Choice Cair offers a full range of respiratory products and services, from the simplest nebulizer to the most revolutionary HomeFill concentrators and the break-through technology of portable concentrators. With the support of community-based respiratory care practitioners, we provide patient education and 24-hour on-call support, every day of the year.

Choice Cair responds to the needs of every patient individually by providing the oxygen system most appropriate for his or her lifestyle. Oxygen concentrators, high pressure cylinders and conserving devices are provided according to the physician's prescription and with consideration for the activity level of each patient. Choice Cair regularly monitors how well each respiratory patient follows the prescribed course of treatment, ensuring compliance with liter flow and hours of use. Regularly monitoring patient compliance increases the likelihood that patients will receive the maximum benefit from the prescribed therapy.

Note To Patients:
The device shown here requires a prescription and must be obtained from a licensed physician.  Your prescription can be faxed to: 760-434-0838.

Supplemental Home Oxygen Therapy and Services

Choice Cair offers multiple options for oxygen systems for patients who need supplemental oxygen at home. Matching the system with the patient's medical and lifestyle needs, we provide the most appropriate supplemental oxygen system utilizing stationary concentrators, portable concentrators, HomeFill concentrators and/or cylinder systems and conserving devices.

Oxygen concentrators:

These devices allow patients to receive uninterrupted continuous oxygen without running empty. An oxygen concentrator is an electrically powered device with a series of filters that extract oxygen from room air. About the size of a window air-conditioner they do not need to be refilled. They effectively concentrate the oxygen already existing in the room air by eliminating the nitrogen component. Concentrators are more mobile than stationary oxygen cylinders, and can be wheeled to any location within the home and within a reasonable distance outside the home.

Also, a backup system, usually stationary compressed gas system, must always accompany a concentrator in case of power failure or other emergency. Regular household current is sufficient for it’s use. In limited cases, a humidifier bottle may be necessary to increase moisture to the oxygen as it passes through tubing to the mask or cannula.

* Suitable for low-flow prescriptions (not exceeding 7-8 liters per minute)
* Dependable
* Easy to operate

Common diagnoses:

• Chronic Obstructive Pulmonary Disease (COPD)
• Emphysema
• Chronic Bronchitis
• Congestive Heart Failure (CHF)
• Acute Myocardial Infarction
• Acute Pulmonary Heart Disease
• Lung Cancer
• Viral Pneumonia
• Bacterial Pneumonia
• Bronciectasis

Portable Concentrators

Inogen One Portable Oxygen Concentrator

Independence. That's what oxygen patients really get from the Inogen One. At home and on the go, the Inogen One achieves the independence that you've been missing - not just for running errands, or short trips out of the house, real independence - true spontaneity. You can now take off on a moment's notice, without having to watch the clock or guess how long your oxygen will last. The Inogen One is not simply a stationary device, not simply a portable one. The Inogen One is designed to be one device to serve all your needs.

Regain your independence with the Inogen One.

In every aspect of its design, the Inogen One is engineered to deliver a better experience to oxygen patients like you.

• Regain Your Independence - With a greater ability to come and go at will, Inogen One patients can enjoy more freedom and independence.
• So Quiet - One of the quietest oxygen devices available, most people don't notice that the Inogen One is on.
• Small and Lightweight - The Inogen One is easy to transport and unobtrusive making it convenient in the home or on the go.
• Surprising Energy Efficiency - The Inogen One uses about as much power as a 40-watt light bulb.
• Easy Operation - The Inogen One is easy to use, creating greater independence for you, your provider, and your physician.

NEWS WIRE
July 18, 2005
FAA relaxes airline oxygen regulation
The move should make it easier for O2 patients to fly

WASHINGTON -- The Federal Aviation Administration passed a rule last week that should make it much easier for respiratory patients to travel onboard commercial airlines.

On July 12, the FAA issued a rule that allows, but does not require, airlines to let patients travel with portable oxygen concentrators during all phases of the flight, including take-off and landing. This is the first time oxygen patients have had the opportunity to fly commercially with their own oxygen. Currently, many airlines don't provide oxygen because its expensive and beyond their scope of expertise. This means oxygen patients have limited and often inconvenient flight options.

The rule change comes after years of advocacy by patients, providers and manufacturers to convince federal regulators that modern portable oxygen systems are safe for air travel. Because regulators can't monitor the contents of oxygen cylinders, patients probably won't be able to bring them on board anytime soon, say industry sources.

Currently, only Inogen make portable concentrators approved by the FAA for this purpose. At some point, however, the FAA plans to develop generic performance standards, and if new products meet these, patients will be able to use them onboard commercial airlines.

The new rule goes into effect Aug. 11.

