Presentation is loading. Please wait.

Presentation is loading. Please wait.

Medical Gas Systems 210a.

Similar presentations

Presentation on theme: "Medical Gas Systems 210a."— Presentation transcript:

1 Medical Gas Systems 210a

2 Medical Gases Oxygen – O2 Air Carbon dioxide – CO2

3 Medical Gases Helium – He Nitrous oxide – N2O Nitric oxide - NO

4 Chemical and Physical Properties of Therapeutic Gases
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 Oxygen – O2 (Green tank) Characteristics
Colorless, odorless, tasteless Non-flammable Supports combustion

6 Oxygen – O2 Characteristics Critical temperature
°C (-181 °F) Makes up approximately 21% of air

7 Oxygen – O2 Commercially produced through fractional distillation
Physical separation Used in oxygen concentrators

8 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 RsCr 220

9 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 RsCr 220

10 Semipermeable Membrane
Pulls air through membrane Oxygen passes through faster than nitrogen Can produce 40% mixture Good for long-term low flow oxygen RsCr 220

11 Physical Separators Will produce concentrations for nasal cannula but only at low flows Used in oxygen concentrators IN THE HOME RsCr 220

12 Air (yellow cylinder) Characteristics Colorless, odorless, tasteless
Non-flammable Supports combustion

13 Therapeutic Gases in Respiratory Care
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 Therapeutic Gases in Respiratory Care
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 Air Produced by filtering and compressing atmospheric air Must be dry
Must be free of oil

16 Therapeutic Gases in Respiratory Care
Carbon dioxide (CO2) 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. CO2 is nonflammable and does not support combustion or animal life. CO2 is a by-product of animal metabolism and the burning of carbonaceous fuels.

17 Carbon Dioxide – CO2 Characteristics Colorless, odorless
Does not support combustion Cannot support life Grey cylinder

18 Carbon Dioxide – CO2 Produced by heating limestone in contact with water Critical temperature above room temperature; stored as liquid in cylinder

19 Carbon Dioxide – CO2 Used in the past in mixtures with oxygen (90% O2 with 10% CO2, 95% O2 with 5% CO2); current use is limited

20 Carbon Dioxide – CO2 Current CO2 mixtures used primarily in membrane oxygenators and for calibration of analyzers

21 Helium – He Characteristics Second lightest of gases
Odorless, tasteless Non-flammable Brown cylinder

22 Helium – He Characteristics
Good conductor of heat, sound, and electricity Inert Cannot support life

23 /watch?v=nripiMQt0ls
Helium – He Produced through liquefaction When used therapeutically, must be mixed with at least 20% O2 (Heliox) /watch?v=nripiMQt0ls

24 Helium – He Used to manage severe airway obstruction to decrease work of breathing

25 Therapeutic Gases in Respiratory Care
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 (N2) is the major component of the atmosphere, 78% by volume. Nitrogen gas is responsible for the blue color of the sky on earth.

26 Nitrous Oxide – N2O Characteristics Colorless
Slightly sweet odor and taste Supports combustion Cannot support life

27 Nitrous Oxide – N2O Produced by thermal decomposition of ammonium nitrate

28 Nitrous Oxide – N2O Critical temperature above room temperature; stored as liquid in cylinder Used as an anesthetic agent

29 Nitric Oxide - NO Characteristics Colorless Non-flammable
Supports combustion


31 Nitric Oxide - NO Produced by oxidation of ammonia at high temperature in the presence of a catalyst

32 Nitric Oxide - NO Respiratory irritant capable of causing chemical pneumonia and pulmonary edema

33 Nitric Oxide - NO High concentrations can cause methemoglobin to form
Used in term and near-term infants for the treatment of persistent pulmonary hypertension

34 Cylinders 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 H Cylinders 2200 psi A.S.S.S safety system Threaded connection
Need to be safety chained and in a secured dolly for moving RsCr 220

36 E Cylinders Small and lightweight (15 pounds) PISS – Pin Index
Yoke connection RsCr 220

37 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 RsCr 220

38 Other Oxygen Tank Markings
RsCr 220

39 Bulk Oxygen Systems Large capacity Small system (or back up)
Liquid oxygen Small system (or back up) Nitrous Oxide Bank of H cylinders RsCr 220

40 Large Oxygen Supply System
RsCr 220

41 Small Bank of Cylinders
RsCr 220

42 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 RsCr 220

43 Go figure RsCr 220

44 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 RsCr 220

45 Wall (low pressure) systems
D.I.S.S. 50 P.S.I The MJC lab has these Quick connect A newer “better system” RsCr 220

46 DISS RsCr 220

47 DISS Wall Outlet RsCr 220

48 Flowmeters Thorpe Tube is most common Can use Bourdon Gauge RsCr 220

49 RsCr 220

50 Zone Valves RsCr 220

51 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. RsCr 220

52 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 RsCr 220

53 Pin Index System RsCr 220

54 Pin Index System RsCr 220

55 Pin Index Numbering RsCr 220

56 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 RsCr 220

57 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 RsCr 220

58 Storage and Distribution of Medical Gases
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 Cylinders Filling cylinders
Compressed gas cylinders filled to service pressure plus 10%

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

61 Cylinders Duration of flow Duration of flow = Contents Flow

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

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

64 Cylinders Factors for determination of duration Liquid system = 860
Amount of gas in liquid = Weight of liquid x 860 2.5

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

66 Cylinder Storage Flammable gases stored separately from gases that support combustion

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

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

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

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

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

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

73 Bulk Systems - Advantages
More economical over the long term More dependable; less prone to interruption

74 Bulk Systems - Advantages
Eliminates need to transport large numbers of cylinders Delivery pressure uniform Operating pressure is lower (50 psig)

75 Bulk Systems - Disadvantages
Expensive to construct Failure may affect large numbers of patients

76 Bulk Systems Supply systems Cylinder manifold system
Cylinder supply system with reserve supply

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

78 Regulation of Medical gases
Food And Drug Administration (FDA) Oversees purity of gases produced

79 Regulation of Medical gases
Department of Transportation (DOT) Oversees construction of cylinders and transportation of medical gases

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

81 Regulation of Medical Gases
Compressed Gas Association (CGA) Regulates handling, storage, fittings, and markings

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

83 American Standard Safety System (ASSS)
26 connections total within the system Thread diameter Threads per inch

84 American Standard Safety System
26 connections total within the system Right-handed vs. left-handed External vs. internal

85 Pin-Index Safety System (PISS)
Sub-system of ASSS Applies only to cylinders up to size “E”

86 Pin-Index Safety System (PISS)
System of two pins aligning with holes in cylinder valve face; six possible positions

87 Pin-Index Safety System (PISS)
Pin Positions Oxygen – 2-5 Oxygen/Carbon dioxide – 2-6 Helium/Oxygen – 2-4 Nitrous oxide – 3-5 Air – 1-5

88 Pin-Index Safety System (PISS)

89 Diameter-index Safety System (DISS)
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 Quick-connect systems
Made by various manufacturers Each connector has distinct shape so it cannot be used with a different gas

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

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

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

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

95 Flowmeters Three types Bourdon gauge Thorpe tube Flow restrictor

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

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

98 Bourdon Gauge

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

100 Thorpe Tube Measures true flow Must be used in the upright position

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

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

103 Thorpe Tube Uncompensated
Flow control valve proximal to the meter; records less than actual flow

104 Thorpe Tube Compensated

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

106 Flow Restrictor Cannot be used during resuscitation
Unable to increase flow for CPR

Download ppt "Medical Gas Systems 210a."

Similar presentations

Ads by Google