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210a.  Oxygen – O 2  Air  Carbon dioxide – CO 2.

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Presentation on theme: "210a.  Oxygen – O 2  Air  Carbon dioxide – CO 2."— Presentation transcript:

1 210a

2  Oxygen – O 2  Air  Carbon dioxide – CO 2

3  Helium – He  Nitrous oxide – N 2 O  Nitric oxide - NO

4  Oxygen and air are life supportive because these gases supports the metabolic production of energy in the carbon-based organisms found on earth.  Atmospheric concentrations are given in percentage values (%), which represent the relative quantities of gases as they are present in the earth’s atmosphere.

5  Characteristics  Colorless, odorless, tasteless  Non-flammable  Supports combustion

6  Characteristics  Critical temperature °C (-181 °F)  Makes up approximately 21% of air

7  Commercially produced through fractional distillation  Physical separation  Used in oxygen concentrators

8 RsCr  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

9 RsCr  Composed of inorganic sodium aluminum silicate pellets  These pellets absorb the nitrogen and water vapor from the air  Produces up to 90% mixture

10 RsCr  Pulls air through membrane  Oxygen passes through faster than nitrogen  Can produce 40% mixture  Good for long-term low flow oxygen

11 RsCr  Will produce concentrations for nasal cannula but only at low flows  Used in oxygen concentrators IN THE HOME

12  Characteristics  Colorless, odorless, tasteless  Non-flammable  Supports combustion

13  At normal atmospheric conditions, air is an odorless, colorless, transparent, tasteless mixture of gases and water vapor that is nonflammable and supports combustion.  Air is composed of about 78% nitrogen and 21% oxygen by volume.  Compressed air may be referred to in medical settings as room air or ambient air.

14  Compressed air is supplied in cylinders that are color coded yellow.  Piped compressed air is commonly provided in hospital medical gas systems for use in areas such as the operating room and intensive care units.  Smaller, portable air compressors are available for hospital or home use.

15  Produced by filtering and compressing atmospheric air  Must be dry  Must be free of oil

16  Carbon dioxide (CO 2 ) is a colorless, transparent, odorless to pungent, and tasteless or slightly acid-tasting gas with a specific gravity of 1.522, making it heavier than air.  CO 2 is nonflammable and does not support combustion or animal life.  CO 2 is a by-product of animal metabolism and the burning of carbonaceous fuels.

17  Characteristics  Colorless, odorless  Does not support combustion  Cannot support life  Grey cylinder

18  Produced by heating limestone in contact with water  Critical temperature above room temperature; stored as liquid in cylinder

19  Used in the past in mixtures with oxygen (90% O 2 with 10% CO 2, 95% O 2 with 5% CO 2 ); current use is limited

20  Current CO 2 mixtures used primarily in membrane oxygenators and for calibration of analyzers

21  Characteristics  Second lightest of gases  Odorless, tasteless  Non-flammable  Brown cylinder

22  Characteristics  Good conductor of heat, sound, and electricity  Inert  Cannot support life

23  Produced through liquefaction  When used therapeutically, must be mixed with at least 20% O 2 (Heliox)  /watch?v=nripiMQt0ls /watch?v=nripiMQt0ls

24  Used to manage severe airway obstruction to decrease work of breathing

25  Nitric oxide (NO) is a colorless, tasteless gas with a slight metallic odor. This nonflammable and non-life-supporting gas supports combustion and is toxic.  Nitrogen (N 2 ) is the major component of the atmosphere, 78% by volume.  Nitrogen gas is responsible for the blue color of the sky on earth.

26  Characteristics  Colorless  Slightly sweet odor and taste  Supports combustion  Cannot support life

27  Produced by thermal decomposition of ammonium nitrate

28  Critical temperature above room temperature; stored as liquid in cylinder  Used as an anesthetic agent

29  Characteristics  Colorless  Non-flammable  Supports combustion

30

31  Produced by oxidation of ammonia at high temperature in the presence of a catalyst

32  Respiratory irritant capable of causing chemical pneumonia and pulmonary edema

33  High concentrations can cause methemoglobin to form  Used in term and near-term infants for the treatment of persistent pulmonary hypertension

34  Markings  Sizes/oxygen contents  D – 12.6 cu.ft./356 L  E – 22 cu.ft./636 L  G – 186 cu.ft./5260 L  H/K – 244 cu.ft./6900 L

35 RsCr  2200 psi  A.S.S.S safety system  Threaded connection  Need to be safety chained and in a secured dolly for moving

36 RsCr  Small and lightweight (15 pounds)  PISS – Pin Index  Yoke connection

37 RsCr  Air-Yellow  Oxygen-Green – Int’l (White)  Helium-Brown  CO 2 -Grey  Nitrogen-Black  Nitrous Oxide-Blue Do NOT trust the color of the tank as sole indicator of it’s contents

38 RsCr

39 RsCr  Large capacity  Liquid oxygen  Small system (or back up)  Nitrous Oxide  Bank of H cylinders

40 RsCr

41 RsCr

42 RsCr  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

43 RsCr

44 RsCr  Constantly losing oxygen despite insulation  Needs pressure and insulation for cold temperature (-118 o C)  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

45 RsCr  D.I.S.S.  50 P.S.I  The MJC lab has these  Quick connect  A newer “better system”

46 RsCr

47 RsCr

48 RsCr  Thorpe Tube is most common  Can use Bourdon Gauge

49 RsCr

50 RsCr

51 RsCr  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.

52 RsCr  A.S.S.S. (American Standard)  H cylinders  High pressure, large tanks  P.I.S.S. (Pin Index)  E cylinders  High pressure, small tanks

53 RsCr

54 RsCr

55 RsCr

56 RsCr  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

57 RsCr  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

58  Steel cylinders are used to store compressed oxygen and other gases.  Medical gases can be stored and transported in the gaseous state or as liquefied gas in various-sized cylinders and cryogenic bulk containers.