The rule also eliminates the lengthy certification process airlines must undertake if they want to provide medical oxygen in flight. Because this process was so expensive, many airlines, especially budget carriers, shunned it.

"Most of the (airline) people we've spoken to like the idea because they spending a lot of money and not making on the provision of oxygen," Fary said. "I think air carriers may see this as an opportunity because people who travel with oxygen never travel alone. So its an opportunity to sell two seats.

The home care provider makes one delivery at the time of initial set-up. The need for additional deliveries of oxygen cylinders or liquid oxygen is eliminated. This reduces costs compared to other ambulatory oxygen modalities

Portable Oxygen

A stationary portable system consists of a regulator that attaches to a cylinder held securely by a stand. The regulator controls the rate of flow of oxygen to the patient using a flowmeter and indicates PSI of pressure in the cylinder with a pressure gauge. Tubing connects to the regulator on one end and attaches to a nasal cannula on the other. A portable unit also includes a cart or carrying case. For ambulatory patients who require a low liter flow or high liter flow for intermittent usage, we offer a range of oxygen cylinders. Suitable for low oxygen usage (such as for emergency or occasional use, occasional portability)

* Can be stored for long periods of time
* Careful storage is important so that the cylinder cannot fall over

HomeFill II™ **

HomeFill II™ Oxygen Compressor - The Invacare HomeFill II complete home oxygen system will revolutionize ambulatory oxygen by allowing patients to fill their own high-pressure cylinders from a concentrator. The HomeFill is a multi-stage pump that simply and safely compresses oxygen from a specially equipped Invacare 5-liter or 10-liter concentrator into oxygen cylinders in sizes ML4, ML6 and M9©. The convenience pack requires no batteries, no cumbersome connection tubes, and uses a standard single lumen cannula. The ability to fill their own cylinders gives ambulatory patients greater independence and freedom.

• Small and lightweight – cylinders weigh less than 5 pounds and last up to 5 hours
• Connection and controls are designed to be easy to use
• Patients fill their own portable oxygen cylinders from the comfort and convenience of their own home
• Fill cylinders while patient continues to receive oxygen from concentrator
• No worrying about deliveries or running out of oxygen
• No batteries or maintenance required
• Safe and easy to use
• Eliminates cumbersome regulator changes
• No liquid freeze-ups
• Gives ambulatory patients greater freedom and independence

Oxygen Conserving Devices

Conserving devices may be used in combination with standard cylinder systems to reduce the amount of oxygen that escapes, and to extend the usable hours of a standard cylinder setup. When used in combination with oxygen cylinders, oxygen-conserving devices can provide patients with the convenience of mobility and longer use of their supplemental oxygen.

Chad Sage Conserver

• Oxygen delivery device that minimizes blood oxygen level fluctuations, resulting in better patient outcomes.

• Incorporates two programmable delivery settings for rest and activity requirements.

• Reduces the risk of desaturation by automatically adjusting flow rates based on movement.

• Allows the home care provider or patient to preset and lock prescribed delivery settings.

• S.M.A.R.T. Technology determines the optimum time to switch between settings based on duration of movement.

• Helps reduce the breathlessness associated with activity, resulting in greater ease of movement and increased compliance with rehab programs.

The Respiratory Consumer: Taking Charge of Your Health

Health care consumers who ask the right questions and are active in making decisions save money and improve the quality of care they receive. But knowing the right questions to ask can be difficult in today's complex health care system. This page discusses different types of oxygen systems that are available and what questions to ask when looking for the system that best serves your needs. Only patients with blood oxygen levels below critical levels will benefit from home oxygen. This means that some determination of arterial oxygen level must be made by the prescribing physician before oxygen can be rationally prescribed.

Questions to Ask

Discuss with your doctor what kinds of activities are best for you. To what extent can you go out from home? By knowing what activities you can do, the doctor can decide whether a stationary or portable oxygen system is best for you. Some tips about services you may require:

*Select a supplier that gives you 24-hour service without additional charges.
*If traveling is something you are able to do, look for a company that will assist you in meeting your oxygen needs while traveling. They should be able to assist you in getting oxygen outside of your normal service area.
*Make sure the supplier can provide clear, written instructions regarding your use of the equipment. Do they have trained representatives to instruct you and to demonstrate the equipment when it is delivered?
* Ask for a complete breakdown of costs and verification of what your Medicare or insurance will cover. Make sure the supplier takes Medicare "assignment" (accepts what Medicare pays for services). After you have paid your yearly deductible, Medicare will pay 80%. All oxygen suppliers in the region get paid the same amount for the same prescription.
* Does the supplier have a clinician on staff to assist you if needed? Do they have a follow-up program that the doctor can order?
* Find out if the supplier provided regular routine equipment maintenance. How often do they service their equipment? Do they provide you with information on how to keep it clean? Do they provide disposable tubing needed on a regular basis? Are there any additional charges for this tubing? Remember- You have the freedom of choice. If you can't get the problems resolved by your current oxygen supplier, look under "OXYGEN" in the Yellow Pages and call.

