Helium-oxygen mixture (heliox) has been advocated for clinical use since 1934, and there has been a growing array of clinical applications. Until recently, administering heliox has required jury-rigging by modifications and/or extension of available devices not designed for use with heliox. This paper reviews devices required to administer heliox and considers how devices designed to deliver air and/or oxygen have been adapted for use with heliox. Use of devices outside of their design limits adds risk and liability, whereas using Food-and-Drug-Administration cleared devices for heliox administration reduces the risk and liability.