Use of portable medical oxygen cd (integral valve) cylinders

The Health and Safety Authority (HSA) is issuing this Safety Alert following a tragic fatal accident involving the use of a Portable Medical Oxygen Cylinder in an ambulance situation.

Oxygen is non-flammable but strongly supports combustion and under high pressure with certain conditions can cause common materials to ignite suddenly (including some materials which do not normally burn in air). It is highly dangerous when in contact with oils, greases, tarry substances and many plastics. 

Portable Medical Oxygen Cylinders are utilised throughout the healthcare system to provide a temporary uninterrupted portable oxygen supply to patients. They may be used where, for example, a patient is being moved on a stretcher from an ambulance to a hospital trolley /bed or vice versa, or in the home environment. 

Although rare, portable medical oxygen cylinder fires can occur, particularly when the cylinder valve is initially opened and flow selected. Operatives need to be mindful of this possibility and treat the cylinder with due care and attention at all times. 

The HSA is providing the following advice to enhance awareness and vigilance in the preparation and use of Portable Medical Oxygen Cylinders.


Important General Advice

  • Oxygen cylinders should be prepared for use in a vertical position, vigilance by the operator during preparation is of critical importance.
  • Set up the cylinder for patient use away from the patient, this includes connecting the appropriate equipment, selecting the flow rate and then opening the valve (slowly). During set up the fir tree opening should not point towards the patient, bed or operator.
  • Place the cylinder in an appropriately designed holder.
  • Do not place the cylinder on the patient’s bed unless there is no alternative. Use extra care when there is no option but to place the cylinder on the bed, ensuring it is has first been turned on with flow selected.
  • In an ambulance situation the oxygen cylinder should be prepared for use outside the ambulance if possible.
  • When medical oxygen is in use, ensure there are no sources of ignition in the vicinity.



Training in the safe use of medical oxygen cylinders, particularly in relation to handling of cylinders and actions to be taken should a fire occur should be provided for all users.

Note:  This advice is for guidance only, reference should also be made to the approved Summary of Product Characteristics (SPC) and Patient Information Leaflets (PIL) and other information in links below.  


Further Information