Medical gas supply

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Medical gas supply systems in hospitals and other healthcare facilities are utilized to supply specialized gases and gas mixtures to various parts of the facility. Products handled by such systems typically include:

Contents

Source equipment systems are generally required to be monitored by alarm systems at the point of supply for abnormal (high or low) gas pressure in areas such as general ward, operating theatres, intensive care units, recovery rooms, or major treatment rooms. Equipment is connected to the medical gas pipeline system via station outlets (US) or terminal units (ISO).

Medical gas systems are commonly color coded to identify their contents, but as coding systems and requirements (such as those for bottled gas) vary by jurisdiction, the text or labeling is the most reliable guide to the contents. Emergency shut-off valves, or zone valves, are often installed in order to stop gas flowing to an area in the event of fire or substantial leak, as well as for service. Valves may be positioned at the entrance to departments, with access provided via emergency pull-out windows.

Oxygen

BeaconMedaes oxygen, vacuum, and medical air medical gas supply outlets on a ceiling at Campbell County Memorial Hospital in Gillette, Wyoming BeaconMedaes oxygen, vacuum, and medical air medical gas supply outlets on a ceiling at Campbell County Memorial Hospital in Gillette, Wyoming.jpg
BeaconMedaes oxygen, vacuum, and medical air medical gas supply outlets on a ceiling at Campbell County Memorial Hospital in Gillette, Wyoming

Oxygen may be used for patients requiring supplemental oxygen via mask. Usually accomplished by a large storage system of liquid oxygen at the hospital which is evaporated into a concentrated oxygen supply, pressures are usually around 345–380 kPa (50.0–55.1 psi), [1] [2] or in the UK and Europe, 4–5 bar (400–500 kPa; 58–73 psi). [3] This arrangement is described as a vacuum insulated evaporator or bulk tank. [4] In small medical centers with a low patient capacity, oxygen is usually supplied by a manifold of multiple high-pressure cylinders. In areas where a bulk system or high-pressure cylinder manifold is not suitable, oxygen may be supplied by an oxygen concentrator. However, on site production of oxygen is still a relatively new technology.

Medical air

Medical air is compressed air supplied by a special air compressor, through a dryer (in order to maintain correct dew point levels), and distributed to patient care areas by half hard BS:EN 13348 copper pipe and also use isolation ball valve for operating the services of compressed air 4 bar. It is also called medical air 4 bar. In smaller facilities, medical air may also be supplied via high-pressure cylinders. Pressures are maintained around 345–380 kPa (50.0–55.1 psi). If not used correctly it can be harmful to humans. [5]

Nitrous oxide

Nitrous oxide is supplied to various surgical suites for its anaesthetic functions during preoperative procedures. It is delivered to the hospital in high-pressure cylinders and supplied through the Medical Gas system. Some bulk systems exist, but are no longer installed due to environmental concerns and overall reduced consumption of nitrous oxide. System pressures are around 345 kPa (50.0 psi), 4 bar (400 kPa; 58 psi) UK.

Nitrogen

Nitrogen is typically used to power pneumatic surgical equipment during various procedures, and is supplied by high-pressure cylinders. Pressures range around 1.2 MPa (170 psi) to various locations.

Instrument air/surgical air

Like nitrogen, instrument air is used to power surgical equipment. However, it is generated on site by an air compressor (similar to a medical air compressor) rather than high-pressure cylinders. Early air compressors could not offer the purity required to drive surgical equipment. However, this has changed and instrument air is becoming a popular alternative to nitrogen. As with nitrogen, pressures range around 1.2 MPa (170 psi). UK systems are supplied at 11 bar (1.1 MPa; 160 psi) to the local area and regulated down to 7–8 bar (700–800 kPa; 100–120 psi) at point of use.

Carbon dioxide

Typically used for insufflation during surgery, and also used in laser surgeries. System pressures are maintained at about 345 kPa (50.0 psi), UK 4 bar (400 kPa; 58 psi). It is also used for certain respiratory disorders. It contains 5 percent.[ clarification needed ]

Medical vacuum

Medical vacuum in a hospital supports suction equipment and evacuation procedures, supplied by vacuum pump systems exhausting to the atmosphere. Vacuum will fluctuate across the pipeline, but is generally maintained around −75 kPa (−560 mmHg; −22 inHg), −450 mmHg (−60 kPa; −18 inHg) UK.

Waste anaesthetic gas disposal/anaesthetic gas scavenging system

Waste anaesthetic gas disposal, or anaesthetic gas scavenging system, is used in hospital anaesthesia evacuation procedures. Although it is similar to a medical vacuum system, some building codes require anaesthetic gases to be scavenged separately. Scavenging systems do not need to be as powerful as medical vacuum systems, and can be maintained around −50 to −65 kPa (−380 to −490 mmHg; −15 to −19 inHg).

