1. MEDICAL GAS SYSTEMS Uganda Experience - By Joel O. Akabway Biomedical Engineer, Biomed Systems Centre Ltd, Ntinda the right Connection

2. WHERE AND WHEN DO THEY APPLY?

3. Introduction Medical gases are manufactured specifically for use in various medical applications. Used as directed by a trained medical personnel (Doctors). the right Connection

4. Introduction Areas of use and application include; treatment, diagnosis, investigations, to operation and running of various instruments and equipment. Medical gases can exist in either gaseous or liquid forms and supplied either by bottles or piped works. the right Connection

5. Introduction The most commonly available and used include; Oxygen Nitrous Oxide Carbon Dioxide Medical Air Medical Vacuum Entonox e.t.c the right Connection

6. Application Purposes cont Medically, medical gases can be used as or for; Anaesthetic Gases (used anesthesia) Analgesic Gases (reduction of sensitivity to pain without loss of consciousness). the right Connection

7. Application Purposes Life Support (Provision of life support i.e. oxygen) Seductive Gases (Mind relaxation) Respiratory Stimulating (a stimulant to breathing Medical Air _ operation of Instruments Medical Suction the right Connection

8. Supply Forms Cylinders/Bottles Piped gas supply systems (Manifold System with a bank of cylinders. Piped gas supply system plant (Central Gas Supply Plant). Equipment i.e. Oxygen concentrators (for therapeutic applications) the right Connection

9. MANIFOLD & CENTRAL PLANT SYSTEMS SETUP MEDICAL OXYGEN Or NITROUS OXIDE BANK OF CYLINDERS BULK TANKS/PLANT SETUPS the right Connection

10. a) Cylinders/Bottles: Find greater use in mobile applications i.e. emergency use, ambulance applications, stand by sources. However, most high level (especially public) health facilities (District to Regional Referral) in Uganda today still use the cylinder bottles. the right Connection Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen

11. Challenges It’s increasingly become over whelming and challenging to effectively support the use and application of the cylinders mainly for the high level facilities due to the rate of consumption, quick example in public health facilities i.e.; Mbarara Regional Referral Hospital (300-400 bed) uses approx; 30 - 40 (7.5m3) medical oxygen cylinders weekly and 15 - 20 (1.36m3) cylinders per week. What the annual consumption? Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen

12. Challenges (Cont’d) Increased consumption rates due to the ever increased or expanding patient numbers (thus upgrading levels of health facilities) Alongside this consumption rate, there is a great challenge of availability of oxygen gas from the sources (procurement challenges). Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen the right Connection

13. Challenges (Con’d) Introduction of departments (i.e. ICU) increase demand and need Equipment (i.e. Ventilators, Pneumatic tools and instruments) Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen the right Connection

14. b) Piped Gas Supply Forms; The piped installations do provide the infrastructure, however there can be various forms of sources which include but not limited to; i) Bank of Cylinders (Forming Manifold Systems); A Medical Gas Pipeline System (MGPS) is installed to provide a safe, convenient and cost-effective system for the provision of medical gases to the clinical and nursing staff at the point of use. Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen

15. b) Piped Gas Supply Forms (Cont’d); i) Bank of Cylinders; Reduces problems associated with the use of gas cylinders such as safety, porterage, storage and noise. This can be used for all new installations, and for refurbishment or upgrading of existing medical and hospital installations. Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen

16. b) Piped Gas Supply Forms; The piped installations do provide the infrastructure, the various forms of sources are not limited to; ii) Central Gas Supply Plant; Liquid plants are set up for more economical use in facilities with very high demand for oxygen use i.e. Mulago National Referral Hospital. Though a much preferred option as a source of medical oxygen, this type of plant requires refilling and with this come challenges of timely ability to refill. Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen

17. b) Piped Gas Supply Forms; The piped installations do provide the infrastructure, the various forms of sources are not limited to; iii) Medical Gas Generation Plants; In relation to the above plants, these are mostly set up and more economical options to use in the long run for use in facilities with very high demand for oxygen use again i.e. Mulago National Referral Hospital (approx 1500 beds). Similarly, this type of plant still provide a great challenge in the initial costs. Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen

18. b) Piped Gas Supply Forms; The piped installations do provide the infrastructure, the various forms of sources are not limited to; iv) Medical Gas Generation Plants This equipment is designed to be used for therapeutic applications and services. Its use is meant to be intermittent and not for prolonged use. Where and When Do they Apply: The Uganda Experience Case Study:Medical Oxygen

19. End of presentation the right Connection