MEDICARE APPROVED LAB VALUES FOR HOME OXYGEN THERAPY

Oxygen Frequently Asked Questions

1. What is oxygen?
2. How is oxygen made and stored?
3. How do I use home oxygen?
4. How do I go about ordering oxygen once my physician prescribes it?
5. How much does home oxygen cost? Will Medicare and/or my insurance pay for it?
6. Why do I need supplemental oxygen?
7. Do all patients with lung or heart disease require supplemental oxygen?
8. How can I tell if I need supplemental oxygen?
9. Can I become addicted to oxygen?
10. Will oxygen relieve my shortness of breath?
11. Does the need for supplemental oxygen mean that I am dying?
12. Do I have to use oxygen all the time?
13. How do I get around in my home while using oxygen?
14. Can I cook and eat while using oxygen?
15. Can I use electrical appliances while using oxygen?
16. Can I use oxygen around smokers?
17. What do I do if I want to leave my home?
18. How heavy are the portable tanks?
19. Can I drive a car while using oxygen?
20. Will I be able to travel when I’m using oxygen?
21. What do I do if I run out of oxygen?
22. Is there anything that I cannot do while using oxygen?
23. Are there any hazards involved in using oxygen?

1. What is oxygen?
Oxygen is a colorless, tasteless, odorless gas that is necessary for life. When we take a breath, we draw air containing 21% oxygen into our lungs. The oxygen passes from our lungs into our bloodstream, where it is carried in the red blood cells to all the organs and tissues of our bodies. Oxygen is needed by our organs and tissues to convert the food we eat into heat and energy, to maintain life.

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2. How is oxygen made and stored?
There are three common methods for obtaining pure oxygen:

• Air is cooled and compressed until it becomes a liquid. Then as the liquid air warms, the oxygen “boils” off and is collected. It is then re-cooled and compressed into liquid oxygen and stored in “thermos bottles” known as reservoirs.
• The oxygen gas is compressed and stored in heavy steel pressurized tanks.
• Room air is pumped through a fine filter that traps all but the oxygen, which is allowed to pass through. This is known as an oxygen concentrator or oxygen enricher.

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3. How do I use home oxygen?
A small, adjustable plastic tube (called a nasal cannula), worn much as you would wear eyeglasses, is placed under the nose. This tubing, through which the oxygen will flow, is attached to the oxygen tank.

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4. How do I go about ordering oxygen once my physician prescribes it?
Your physician, respiratory therapist, social worker, or nurse may recommend an oxygen supplier to you, or you may look in the yellow pages under “Oxygen.” When selecting an oxygen supplier, consider the following:

• Will the company deliver and install the equipment?
• Does the company have a delivery service 24 hours a day? Seven days a week?
• Does the company provide information on the use and cleaning of the equipment?
• Is a nurse or therapist available to answer your questions and come to your home if necessary?
• Will the company bill Medicare or your insurance for you?

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5. How much does home oxygen cost? Will Medicare and/or my insurance pay for it?
The cost can vary greatly depending on your prescription. There is a variety of oxygen equipment available. Your physician decides how much oxygen you need. The supplier will help you select the most economical system to meet your needs and activities, and should be able to give you and approximate monthly cost.

Medicare will pay 80% of approved expenses. Many private insurance carriers also pay for oxygen within the limits of their policies. To be sure your policy does cover oxygen, call your insurance claims representative.

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6. Why do I need supplemental oxygen?
Normally oxygen passes readily from lungs into the bloodstream and is pumped by the heart to all parts of the body. When lung disease occurs, oxygen may not be able to pass as readily into the bloodstream. When the heart is diseased, it may not be able to pump as much oxygen-carrying blood.

Either of these situations can result in not enough oxygen reaching the organs and tissues of the body, preventing them form functioning properly. This can cause undesirable effects, such as decreased ability to exercise, difficulty breathing, fatigue, contusion, memory loss, etc. Breathing supplemental oxygen increases the amount of oxygen that passes into the bloodstream and is carried to the organs and tissues.

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7. Do all patients with lung or heart disease require supplemental oxygen?
It is estimated that over 4 million patients with lung or heart problems either are benefiting or could benefit from supplemental oxygen. This is a rather small percent of the estimated 60 million Americans affected my lung or heart and circulatory disease.

