I’ve been using home oxygen (at night, while I’m sleeping, supplied by the VA) for the past 2.5 years. Today I learned that my oxygen system has been non-compliant with VA safety requirements since September 2018.
UPDATE: Spousal Unit found paperwork indicating that the oxygen personnel at my gaining VA *did* try to contact me after I arrived. Apparently in the confusion of the move and dealing with my poor health, I misunderstood that they were calling about more than the delivery of the equipment, and I failed to return their missed call. I publicly admit that this failed hand-off was likely my fault, not the VA’s.
After much frustration and confusion, today I received my home oxygen equipment in Florida. 13 months after I relocated. Apparently the hand-off between the Colorado and Florida VA hospitals failed, and my gaining hospital was *never notified* that they were gaining an oxygen patient. However, I didn’t know that because I was supplied with an oxygen concentrator upon arrival in Florida. I *did* think it odd that the supplier never returned to refresh my hose stock or to service the machine, as the Colorado supplier had, but I had a few extra hoses and cannulas and I had bigger problems to deal with (like my gaining PCM refusing to renew my medication prescriptions and not referring me to the required specialists for continuing care at my gaining VA hospital).
But I finally got most of those problems resolved, and so my attention shifted to the oxygen supplier mystery. Recently, while I was at the VA hospital for an (unrelated) appointment, I started asking questions about the oxygen situation. This rapidly brought me to the attention of the nurse manager of the home oxygen program at my VA hospital, and he freaked the heck out when I explained the situation to him. He explained that he had never been notified that his hospital was gaining me as an oxygen patient (despite my having worked with a VA patient transfer specialist in Colorado for the move). I had been in Florida for a year, and my local VA home oxygen program had no knowledge of my existence.
Upon learning of my existence, this nurse manager (himself also a veteran) sprang into action. He called me that day, as I was on my way home, and gave me his personal cell phone number. He established exactly what I needed, and made arrangements for the acquisition of necessary equipment even though he was out-of-town (not in the office). In less than a day-and-a-half, he had arranged for delivery of everything I needed. His care has been exceptional, and I cannot say enough good things about him.
So today the oxygen supply company delivered my equipment. Again, excellent service. And as the technician was setting up my equipment and explaining everything, I noticed that the equipment looked a bit different from what I was used to, and the technician was saying that he was installing the fire-safe valves. Which led to a discussion about what they were and how they worked…
And after he left, I researched them (because of course I did), and this is what I learned: fire-safe valves are also known as oxy-safe valves, fire-break valves, or oxygen thermal fuses. Thermal fuses, a.k.a. fire-safe valves, work to restrict the supply of oxygen in the case of a fire. “A thermal fuse does not prevent the start of a fire nor extinguish a fire; it simply limits the flow of oxygen that might continue to feed the fire.” When a thermal fuse detects fire, it closes and shuts off the supply of oxygen flowing through the tubing.
And, according to this firesafe cannula valve introductory video, the VA has required their use since 2018:
Fire-safe valve
This was news to me, since I had never seen or heard of these valves until today, despite having been provided oxygen equipment and equipment servicing through the VA throughout 2018 (the year the policy took effect) and 2019. So I did some further research and found VA Patient Safety Alert AL18-01, dated March 12, 2018, which states that “use of thermal fuses may reduce the severity of fires involving home oxygen delivery systems,” and lays out a timeline for the notification of providers and the modification of existing contracts to reflect that the use of thermal fuses IS MANDATORY for all VA patients (AL18-01, pp. 3-4). Furthermore, the Safety Alert requires that “by COB September 21, 2018, the Patient Safety Manager must document on the VHA Alerts and Recalls Web site (http://vaww.recalls.ncps.med.va.gov/WebRecalls/Recalls.html) that medical center leadership has reviewed and implemented these actions [italics added by me].”
Now, I was always very satisfied with the service I received from my VA-contracted oxygen equipment supplier in Colorado, but they certainly were not in compliance with this directive by this deadline, since I left Colorado in October of 2018 and had not been equipped with this new safety item nor informed of the fact that a device existed that would make my home oxygen use safer.
According to this directive, there should be two fire-safe valves in each oxygen delivery system – one near the machine, and one near the user (see diagram, AL18-01, p. 7).
As you can see, my old set-up did not have a fire-safe valve near the machine *or* near my head – the hose (with no thermal fuse) ran from the machine…
…and attached to the cannula with a regular connector (not a fire-safe valve).
Whereas my new machine has a pigtail cord attached to the machine with a fire-safe connector to attach to the hose…
…and the hose attaches to the cannula with a fire-safe valve connector:
So my new system is in compliance with the VA Patient Safety Alert.
Since I consider myself fairly well-informed about my healthcare matters, it was a bit shocking to discover today that this safety device existed and was required by the VA, but I’d never heard of it. So I’m passing this information along to you.
IN ORDER TO REDUCE/PREVENT SERIOUS BURNS FROM FIRES FED BY HOME OXYGEN, MAKE SURE YOUR OXYGEN DELIVERY SYSTEM HAS PROPERLY-INSTALLED FIRE-SAFE VALVES. AND DO NOT SMOKE OR HAVE HEAT SOURCES OR OPEN FLAMES NEAR YOUR OXYGEN EQUIPMENT.
NOTE: You can find more information about home oxygen use here and more information about fire safety & home oxygen use here.