are not required to provide oxygen service and many do not. Passengers may carry portable oxygen concentrators (POCs).

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A simple pulse oximeter reading while you are at high altitude, at rest and during activity, can determine if oxygen is needed at altitude. Alternatively, some pulmonary function labs can perform an altitude simulation test to determine your oxygen saturation at altitude.

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Resting Pulse Oximetry
Values >95% on room air suggest that inflight hypoxemia is unlikely and that further evaluation is likely not necessary. Patients with saturations <92% on room air at rest should receive supplemental oxygen inflight, because they are at high risk of hypoxemia at altitude.

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The only oxygen equipment allowed on an airplane is the portable oxygen concentrator (POC). If you need oxygen in flight, you must take a portable oxygen concentrator with you, and , you must let your airline know ahead of time. They may require a doctor's letter to verify the need for the POC on the plane.

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When you fly on an airplane, the flight attendant instructs you to “put your oxygen mask on first,” before helping others. Why is this an important rule for ensuring survival? Because if you run out of oxygen yourself, you can't help anyone else with their oxygen mask.

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If oxygen deficiency continues over a long enough period of time, it can cause unconsciousness, permanent brain damage or even death. So, in order to keep everyone maintained with enough oxygen, the masks fall down and provide a personal flow.

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Oxygen production cannot be shut off once a mask is pulled, and oxygen production typically lasts at least 15 minutes, sufficient for the plane to descend to a safe altitude for breathing without supplemental oxygen.

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Answer: No. The cabin is pressurized between 6,000 and 8,000 feet on long flights. Adding supplemental oxygen is not necessary, because the percentage of oxygen is the same as being on the ground at those altitudes.

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The airline may charge you for any oxygen it supplies during the flight. You will likely have to pay for oxygen for each leg of a trip. And airlines usually do not supply oxygen during layovers, so try to book a direct flight. At least two weeks before your flight, notify the airline that you will need oxygen.

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Answer: No. The cabin is pressurized between 6,000 and 8,000 feet on long flights. Adding supplemental oxygen is not necessary, because the percentage of oxygen is the same as being on the ground at those altitudes.

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Choose a seat in the middle of the plane. As the air circulates across the rows and not up and down the plane, some experts believe the worst air is in the front or the back of the plane. Stay well hydrated by drinking lots of fluids (water or fruit juice) and avoiding caffeine and alcohol, which will dehydrate you.

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Pressurised aircraft do not maintain a sea level pressure during flight for practical reasons. During commercial flights most cabins are pressurised to an equivalent altitude of 5000–8000 ft, which equates to an inspired oxygen fraction of 0.17–0.15 at sea level [5].

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