Central Medical Gas System Arif Raza

Introduction Gases and Vacuum are used in hospitals for therapeutic purposes The gases used in hospitals are Medical Gases Oxygen Nitrous Oxide Compressed air Vacuum

Introduction Centralized gas and vacuum supply service is a modern system of piped supply of medical gases from a central storage area called manifold room to all delivery points in hospital It provides a very efficient, economical and highly dependable life support service Makes better patient care in all the areas of hospital

Functions Supply of right medical gases at right pressure Supply of compressed air at right pressure Supply of clinical vacuum at right pressure Proper planned maintenance of all equipments, including distribution network Optimum level of cleanliness and pollution free environment Prevention of hazards such as fire, explosion or contamination of gases supplied

Components Source of supply: Central supply room with control equipments and panels Distribution system: piping Point of use delivery connections: Suitable station outlet valves and pendants Monitoring and control equipment and alarms

Manifold Room Consists of a cylinder manifold and a control panel Manifold can be of 2 banks of 2 cylinders each or 2 banks of 20 cylinders each Control panel: primary and secondary pressure regulators; warning lamp Pressure gauges

Manifold Room Vacuum Unit Vacuum pump with an electric motor Cylindrical reservoir tank: stabilizes the pressure of the pipeline system at all outlet points Motor has switch for automatic start and stop Vacuum pumps are duplexed

Manifold Room Compressed air unit Compressor with electric motor, after cooler, air receiver and air dryer Instantly provides compressed air Compressor are duplexed

Manifold Room Primary supply Secondary supply when primary supply is exhausted Primary and secondary provides normal operating supply When operating supply fails, a reserve supply takes over

Manifold Room In case of breakdown of control panel of oxygen and nitrous oxide, an emergency kit ensures supply of gas through the pipes Emergency kit comprises a regulator and high pressure tubing to a bulk cylinder and the gas is fed directly to the pipeline through a service outlet In case the vacuum and air supply system fails, a standby motor-cum-pump is used to provide uninterrupted supply

Manifold Room Half of the total daily consumption of oxygen and nitrous oxide is kept in the manifold room as reserve Oxygen and nitrous oxide should be stored seperately from flammable gases and liquids Storage location should be free of combustible materials If exceeding 2,000 cubic feet storage should be outside the building Must have generator backup, adequate ventilation, lighting and telephone communication

Advantages of Centralized Medical Gas System For the patients No distressing sight of oxygen cylinders at the bedside Elimination of irritating noise from movement of cylinders Protection of contamination due to movement of cylinders Uninterrupted and clean supply at desired location

Advantages of Centralized Medical Gas System For Hospital Staff Instant availability of gas on taps Clean, safe and reliable delivery of gases Continuous flow of gases when and where required Minimal accident hazards due to mishandling of cylinders

Advantages of Centralized Medical Gas System For Hospital Administrator Easy purchase of gases in bulk quantities at favourable terms Economy on purchase of cylinders Fewer breakages Rationalization in ordering, storing and transporting a wide variety and size of gas cylinders Minimum damage to building due to handling of cylinders

Oxygen Increased demand of oxygen May be supplied from a bulk tank or from cylinders Can be stored as gas or liquid Oxygen containers may be stationary or movable

Oxygen and Nitrous Oxide Bulk oxygen system: assemblage of equipment such as oxygen containers, pressure regulators, safety devices, vaporizer, manifolds and interconnecting piping with a storage capacity of more than 20,000 cu ft of oxygen including reserves The system terminates at the point where oxygen first enters the supply line at service pressure

Vacuum Used for patient draining, aspiration and suction Also used in hospital laboratory Distributed through network of pipes Central vacuum supply system with control equipments, an alarm and piping The piping terminates with outlet valves at user points

Vacuum Central vacuum consists of two (or more) vacuum pumps that operate either simultaneously or alternately Each pump should be capable of maintaining 75% of calculated demand during peak time The pumps should alternate automatically Pumps should be equipped with a motor starting device and overload protection Failure of one vacuum should not affect other

Compressed Air Compressed air is used for both medical and non-medical puposes Medical use – Laboratory work, inhalation therapy equipment and powering of surgical tools Non-medical use – maintain tools and equipments and in engineering department

Compressed Air Should be free of dust and moisture Done by means of oil filters, dust filters, moisture seperator and the dryer at equipment level Separate dryer for air compressor system If compressed air not used properly, it can damage equipment and contaminate chemicals, food and drugs

Pipes Should be seamless type, non-ferrous, non-arsenic, of high quality copper tubing Should be protected against physical damage and corrosion Exposed oxygen pipelines should not be installed in areas like kitchen, laundry and rooms where combustible materials are stored Colour coded as per the gas content

Pipes Before pipes are erected, all pipes, tubes and fittings should be cleaned thoroughly and washed with tetrachloride Pipes should be blown clear using oil-free air or nitrogen When whole system is in place, it should be subjected to a test pressure of 150 psi or 1 ½ times the working pressure for 24 hours to check, if it can withstand the pressure as well as leakages This test, called pressure lock is done section by section

Terminal units Gas outlets / vacuum inlet units Connected to source equipment through the distribution system Located at actual usage point Outlets should be gas specific and non-interchangeable Fitted with locking system and non-return valves

Alarm system Audio-visual Monitoring of pressure Meant to warn maintenance dept

Location and space Ground floor in rear part Near maintenance area Seperate enclosure for full cylinders, empty cylinders, compressed air, vacuum supply No fire hazard Compresor unit in sound proof area Liquid oxygen area shall be cordoned off

Staffing No specific norms Total 6 technicians (including supervisors and 25% leave relief) Under chief engineer

Quality Indicators Number of complaints of malfunctioning, from the users Correctness of pressure level in the oxygen, nitrous oxide and compressed air pipeline Correctness of negative pressure in the vacuum line Bacteriological culture of the gases and the air delivered Leakage at the outlet points Functioning of audio-visual alarm system

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