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8. How can I tell if I need supplemental oxygen?
You might suspect you need supplemental oxygen in you have one or more of the following symptoms: decreased ability to exercise, difficulty breathing, and fatigue easily, periods of disorientation or memory loss.

The only way to know for sure, however, is to measure the amount of oxygen in your blood with Arterial Blood Gas or goniometry. Your physician will evaluate your test results and symptoms to determine if you might benefit from additional oxygen. If you do need supplemental oxygen, your physician will prescribe the proper flow rate and duration of use.

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9. Can I become addicted to oxygen?
Oxygen is not addicting. We all need oxygen to live. If your lungs and/or heart are diseased and cannot supply enough oxygen to your body from normal room air, you need to breath supplemental oxygen. Should your condition improve, you may no longer require supplemental oxygen.

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10. Will oxygen relieve my shortness of breath?
Oxygen frequently does help, but there are reasons other than lack of oxygen for shortness of breath. In such cases, oxygen may not relieve the condition. By itself, shortness of breath isn’t life threatening.

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11. Does the need for supplemental oxygen mean that I am dying?
Patients may live for years on home oxygen. Others require supplemental oxygen at home temporarily to relieve their discomfort after being hospitalized or experiencing other stressful situations.

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12. Do I have to use oxygen all the time?
Your physician will determine how many hours per day you should use the oxygen. Note: be sure to follow your doctor’s directions carefully for desired therapeutic benefit.

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13. How do I get around in my home while using oxygen?
There is a variety of oxygen equipment available. Usually it will be placed where you will be using it most. Up to 50 ft. of tubing can also be added to allow you to move about. Your home oxygen supplier will discuss with you the best choice of equipment for your activities.

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14. Can I cook and eat while using oxygen?
You can carry on your normal activities as long as you use common sense while you’re using oxygen – don’t cook on an open flame; don’t smoke; and be careful that your oxygen tubing doesn’t come into contact with hot burners, pots, pans or anything that could cause the tubing to melt.

Using oxygen while eating may be beneficial in reducing the shortness of breath that many patients experience during and after eating.

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15. Can I use electrical appliances while using oxygen?
Electrical appliances that get hot or spark during operations should be kept at least 5 feet away from the oxygen system.

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16. Can I use oxygen around smokers?
Yes, as long as no one smokes within 5 feet of the oxygen equipment or the person using the oxygen.

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17. What do I do if I want to leave my home?
There are small portable tanks that can be taken with you, some of which hold enough oxygen to provide up to 8 hours of continuous use. If you’re traveling, additional, refillable tanks may be carried in your vehicle. Your supplier may also arrange for you to pick up the oxygen en route and at your destination.

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18. How heavy are the portable tanks?
Portable tanks vary in weight from 6 to 15 pounds. These tanks may be carried in a shoulder bag during use or pull carts may also be available.

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19. Can I drive a car while using oxygen?
Yes. Again, all you need do is use common sense. While driving, secure the oxygen unit so it will not tip over. Leave a window open slightly for ventilation so the oxygen will not accumulate in the car.

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20. Will I be able to travel when I’m using oxygen?
Yes. You can travel on public transportation while using oxygen. Be sure to make reservations early, alerting the reservations people to any special needs you may have, so they will have time to accommodate them. Your supplier can help you arrange for you r oxygen en route and at your destination.

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21. What do I do if I run out of oxygen?
You will probably feel some sort of discomfort you experienced before you went on your oxygen therapy, but this discomfort shouldn’t be life threatening. Call your supplier to replace or refill the container. You can reduce the discomfort until they arrive by placing as little demands on your lungs as possible. For example, you might sit or lie down and relax until the supplier arrives to fill your tank.

If you are with your portable tank and it should run out, return home and continue using your oxygen.

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22. Is there anything that I cannot do while using oxygen?
You can do anything that you would normally do, except for those things that would bring you within five feet of an open flame, a burning cigarette, or an electrical appliance that sparks. Actually you may find that you will be able to do some activities while using oxygen that you couldn’t do without it.

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23. Are there any hazards involved in using oxygen?
While oxygen doesn’t burn, anything that can burn will do so more easily and more rapidly in an oxygen-rich environment. Therefore, do not use oxygen near an open flame, a burning cigarette, or an electrical appliance that sparks during operation.

Do not use oil, grease, or Vaseline on oxygen equipment. Should frost form on your liquid oxygen system, do not allow the frosted portions of the equipment come into contact with your skin. Your home oxygen supplier will thoroughly explain all safety precautions related to your home oxygen therapy.

Be careful to follow your doctor’s orders exactly when using oxygen, and never change the liter flow without his or her approval.