2022 HME Business Handbook: Respiratory

How To Keep Home Oxygen Patients Safe and Prevent Costs

RespiratoryEach year, hundreds of homecare patients are unnecessarily killed or injured in home oxygen-related fires in the United States.

The cause is all too often the same. Patients that are prescribed home oxygen therapy are commonly being treated for respiratory conditions from long-term smoking. Despite the known hazards, research has found that up to half of all home oxygen users continue to smoke while on oxygen. That is startling, given that a fire ignited by a cigarette spreads very rapidly in an oxygen-enriched atmosphere.

While smoking is believed to be the leading cause of home oxygen-related fires, any open flame is considered hazardous to home oxygen patients and those around them. And high-pressure oxygen tanks are at great risk of exploding when engulfed in fire, endangering occupants and emergency workers even further. In fact, research on these types of fires suggests that, despite extensive safety efforts by the oxygen industry, a tank explodes in one out of every three oxygen fires.

These fires can quickly spread — one in four results in a whole house fire — affecting neighbors, emergency workers, and communities. However, HME providers can provide life-saving products that help prevent this.


Firefighters are acutely aware of the dangers of house fires where oxygen equipment is present, and have been stepping up their efforts to educate, riskassess and mitigate against them.

“Patients [involved in a] home oxygen [fire] are five times more likely to end up on a ventilator compared to patients with burns unrelated to home oxygen tanks,” explains Deputy Chief Greg Rogers of the Spokane Valley Fire Department (SVFD). “One study of late outcomes following burn center admission for home oxygen tank-related burns noted that just over one-third of patients never return home, and that mortality at one year was over 50 percent. The medical and insurance costs for these burn injuries are in the billions of dollars.”


One of SVFD’s newest initiatives promotes thermal fuses, a small preventative device that they say will reduce the risk of fire injuries and fatalities.

A thermal fuse (also known as a firebreak) cuts the flow of oxygen if the patient’s downstream oxygen tubing is ignited. It is installed directly onto the oxygen concentrator or tank and as close to the patient as possible. It is designed to work no matter which method of oxygen delivery patients use and—with a lifespan of five years—is a longer-lasting replacement for standard oxygen tubing connectors.

Throughout Europe, the installation of thermal fuses is required for all home oxygen installations. In fact, the chance of an oxygen fire fatality is 20 times greater in the United States than in England, where firebreaks have been mandatory since 2006.

In 2018, the United States Veterans Health Administration (VA) mandated the fitting of thermal fuses to all 85,000 veterans’ home oxygen installations.


A recent survey by a thermal fuse manufacturer asked home oxygen equipment providers about their awareness of fires and preventative strategies. Many respondents did not grasp the scale of the issue due to the infrequent reporting of fires. One respondent said it was not unusual to hear about a fire involving home oxygen months up to a year after the incident.

Most home oxygen providers said they were aware of thermal fuses and around half know that the VA mandates their use. Of the home oxygen providers surveyed, 95 percent said that thermal fuses are effective in preventing fires.


Home oxygen fires remain a serious public health concern in many countries worldwide, but particularly in the United States: from 2017 to 2021, 567 fires involving home oxygen and 316 fatalities were reported by the media.

However, experiences around the world show that a coordinated approach to patient safety and simple safety devices can make a big difference.


  • Home oxygen fires remain a serious public health concern, with hundreds of people killed or injured each year in the US
  • Firefighters increasingly recommend thermal fuses to reduce the risk of fire injury or fatality
  • Also known as a firebreak, a thermal fuse cuts the flow of oxygen if the patient’s downstream tubing is ignited
  • Thermal fuses last five years and can replace standard oxygen tubing connectors, saving money
  • 95 percent of providers say thermal fuses are effective


To learn more about the Spokane Valley Fire Department’s initiative at spokanevalleyfire.com. For more information on firebreaks, visit firebreaks.info.

This article originally appeared in the May/Jun 2022 issue of HME Business.

About the Author

Elizabeth Ramer is the Content Editor for Sunset Healthcare Solutions and works closely with the sales, product development, and marketing departments to ensure that the most helpful information about Sunset's products is effectively communicated to customers and patients.

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