Safe Use of Supplemental Oxygen with Powered Wheelchairs
User Experience Network™ [Health Devices Aug 1992;21(8):291]
A major wheelchair manufacturer told us not to use an oxygen cylinder
(E-cylinder) with its powered wheelchair. We are concerned that such use presents a risk
of fire for our patients who use powered wheelchairs and supplemental oxygen. What is an
We have been investigating the risks of an oxygen-enriched atmosphere
(OEA) near ignition sources (e.g., electric motors, surgical lasers) for many years;
however, we know of no standards that directly address the use of oxygen cylinders with
powered wheelchairs. The National Fire Protection Association
standard addressing the use of electrical equipment during oxygen administration (NFPA 99,
Section 7-6.2.3, 1990 edition) limits equipment use only within 1 ft of the "site of
intentional expulsion" of the oxygen. The electrical components of the wheelchair,
with the exceptions noted below, would be at least 1 ft from the patient's face. Although
chin-operated joysticks and some switches may be within this distance, these components
are not hot electrically or to the touch. Therefore, the use of a D- or E-cylinder of
pressurized oxygen with a powered wheelchair is reasonably safe—provided that the
cylinder is secured and protected (i.e., the cylinder is immobilized so that the stem and
regulator cannot be bumped or broken off) and the oxygen is not allowed to accumulate
under the patient's clothing or wheelchair upholstery or near the electric controls,
motors, or battery compartments.
Hospitals and their patients who use powered wheelchairs should follow
these guidelines whenever using supplemental oxygen:
- Never smoke. Oxygen greatly increases the
ignitability and flammability of surrounding fuels (e.g., hair, clothing,
- Be sure that the oxygen cylinder is secured to the
wheelchair and protected from inadvertent collisions, positioning the stem
and regulator so that they will not be accidentally bumped. Any bumping or
movement of the cylinder could damage the regulator, valves, or tubing and
cause an oxygen leak, permitting oxygen accumulation.
- Never charge or replace the wheelchair batteries.
Both activities carry a high risk of producing an electric spark, which
could lead to a flash fire or explosion in an OEA.
- Be sure that the oxygen line is not draped near
moving components of the wheelchair, especially near a powered recliner.
This may lead to entangled tubing (leading to patient injury), leaks in the
oxygen line, or damage to the wheelchair.
- Check the oxygen tubing daily, from the cylinder to
the delivery site, for leaks.
- Turn off the oxygen source if the mask or cannula is not in use.
Strictly following these guidelines should safely allow the use of oxygen
with powered wheelchairs.
- Medical Gas Cylinders [16-501]
- Wheelchairs, Powered [16-214]
Cause of Device-Related Incident
Device factor: Device interaction
External factor: Medical gas and vacuum supplies
Mechanism of Injury or Death