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CENTRALIZED MEDICAL GAS

supplies

PRESENTED BY:-DR. KARANBIR KAUR

MBA 1ST YR.ROLL NO:- 9

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INTRODUCTION…

• Gases administered to patients are called medical gases

• Medical gases used are life supporting element that shows direct influence in maintaining life of the patient

• Medical gases include oxygen, nitrous oxide, vacuum (suction) & compressed air to operating & special procedure rooms, ICU’s & patient floors

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Contd…

• So at the sections where medical gases are used, the medical gas

must be clean highly pure supplied under stable pressure

• The system must has a through going color coordination audio visual monitoring system a device to prevent cross

connection at medical gas outlet

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Medical gases… oxygen…

• Oxygen may be used for patients requiring supplemental oxygen via a mask.

• Supplied in bulk tank/ cylinders• Stored as gas/ liquid• Containers stationary/ movable• Bulk 20,000 ft3 including reserves

• liquid oxygen at the hospital which is evaporated into a concentrated oxygen supply, pressure is usually around 55 psi.

• In small hospitals with a low patient capacity, oxygen is usually supplied by multiple standard cylinders.

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nitrous oxideo Nitrous Oxide is supplied to various

surgical suites for its anaesthetic functions during pre-operative procedures.

o Delivered to the hospital in standard tanks and supplied through the Medical Gas system.

o System pressures around 50 psi.

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vacuum (suction)

o For patient draining, aspiration & suction & in labs

o Consists of 2 or more vacuum pumps that operate simultaneously/ alternately

o Each pump capable of maintaining 75% of calculated demand

o Continuous vacuum is maintained around 22 inches of mercury.

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compressed airo Medical uses- labs, inhalation

therapy, powering surgical toolso Non medical uses – maintain tools &

equipments in clinical engineering department

o Should be free of dust & moisture…if not done will damage equipment/ contaminate chemicals, foods & drugs

o Pressures are maintained around 55 psi

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Design…

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Components of cmgs…

There are 4 main components:- source of supply: - include central supply room control equipment/

panel Distribution system:- includes piping Point of use delivery connections:-

include outlet valves & pendants Monitoring & control equipments &

alarms

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Central supply room: manifold room

consists of

Cylinder manifold:

May

be as small as 2

banks

of 2 cylinders

each/ as

large as 2

banks of 20 cylinders

each

Control panel

:Consist of primary & secondary pressure

regulators to

ensure delivery of gas at a require

d pressure

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Types of supplies…

PRIMARY SUPPLY

• Part of system that actually supplies the system

Secondary supply

• Automatically supplies the system when primary supply is exhausted

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Various units…

VACUUM UNIT• consist of vacuum pump with

electric motor• A cylindrical reservoir tank stabilizes

the pressure of pipeline system at all outlet points

• Motor has negative pressure switch for automatic on/ off

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COMPRESSED AIR UNIT• Includes compressor with electric

motor , after cooler, air receiver & air dryer

• Instantly provide compressed air where required

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OXYGEN & NITROUS OXIDEo emergency kit ensures supply of gas

through pipes

o Emergency kit includes regulator & high pressure tubings connected to bulk cylinders & gas is fed directly to pipeline through service outlet

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Control panel…

control panel has pressure gauges that indicates the pressure in the gas

When cylinder is empty/ there is some regulator mal function, a warming lamp on control panel glows

BACK

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Distribution system…

through pipes – should be seamless type non ferrous, non arsenic of high quality copper tubing

Piping should be protected against physical damage & corrosion

Gas content of pipeline should be readily identifiable by color of tubing that bears the name of gas

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Before they are erected, all pipes valves, tubes & fittings should be cleaned thoroughly with

tetrachloride/ hot sol. Of sodium carbonate/ trisodium phosphate mixed with water

& rinse thoroughly with warm water

After installation but before connection pipes should be blown clear using oil free air/nitrogen

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When whole system is in place then subjected to test pressure of 150 psi/ 1.5 time working pressure for 24 hrs to check if it can withstand required pressure/ any leakage

This is known as PRESSURE LOCK & it is done section by section

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Outlet pendants…

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Alarm systems…

mainly 2 types of alarm systems

monitors the pressure of various gases at different areas of distribution

• When abnormal pressure is sensed system sets off alarm….normal green light goes off & red warning signal glows with audible alarm until pressure returns to normal

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remote signal lamp visual & audible• The lamp lights up & alarm goes off

when either the banks of cylinders in manifold room becomes empty

• No immediate action is required b’coz when 1 bank is empty then other bank takes over

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Requirements…

The Department of Building and Safety is to issue building permits, plan check, inspect and approve the construction and installation of Medical Gas Systems (including all piping and equipment).

The Fire Department must verify that

construction and installation requirements have been met and sign off new or modified existing systems prior to operation

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Areas where medical gases are stored shall be dedicated to such use without other storage or uses.

.All piping, fittings, valves and equipment shall be designed for the use and installed as required by the Plumbing Code.

Equipment and piping shall be protected from physical damage

Signs/LabelsDoors to supply rooms and cabinets

shall have a sign indicating “No Smoking-Oxygen/Nitrous Oxide”.

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Compressed gas cylinders shall be identified by nationally recognized standards.

Each valve, manifold and all piping shall be labelled identifying the contents with the following colours: a) Oxygen: Green background with white

letters. b) Nitrous Oxide: Blue background with

white letters. Shutoff valve labels shall indicate “(Type

Gas) Shutoff Valve for (Location or Zone)”, or “(Type Gas) Main Shutoff Valve”.

All piping shall have labels indicating contents with lettering at least

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All piping shall have labels indicating contents with lettering at least 3/8” high and a direction of flow arrow.

Piping labels shall be at the following locations: a) Each valve. b) Both sides of each floor, wall or ceiling

penetration. c) Each change of direction. d) Every 20 feet or fraction thereof.

All cylinders shall be secured to prevent falling and those not in use shall have the protective cap in place.

A record of as-built plans and valve identification shall remain on the site at all

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Safe handling of gases…Ensure only experienced & well instructed

person handle compressed gasesObserve all regulations & statutory

requirements concerning storage of cylinders

Do not remove/ deface labels provided by supplier

Ascertain the identity of gas before using itKnow the properties & hazards associated

with each gas

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Contd…

Establish & be familiar with plans to cover any emergency situation that may arise

Never lift a cylinder with cap/ guard ; use cylinder trolley for transportation

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Advantages…

FOR THE PATIENTSNo distressing sight of oxygen

cylinders at bedsideElimination of irritating noise of

movement of oxygen cylinders protection of sterile areas from

contamination caused by cylindersUninterrupted & clean supply at

desired locations

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FOR HOSPITAL STAFFInstant availability of gas on tapsClean, safe & reliable delivery of

gasesContinuous flow of gases when &

where requiredMinimal accidental hazards due to

mishandling of cylinders

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FOR THE HOSPITAL ADMINISTRATOR

Easy purchase of gases in bulk quantities at favorable terms

Economy on purchase of cylindersFewer breakagesRationalization in ordering, storing &

transporting wide variety & size of gas cylinders

Minimum damage to building due to handling of cylinders

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