Kevin Raver, Manager, Respiratory Therapy MultiCare Valley Hospital, Spokane Valley, Washington

One patient dies every four days from home oxygen therapy (HOT) related fires. Kevin Raver, wants to change that—and there’s a relatively simple solution.

Raver has helped spearhead an initiative locally that has spread nationally involving home oxygen therapy and thermal fuses. A thermal fuse is a bi-directional valve, and when exposed to fire it completely stops the flow of oxygen. Therefore, when placed at the nasal cannula connection and at the oxygen concentrator, it has the potential to reduce and stop HOT fires.

Raver said he had never heard of this small, yet critical, piece of equipment before the Spokane Valley Fire Department contacted the hospital where he works in April 2022 looking for partners to help distribute the fuse throughout the community. He was even more surprised to learn that thermal fuses are mandatory for all United States Department of Veterans Affairs patients who are on HOT—and that they have been mandatory in the United Kingdom for about 20 years.

“If the VA is mandating it, then how come Medicare and Medicaid haven’t followed suit? It just seems silly that they haven’t,” Raver said. “Adding a couple of thermal fuses to someone’s oxygen equipment seems like a no-brainer to me.”

Raver will be the first to say he never does anything in a half-hearted way. So once he decided he was in, he hasn’t slowed down his mission to educate homecare professionals and the public about the value of the thermal fuse.

MultiCare Valley Hospital, where Raver is the respiratory therapy manager, agreed to begin sending HOT patients home with thermal fuses. Raver also worked with the oxygen companies and home oxygen representatives in the Northwest to educate them about fuses.

Due to the combined efforts of Raver, his team, the fire department and home oxygen companies in the area, there has not been a single home oxygen fire incident in Spokane Valley since the safety program began in July 2022.

And if saving lives isn’t enough of a reason for thermal fuses to become standard in all HOT setups, they also help save the U.S. health care system money.

According to the International Association of Fire Chiefs (IAFC), which has pushed the Centers for Medicare & Medicaid Services to cover thermal fuses, a recent fire in Nevada, Iowa, involving home oxygen therapy and a cigarette could have been prevented with the placement of two thermal fuses. The fire killed one person and injured two others. The treatment costs totaled almost $20,000 per day per person (excluding ambulance and helicopter transportation). The IAFC said the total cost will top $1.2 million for the care received and anticipated additional surgeries. The funds spent healing people from that fire alone could have paid for 269,000 thermal fuses for high-risk patients.

Raver is now working with a large home oxygen working group that consists of 28 members representing 23 organizations that are committed to partnering with the Centers for Medicare and Medicaid Services to get coverage for thermal fuses and to reduce burn deaths, civilian injuries and injuries to the nation’s firefighters.

“I’m proud to be involved,” Raver said. “I’m proud to be a part of this group that are working really hard to make these mandatory. Obviously, it’s a worthwhile thing or the VA wouldn’t have mandated it. So, we just need to get Medicare and Medicaid to follow suit. And I think we’ll see a lot less oxygen fires, and we’ll be able to save a lot more lives. And that’s what it’s all about.”

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