Medical gas mixtures

There are many gas mixtures used for clinical and medical applications. They are often used for patient diagnostics such as lung function testing or blood gas analysis. Test gases are also used to calibrate and maintain medical devices used for the delivery of anaesthetic gases. In laboratories, culture growth applications include controlled aerobic or anaerobic incubator atmospheres for biological cell culture or tissue growth. Controlled aerobic conditions are created using mixtures rich in oxygen and anaerobic conditions are created using mixtures rich in hydrogen or carbon dioxide. Supply pressure is 4 bar (400 kPa; 58 psi).

Two common medical gas mixtures are entonox and heliox.

Related Research Articles

Nitrox refers to any gas mixture composed of nitrogen and oxygen. This includes atmospheric air, which is approximately 78% nitrogen, 21% oxygen, and 1% other gases, primarily argon. In the usual application, underwater diving, nitrox is normally distinguished from air and handled differently. The most common use of nitrox mixtures containing oxygen in higher proportions than atmospheric air is in scuba diving, where the reduced partial pressure of nitrogen is advantageous in reducing nitrogen uptake in the body's tissues, thereby extending the practicable underwater dive time by reducing the decompression requirement, or reducing the risk of decompression sickness.

<span class="mw-page-title-main">Pneumatics</span> Branch of engineering

Pneumatics is a branch of engineering that makes use of gas or pressurized air.

<span class="mw-page-title-main">Breathing gas</span> Gas used for human respiration

A breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and only natural breathing gas, but other mixtures of gases, or pure oxygen, are also used in breathing equipment and enclosed habitats such as scuba equipment, surface supplied diving equipment, recompression chambers, high-altitude mountaineering, high-flying aircraft, submarines, space suits, spacecraft, medical life support and first aid equipment, and anaesthetic machines.

<span class="mw-page-title-main">Diving cylinder</span> Cylinder to supply breathing gas for divers

A diving cylinder or diving gas cylinder is a gas cylinder used to store and transport high pressure gas used in diving operations. This may be breathing gas used with a scuba set, in which case the cylinder may also be referred to as a scuba cylinder, scuba tank or diving tank. When used for an emergency gas supply for surface supplied diving or scuba, it may be referred to as a bailout cylinder or bailout bottle. It may also be used for surface-supplied diving or as decompression gas. A diving cylinder may also be used to supply inflation gas for a dry suit or buoyancy compensator. Cylinders provide gas to the diver through the demand valve of a diving regulator or the breathing loop of a diving rebreather.

<span class="mw-page-title-main">Diving air compressor</span> Machine used to compress breathing air for use by underwater divers

A diving air compressor is a gas compressor that can provide breathing air directly to a surface-supplied diver, or fill diving cylinders with high-pressure air pure enough to be used as a breathing gas. A low pressure diving air compressor usually has a delivery pressure of up to 30 bar, which is regulated to suit the depth of the dive. A high pressure diving compressor has a delivery pressure which is usually over 150 bar, and is commonly between 200 and 300 bar. The pressure is limited by an overpressure valve which may be adjustable.

<span class="mw-page-title-main">Anaesthetic machine</span> Medical device used to generate a fresh gas flow for anaesthesia

An anaesthetic machine or anesthesia machine is a medical device used to generate and mix a fresh gas flow of medical gases and inhalational anaesthetic agents for the purpose of inducing and maintaining anaesthesia.

<span class="mw-page-title-main">Bottled gas</span> Gas compressed and stored in cylinders

Bottled gas is a term used for substances which are gaseous at standard temperature and pressure (STP) and have been compressed and stored in carbon steel, stainless steel, aluminum, or composite bottles known as gas cylinders.

<span class="mw-page-title-main">Gas blending for scuba diving</span> Mixing and filling cylinders with breathing gases for use when scuba diving

Gas blending for scuba diving is the filling of diving cylinders with non-air breathing gases such as nitrox, trimix and heliox. Use of these gases is generally intended to improve overall safety of the planned dive, by reducing the risk of decompression sickness and/or nitrogen narcosis, and may improve ease of breathing.

An oxygen concentrator is a device that concentrates the oxygen from a gas supply by selectively removing nitrogen to supply an oxygen-enriched product gas stream. They are used industrially and as medical devices for oxygen therapy.

<span class="mw-page-title-main">Pressure swing adsorption</span> Method of gases separation using selective adsorption under pressure

Pressure swing adsorption (PSA) is a technique used to separate some gas species from a mixture of gases under pressure according to the species' molecular characteristics and affinity for an adsorbent material. It operates at near-ambient temperature and significantly differs from the cryogenic distillation commonly used to separate gases. Selective adsorbent materials are used as trapping material, preferentially adsorbing the target gas species at high pressure. The process then swings to low pressure to desorb the adsorbed gas.