59  Filling cylinders  Compressed gas cylinders filled to service pressure plus 10%

60  Measuring contents  Compressed gas cylinders Contents directly proportional to pressure  Liquid gas cylinders Contents determined by weight of cylinder

61  Duration of flow  Duration of flow = Contents Flow

62  Factors for determination of duration  “ E” cylinder = 0.28  “H/K” cylinder = 3.14 Duration of flow = Pressure x Cylinder factor Flow

63  Cylinder cap in place when not in use  Segregate full and empty cylinders

64  Factors for determination of duration  Liquid system = 860 Amount of gas in liquid = Weight of liquid x

65  Must be in racks or chained to wall  No combustible material in the vicinity

66  Flammable gases stored separately from gases that support combustion

67  Always use “No Smoking” signs when oxidizing gas is present  Liquid oxygen containers must be in a cool, well-vented area

68  Use approved carts for transporting cylinders  Keep protective cap in place during transport

69  Cylinders must always be secured either with a chain to the wall, or an approved cart or stand

70  Cylinders must be uncovered  “Crack” a cylinder valve before use  Storing cylinders:  AtyUn0aBYiw&feature=related AtyUn0aBYiw&feature=related

71  Do not position cylinders near sources of heat  Do not alter the safety system for the cylinder

72  Defined as containing at least 20,000 cubic feet of gas  May be in either gaseous or liquid form

73  More economical over the long term  More dependable; less prone to interruption

74  Eliminates need to transport large numbers of cylinders  Delivery pressure uniform  Operating pressure is lower (50 psig)

75  Expensive to construct  Failure may affect large numbers of patients

76  Supply systems  Cylinder manifold system  Cylinder supply system with reserve supply

77  Supply systems  Bulk gas system with reserve  Shut-off valves, zone valves

78  Food And Drug Administration (FDA)  Oversees purity of gases produced

79  Department of Transportation (DOT)  Oversees construction of cylinders and transportation of medical gases

80  National Fire Prevention Association (NFPA)  Oversees construction of bulk systems and sets standards for storage of medical gases

81  Compressed Gas Association (CGA)  Regulates handling, storage, fittings, and markings

82  American Standard Safety System (ASSS)  Standardizes threaded high-pressure connections for cylinder sizes “F” to “H/K”  XZ59c&feature=related XZ59c&feature=related

83  26 connections total within the system  Thread diameter  Threads per inch

84  26 connections total within the system  Right-handed vs. left-handed  External vs. interna l

85  Sub-system of ASSS  Applies only to cylinders up to size “E”

86  System of two pins aligning with holes in cylinder valve face; six possible positions

87  Pin Positions  Oxygen – 2-5  Oxygen/Carbon dioxide – 2-6  Helium/Oxygen – 2-4  Nitrous oxide – 3-5  Air – 1-5

88

89  Used For low pressure (<200 psig) medical gas connectors  Consists of an externally threaded body and mated nipple with a nut  Twelve standardized connections

90  Made by various manufacturers  Each connector has distinct shape so it cannot be used with a different gas

91  Two types of high pressure reducing regulators  Single stage – Reduces cylinder pressure to working pressure in one stage

92  Two types of high pressure reducing regulators  Multiple stage – reduces cylinder pressure to working pressure in two or more stages

93  Pre-Set pressure reducing regulator  Delivers fixed, pre- set outlet pressure  Adjustable reducing regulator  Delivers outlet pressure adjusted to specific need

94  Used to set and control the flow of gas to the patient from a 50 psig source

95  Three types  Bourdon gauge  Thorpe tube  Flow restrictor

96  Measures pressure within the flowmeter; calibrated to read as flow  Unaffected by gravity; can be used in any position

97  Inaccurate when pressure distal to the orifice increases, causing back pressure to increase; causes flowmeter to read high

98

99 Figure 15-15: DISS safety systems: flow meter and 50-psig outlet. Courtesy of Western/Scott Fetzer Company

100  Measures true flow  Must be used in the upright position  6UwXKXS9Xao 6UwXKXS9Xao

101 Figure 15-11A: ASSS, PISS, and DISS connections. Courtesy of Western/Scott Fetzer Company

102  Pressure compensated  Flow control valve distal to the meter; Prevents changes in downstream resistance from affecting accuracy of reading

103  Uncompensated  Flow control valve proximal to the meter; records less than actual flow

104 Compensated

105  Has a fixed orifice capable of delivering one specific flow  Need variety of restrictors in the event of patient needs changing

106  Cannot be used during resuscitation  Unable to increase flow for CPR


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