This is the aftermath from one of two deadly fires in Nevada where the occupants were on home oxygen and smoking. This incident resulted in one fatality and two relatives suffering from severe burns. Both survivors of this fire were treated long-term at the U of I Hospitals and Clinics Burn Unit.
After the Nevada Fire Department experienced a deadly fire on April 22, 2023, involving the use of home oxygen and cigarettes, the department was determined to reduce these incidents in both Iowa and nationwide. The state’s Department of Health and Human Services is the first in the nation to release an informational letter covering the cost of a device for Medicaid patients. The Department of Veterans Affairs implemented a thermal fuse mandate for all veterans who are prescribed home oxygen.
On Nov. 30, Iowa Medicaid officials released guidance to home medical equipment suppliers regarding thermal fuses and Medicaid reimbursement for installation of these safety devices in home oxygen therapy cases.
Thermal fuses are bidirectional valves placed at the oxygen concentrator and in the oxygen tubing near the patient. When fire reaches these devices, the flow of oxygen is stopped, reducing the intensity of the fire. Thermal fuses cost approximately $4.45.
Nevada Fire Chief Ray Reynolds says, “This is monumental news for Iowans and the rest of the nation. Our fire department is leading efforts in Iowa and in the U.S. to get Medicare and the private insurance industry to follow suit. People are being injured and dying in oxygen-rich fires as a result of home oxygen use.”
According to information provided by the American Thoracic Society, 1.5 million people in the U.S. are prescribed home oxygen for various respiratory illnesses. Reynolds says as many as 50 percent of home oxygen users continue to smoke because of their nicotine addiction.
Iowa officials informed Reynolds they would follow a direction similar to the Department of Veterans Affairs coming short of mandating thermal fuses. However, making them reimbursable as medical equipment will likely see other states follow suit. Reynolds is working with the International Association of Fire Chiefs (IAFC) and a working group of U.S. fire and medical experts, hoping to eventually see the Centers for Medicare and Medicaid Services (CMS) mandate thermal fuses for all home oxygen therapy patients. Reynolds says a decision of that magnitude will likely reduce U.S. fire deaths by 12 percent and have a cost savings for Medicare in the neighborhood of $500 million currently being spent on burn care for those who survive their burns from oxygen use and smoking.
The Nevada Fire Department is taking tragedy and trying to make home oxygen use safer for firefighters and home oxygen-prescribed patients.
As a reminder, smoking cessation, having working smoke alarms, and the use of two thermal fuses are recommended for people who are prescribed home oxygen. Residential sprinklers are also a best practice in protecting lives during a fire event.
