ATTACHMENT I Mandatory use of thermal fuses

ATTACHMENT I– MANDATORY REQUIREMENTS FOR USE OF THERMAL FUSES

Mandatory requirements for use of thermal fuses are as follows:

Thermal fuses must be provided for all patients on home oxygen therapy unless there is a documented clinical contraindication (e.g., patients using heated humidity, patients with flow rates in excess of 25 Liters per minute, patients with behavioral conditions that make use of thermal fuses impractical). If thermal fuses are not provided due to clinical contraindication, this must be documented in the patient’s medical record. Two thermal fuses must be provided and installed in each home oxygen delivery system (one at the patient end and one at the oxygen source). This must be done for the patient’s primary oxygen therapy equipment as well as any portable oxygen therapy equipment. Back-up oxygen systems must also have the thermal fuses in place. Thermal fuses are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have a continuous flow setting. If conserving device has the continuous flow setting option, then thermal fuses are required to be placed in line. Thermal fuses provided must work regardless of their orientation in the oxygen tubing (bidirectional) or have a design that prevents them from being installed in the wrong orientation (e.g., source end of thermal fuse has threads or bayonets that make backwards installation impossible). Existing unidirectional thermal fuses that are capable of being installed in the wrong orientation must be replaced at the next scheduled home oxygen visit or sooner if possible. At the time of installation, education must be provided to the patient describing the proper use and placement of thermal fuses, including that a thermal fuse does not make it safe to smoke, be near people who are smoking, or be near any source of sparks or flame while using oxygen. Thermal fuses must be replaced at the end of their expected life per manufacturer’s guidelines. Thermal fuses must be replaced if actuated or involved in a fire.

Education, as well as the number of thermal fuses provided, must be documented in the in ‘Follow up Home O2 Vendor Assessment’ note in the Computerized Patient Recordkeeping System (CPRS).