<span class="mw-page-title-main">Industrial gas</span> Gaseous materials produced for use in industry

Industrial gases are the gaseous materials that are manufactured for use in industry. The principal gases provided are nitrogen, oxygen, carbon dioxide, argon, hydrogen, helium and acetylene, although many other gases and mixtures are also available in gas cylinders. The industry producing these gases is also known as industrial gas, which is seen as also encompassing the supply of equipment and technology to produce and use the gases. Their production is a part of the wider chemical Industry.

<span class="mw-page-title-main">Pin Index Safety System</span>

The Pin Index Safety System, or PISS, is a means of connecting high pressure cylinders containing medical gases to a regulator or other utilization equipment. It uses geometric features on the valve and yoke to prevent mistaken use of the wrong gas. This system is widely used worldwide for anesthesia machines, portable oxygen administration sets, and inflation gases used in surgery.

<span class="mw-page-title-main">Cascade filling system</span> Filling pressurized gas from a series of storage cylinders

A cascade filling system is a high-pressure gas cylinder storage system that is used for the refilling of smaller compressed gas cylinders. In some applications, each of the large cylinders is filled by a compressor, otherwise they may be filled remotely and replaced when the pressure is too low for effective transfer. The cascade system allows small cylinders to be filled without a compressor. In addition, a cascade system is useful as a reservoir to allow a low-capacity compressor to meet the demand of filling several small cylinders in close succession, with longer intermediate periods during which the storage cylinders can be recharged.

An air separation plant separates atmospheric air into its primary components, typically nitrogen and oxygen, and sometimes also argon and other rare inert gases.

<span class="mw-page-title-main">Booster pump</span> Machine to increase pressure of a fluid

A booster pump is a machine which will increase the pressure of a fluid. They may be used with liquids or gases, but the construction details will vary depending on the fluid. A gas booster is similar to a gas compressor, but generally a simpler mechanism which often has only a single stage of compression, and is used to increase pressure of a gas already above ambient pressure. Two-stage boosters are also made. Boosters may be used for increasing gas pressure, transferring high pressure gas, charging gas cylinders and scavenging.

<span class="mw-page-title-main">Scuba gas management</span> Logistical aspects of scuba breathing gas

Scuba gas management is the aspect of scuba diving which includes the gas planning, blending, filling, analysing, marking, storage, and transportation of gas cylinders for a dive, the monitoring and switching of breathing gases during a dive, efficient and correct use of the gas, and the provision of emergency gas to another member of the dive team. The primary aim is to ensure that everyone has enough to breathe of a gas suitable for the current depth at all times, and is aware of the gas mixture in use and its effect on decompression obligations, nitrogen narcosis, and oxygen toxicity risk. Some of these functions may be delegated to others, such as the filling of cylinders, or transportation to the dive site, but others are the direct responsibility of the diver using the gas.

<span class="mw-page-title-main">Internal combustion engine</span> Engine in which the combustion of a fuel occurs with an oxidizer in a combustion chamber

An internal combustion engine is a heat engine in which the combustion of a fuel occurs with an oxidizer in a combustion chamber that is an integral part of the working fluid flow circuit. In an internal combustion engine, the expansion of the high-temperature and high-pressure gases produced by combustion applies direct force to some component of the engine. The force is typically applied to pistons, turbine blades, a rotor, or a nozzle. This force moves the component over a distance, transforming chemical energy into kinetic energy which is used to propel, move or power whatever the engine is attached to. This replaced the external combustion engine for applications where the weight or size of an engine were more important.

Gas blending is the process of mixing gases for a specific purpose where the composition of the resulting mixture is specified and controlled. A wide range of applications include scientific and industrial processes, food production and storage and breathing gases.

Diving support equipment is the equipment used to facilitate a diving operation. It is either not taken into the water during the dive, such as the gas panel and compressor, or is not integral to the actual diving, being there to make the dive easier or safer, such as a surface decompression chamber. Some equipment, like a diving stage, is not easily categorised as diving or support equipment, and may be considered as either.

References

  1. NFPA 99: Health Care Facilities Code (2015)
  2. CSA Z7396.1-17 - Medical gas pipeline systems - Part 1: Pipelines for medical gases, medical vacuum, medical support gases, and anaesthetic gas scavenging systems
  3. ISO 7396-1:2016 Medical gas pipeline systems - Part 1: Pipeline systems for compressed medical gases and vacuum
  4. "Anaesthesia UK : Oxygen".
  5. "HazCom: Medical Gases". www.fairview.org. Retrieved 2021-05-31.