1. MEDICAL GASES Manufacture, Storage, Transport + Delivery
First Year Respiratory Therapy
MJC
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2. Composition of the Air We breathe earth’s atmosphere composed of:
Nitrogen (78%)
Oxygen (21%)
Carbon Dioxide (0.03%)
Argon and trace gases (0.93%)
Neon, Xenon, Krypton and Deon
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3. How Oxygen is produced Fractional Distillation Physical Separation
Nitrogen Molecular sieve
Semi-Permeable membrane

4. Fractional Distillation
Large Manufacturing Facility

5. Fractional Distillation for liquid O2
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6. Fractional Distillation
Atmospheric air is filtered of pollutants, carbon dioxide and water
Air is compressed and cooled to a liquid
Then it is slowly heated and the nitrogen boils off.
Liquid oxygen remains
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7. Molecular Sieve Semi-Permeable Plastic Membrane (in the home)
Physical Separation
Molecular Sieve
Semi-Permeable Plastic Membrane
(in the home)

8. Molecular Sieve Composed of inorganic sodium aluminum silicate pellets
These pellets absorb the nitrogen and water vapor from the air
Produces up to 90% mixture
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9. Oxygen Concentrator
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10. Semipermeable Membrane
Pulls air through membrane
Oxygen passes through faster than nitrogen
Can produce 40% mixture
Good for long-term low flow oxygen
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11. Oxygen concentrator–Semi-permeable membrane
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12. Physical Separators
Will produce concentrations for nasal cannula but only at low flows
Used in oxygen concentrators IN THE HOME
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13. Home Concentrator
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14. Medical Gases
Oxygen, Carbon Dioxide, Helium, Nitrous Oxide, Nitric Oxide, Nitrogen, Carbon Monoxide

15. Properties of Common Gases
Chemical symbol
Molecular weight
Color, odor, taste
Physical state
Critical temperature, boiling point
Combustion characteristics
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16. Oxygen 02 Molecular Weight 32 Colorless, odorless, tasteless
Slightly heavier than air
Density of 1.29 g/L
Nonflammable but supports combustion
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17. Compressed Air
Is the same mixture of nitrogen, oxygen, carbon dioxide and argon.
Is piped in to all modern hospitals
Used to power pneumatically powered equipment
Some situations (patients are C02 retainers) when oxygen is contraindicated
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18. Carbon Dioxide C02 Colorless and Odorless Does not support combustion
Used in fire extinguishers
More soluble in liquids than oxygen
Easier transporting in blood then oxygen
Used to treat hiccups (singulation)
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19. Helium He Odorless, tasteless, non-flammable Second lightest of gases
Combined with oxygen (heliox) to reduce work of breathing with swollen upper airways
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20. Nitrous Oxide N20 Nonflammable but supports combustion
Used as an anesthesia in OR (laughing gas)
Always mixed with oxygen (Entonox) and other anesthesia agents
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21. Nitric Oxide N0 Is nonflammable but supports combustion
Used experimentally in low concentrations (ppm) for pulmonary vasodilation
Recently has had excellent results with premature babies
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22. Nitrogen N2
Used as lab gas (liquid) for freezing tissue
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23. Carbon Monoxide CO Used in Pulmonary Function Lab
Very diffusible – used to test how easily gas will pass through the lung membranes
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24. Cyclopropane
Strictly an anesthesia gas
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25. Ethylene Oxide Used to gas sterilize medical equipment
Useful for equipment that can’t handle high temperatures or immersion in water
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26. Tanks – Liquid Tanks - Gas
Oxygen Storage
Tanks – Liquid
Tanks - Gas

27. Tank Sizes and Capacities
Large Cylinders
Small Cylinders

28. Oxygen Tank Sizes
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29. H Cylinders 2200 psi A.S.S.S safety system Threaded connection
Need to be safety chained and in a secured dolly for moving
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30. E Cylinders Small and lightweight (15 pounds) PISS – Pin Index
Yoke connection
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31. Types and colors of cylinders
Air - Yellow
Oxygen - Green – Int’l (White)
Helium - Brown
CO2 - Grey
Nitrogen - Black
Nitrous Oxide-Blue
Do NOT trust the color of the tank as sole indicator of it’s contents
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32. Labels – The only sure way
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33. Other Oxygen Tank Markings
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34. Regulation of cylinders
D.O.T
O.S.H.A.
F.D.A.
B.M.D.

35. Recommending Agencies
C.G.A.
N.F. P.A.
A.N.S.I.
I.S.O
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36. Bulk Supply Systems
Liquid Oxygen

37. Bulk Oxygen Systems Large capacity Small system (or back up)
Liquid oxygen
Small system (or back up)
Nitrous Oxide
Bank of H cylinders
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38. Large Oxygen Supply System
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39. Small Bank of Cylinders
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40. Liquid vs Gas Insulated – Liquid Solid metal - Gas
Large continuous demand – Liquid
Small portable – Liquid or tank
Tanks act differently if they contain gas or liquid
No accurate gauge on liquid tank content
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41. Go figure
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42. Liquid Oxygen Constantly losing oxygen despite insulation
Needs pressure and insulation for cold temperature (-118oC)
Low pressure (200 psi)
Large system has vaporizers fins to help with heat transfer when liquid turns to gas (frozen year round)
Small system is great for mall shopping
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43. Bulk Liquid Oxygen supply
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44. Bulk Oxygen Supply System
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45. Home Liquid Oxygen
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46. Low Pressure Safety Systems
Diameter Index Safety System
Quick Connect

47. Wall (low pressure) systems
D.I.S.S.
50 P.S.I
The MJC lab has these
Quick connect
A newer “better system”
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48. DISS (and Dat)
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49. DISS Wall Outlet
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50. Different Quick Connects
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51. More Quick Connects
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52. Flowmeters
Thorpe Tube is most common
Can use Bourdon Gauge
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54. Other Safety Features
Zone Valves

55. Zone Valve System
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56. Zone Valves for bulk O2 supply
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57. Cylinder Connections (High Pressure)
American Standard Safety System
Pin Index Safety System
Key Index Safety System

58. Regulators
They decrease internal tank pressure down to a working pressure (50psi)
They read and display the internal tank pressure
They meter out the precise flow for patient use.
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59. Cylinder connections A.S.S.S. (American Standard) P.I.S.S. (Pin Index)
H cylinders
High pressure, large tanks
P.I.S.S. (Pin Index)
E cylinders
High pressure, small tanks
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60. American Safety Standard System
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61. Pin Index System
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62. Pin Index System
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63. Pin Index Numbering for small cylinders
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64. Tank Duration
How long will they last

65. Cylinder Duration Calculations
You can memorize size of tank then calculate how long it will last
Or use:
Conversion factors
3.14 for H cylinders
0.28 for E cylinders
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66. Liquid Oxygen Duration
Convert pounds to liters
Multiply by 860 to get volume of gaseous oxygen (Liters)
Divide by the liter flow (L/min)
Convert minutes to hours and minutes
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67. Thanks for listening
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