VENKAT THEJA.BIHMR-B/PGDHM2011-2013/51

Central Medical Gas System

DIFFERENCE BETWEEN TRADITIONAL MEDICAL GAS DELIVERY SYTEM AND CENTRAL MEDICAL SUPPLY

IntroductionGases administered to the patients are

called as Medical GasesCentralized medical gas system provides as

efficient, economical and dependable medical life support network that supplies :

a.Medical gases (oxygen and nitrous oxide)b.Vacuum (suction)c.Compressed air for operating rooms and

ICUs

IntroductionCentralized gas and vacuum supply service

is a modern system of piped supply of medical gases from a central storage area called manifold room to all delivery points in hospital

It provides a very efficient, economical and highly dependable life support service

Makes better patient care in all the areas of hospital

CENTRAL MEDICAL GAS SYSTEM

FunctionsSupply of right medical gases at right

pressureSupply of compressed air at right pressureSupply of clinical vacuum at right pressureProper planned maintenance of all

equipments, including distribution networkOptimum level of cleanliness and pollution

free environmentPrevention of hazards such as fire, explosion

or contamination of gases supplied

ComponentsSource of supply: Central supply room with

control equipments and panelsDistribution system: piping Point of use delivery connections: Suitable

station outlet valves and pendantsMonitoring and control equipment and

alarms

Manifold RoomConsists of a cylinder manifold and a

control panelManifold can be of 2 banks of 2 cylinders

each or 2 banks of 20 cylinders eachControl panel: primary and secondary

pressure regulators; warning lampPressure gauges

Manifold RoomVacuum Unit

Vacuum pump with an electric motorCylindrical reservoir tank: stabilizes the

pressure of the pipeline system at all outlet points

Motor has switch for automatic start and stopVacuum pumps are duplexed

Manifold RoomCompressed air unit

Compressor with electric motor, after cooler, air receiver and air dryer

Instantly provides compressed air Compressor are duplexed

Manifold RoomPrimary supply Secondary supply when primary supply is

exhaustedPrimary and secondary provides normal

operating supplyWhen operating supply fails, a reserve

supply takes over

Manifold RoomIn case of breakdown of control panel of

oxygen and nitrous oxide, an emergency kit ensures supply of gas through the pipes

Emergency kit comprises a regulator and high pressure tubing to a bulk cylinder and the gas is fed directly to the pipeline through a service outlet

In case the vacuum and air supply system fails, a standby motor-cum-pump is used to provide uninterrupted supply

Manifold RoomHalf of the total daily consumption of oxygen

and nitrous oxide is kept in the manifold room as reserve

Oxygen and nitrous oxide should be stored seperately from flammable gases and liquids

Storage location should be free of combustible materials

If exceeding 2,000 cubic feet storage should be outside the building

Must have generator backup, adequate ventilation, lighting and telephone communication

Advantages of Centralized Medical Gas SystemFor the patients

No distressing sight of oxygen cylinders at the bedside

Elimination of irritating noise from movement of cylinders

Protection of contamination due to movement of cylinders

Uninterrupted and clean supply at desired location

Advantages of Centralized Medical Gas SystemFor Hospital Staff

Instant availability of gas on tapsClean, safe and reliable delivery of gasesContinuous flow of gases when and where

requiredMinimal accident hazards due to mishandling

of cylinders

Advantages of Centralized Medical Gas SystemFor Hospital Administrator

Easy purchase of gases in bulk quantities at favourable terms

Economy on purchase of cylindersFewer breakagesRationalization in ordering, storing and

transporting a wide variety and size of gas cylinders

Minimum damage to building due to handling of cylinders

OxygenIncreased demand of oxygenMay be supplied from a bulk tank or from

cylindersCan be stored as gas or liquidOxygen containers may be stationary or

movable

Oxygen and Nitrous OxideBulk oxygen system: assemblage of

equipment such as oxygen containers, pressure regulators, safety devices, vaporizer, manifolds and interconnecting piping with a storage capacity of more than 20,000 cu ft of oxygen including reserves

The system terminates at the point where oxygen first enters the supply line at service pressure

VacuumUsed for patient draining, aspiration and

suctionAlso used in hospital laboratoryDistributed through network of pipesCentral vacuum supply system with control

equipments, an alarm and pipingThe piping terminates with outlet valves at

user points

VacuumCentral vacuum consists of two (or more)

vacuum pumps that operate either simultaneously or alternately

Each pump should be capable of maintaining 75% of calculated demand during peak time

The pumps should alternate automaticallyPumps should be equipped with a motor

starting device and overload protectionFailure of one vacuum should not affect

other

OUTLETS COLOR CODING

Compressed AirCompressed air is used for both medical

and non-medical puposesMedical use – Laboratory work, inhalation

therapy equipment and powering of surgical tools

Non-medical use – maintain tools and equipments and in engineering department

Compressed AirShould be free of dust and moistureDone by means of oil filters, dust filters,

moisture seperator and the dryer at equipment level

Separate dryer for air compressor systemIf compressed air not used properly, it can

damage equipment and contaminate chemicals, food and drugs

PipesShould be seamless type, non-ferrous, non-

arsenic, of high quality copper tubingShould be protected against physical

damage and corrosionExposed oxygen pipelines should not be

installed in areas like kitchen, laundry and rooms where combustible materials are stored

Colour coded as per the gas content

PipesBefore pipes are erected, all pipes, tubes and

fittings should be cleaned thoroughly and washed with tetrachloride

Pipes should be blown clear using oil-free air or nitrogen

When whole system is in place, it should be subjected to a test pressure of 150 psi or 1 ½ times the working pressure for 24 hours to check, if it can withstand the pressure as well as leakages

This test, called pressure lock is done section by section

Terminal unitsGas outlets / vacuum inlet unitsConnected to source equipment through

the distribution systemLocated at actual usage pointOutlets should be gas specific and non-

interchangeableFitted with locking system and non-return

valves

Alarm systemAudio-visualMonitoring of pressureMeant to warn maintenance dept

Location and spaceGround floor in rear part Near maintenance areaSeperate enclosure for full cylinders, empty

cylinders, compressed air, vacuum supplyNo fire hazardCompresor unit in sound proof areaLiquid oxygen area shall be cordoned off

Centralized Medical Gas System

StaffingNo specific normsTotal 6 technicians (including supervisors

and 25% leave relief)Under chief engineer

Quality IndicatorsNumber of complaints of malfunctioning,

from the usersCorrectness of pressure level in the oxygen,

nitrous oxide and compressed air pipelineCorrectness of negative pressure in the

vacuum lineBacteriological culture of the gases and the

air deliveredLeakage at the outlet pointsFunctioning of audio-visual alarm system

Thank You