1. Oxygen Cylinder: Conversion & Storage

2. Objectives Provide a safe environment of work and care through proper use & storage of oxygen E- Cylinders in user areas. Notify users of E-Cylinder storage requirements for proper segregation of “Full, Partial and Empty” E-Cylinders.

3. Oxygen Cylinder Conversion-MBB Effective Nov. 1, 2015, BJC’s supplier of medical gas tank management and distribution will be Praxair Technology, Inc. This change in supplier provides BJC with an annual savings of $400,000, and significant contractual improvements in service level agreements and key performance metrics.

4. Oxygen Cylinder Comparison Current State: Airgas Separate Regulator and Liter Flow Adjustment Knob. Black Liter Flow Adjustment Knob. Small Bore Oxygen Device Access located on back of Regulator. No oxygen delivered if Liter Flow Adjustment Knob is between settings. Portable Ventilator: Use Portable Ventilator Access for hook-up AND set Liter Flow Adjustment Knob to desired flow rate. Closed carrying Handle. Full cylinders have 3 caps (Red, Black and Clear).

5. Oxygen Cylinder Comparison Future State: Praxair Combined Regulator and Liter Flow Adjustment Knob. White Liter Flow Adjustment Knob. Small Bore Oxygen Device Access located on side of Regulator. No oxygen delivered if Liter Flow Adjustment Knob is between settings. Clicking noted when in proper position. Open carrying handle. DO NOT HANG FROM HANDLE. Full cylinders have 2 caps (Black and Green). Portable Ventilator: Use AUX Access for hook-up AND set Liter Flow Adjustment knob to “AUX”. CAN NOT use AUX Liter Flow setting and Small Bore Oxygen Device Access simultaneously. No Oxygen Flow will be delivered to Small Bore Access. Small Bore AUX Side View of Cylinder

6. Joint Commission Requirements for Storage The Joint Commission requires organizations to segregate full, partial and empty cylinders by physically separating and clearly labeling the cylinders Once a cylinder valve is opened, the cylinder is considered empty, even if gas remains in the cylinder. Opened cylinders must be physically separated from full (unopened) cylinders for storage

7. New Definitions for BJH All Caps Intact FULL Cap Missing or Tank Used or Regulator in Place 2200 PSI – 501 PSI PARTIAL <500 PSI EMPTY

8. Implementing the Change PARTIAL Greater Than 500 psi M issing O riginal Caps Gauge R egulator is in P lace EMPTY Less Than 500 psi Gauge Regulator Needle Near or at R efill Area – Red Section FULL original caps intact

9. Original Caps (Praxair) Small bore- Photo shown as Black Cap AUX- Photo Shown as Green Cap

10. Roll Out 70% Complete –East Pav. –West/Central Pav. –Rand Johnson –Queeny Remaining Areas 6200 Peri-Operative Services ED CAM North Campus COH CAM PSQ CPAP

11. Education Committees Email Staff Meetings Huddle Flyers

12. Take Aways-Usage 3L and 6L Flow Rate –Venti Mask 15L Flow Rate –Non Re-breather mask – Ambu Bag AUX Flow Rate –Portable Ventilator –No oxygen flow will be delivered to Small Bore Access when in AUX mode

13. Take Aways-Storage Notify all users of E-Cylinder storage rack changes for proper segregation including: –Obtain cylinders from Green or Yellow storage rack sections only –Place used cylinders in Yellow or Red storage rack sections, based upon psi levels. <500Red Section >501Yellow Section Original Cap is IntactGreen Sectio n

14. Questions? Emma Hooks Director Environmental Health and Services Emma.Hooks@bjc.org 769-6002 Hans Trefny Manager Environmental Safety hwt9592@bjc.org 454-7019 Peggy Watts Manager Respiratory Care Peggy.watts@bjc.org 454-5238