MEDICAL GASES Manufacture, Storage, Transport + Delivery

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MEDICAL GASESManufacture, Storage, Transport
Delivery

• First Year Respiratory Therapy
• MJC
• RsCr 220

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Composition of the Air

• We breathe earths atmosphere composed of
• Nitrogen (78)
• Oxygen (21)
• Carbon Dioxide (0.03)
• Argon and trace gases (0.93)
• Neon, Xenon, Krypton and Deon

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How Oxygen is produced

• Fractional Distillation
• Physical Separation
• Nitrogen Molecular sieve
• Semi-Permeable membrane

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Fractional Distillation

• Large Manufacturing Facility

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Fractional Distillation
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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

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Physical Separation

• Molecular Sieve
• Semi-Permeable Plastic Membrane
• (in the home)

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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

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Oxygen Concentrator
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Semipermeable Membrane

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

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Oxygen concentrator Semi-permeable membrane
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Physical Separators

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

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Home Concentrator
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Medical Gases

• Oxygen, Carbon Dioxide, Helium, Nitrous Oxide,
  Nitric Oxide, Nitrogen, Carbon Monoxide

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Properties of Common Gases

• Chemical symbol
• Molecular weight
• Color, odor, taste
• Physical state
• Critical temperature, boiling point
• Combustion characteristics

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Oxygen

• 02
• Molecular Weight 32
• Colorless, odorless, tasteless
• Slightly heavier than air
• Density of 1.29 g/L
• Nonflammable but supports combustion

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Compressed Air

• Is the same mixture of nitrogen, oxygen, carbon
  dioxide and argon.
• Is piped in to all modern hospitals
• Used to power pneumatically powered equipment
• Some situations (patients are C02 retainers) when
  oxygen is contraindicated

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Carbon Dioxide

• C02
• Colorless and Odorless
• Does not support combustion
• Used in fire extinguishers
• More soluble in liquids than oxygen
• Easier transporting in blood then oxygen
• Used to treat hiccups (singulation)

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Helium

• He
• Odorless, tasteless, non-flammable
• Second lightest of gases
• Combined with oxygen (heliox) to reduce work of
  breathing with swollen upper airways

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Nitrous Oxide

• N20
• Nonflammable but supports combustion
• Used as an anesthesia in OR (laughing gas)
• Always mixed with oxygen (Entonox) and other
  anesthesia agents

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Nitric Oxide

• N0
• Is nonflammable but supports combustion
• Used experimentally in low concentrations (ppm)
  for pulmonary vasodilation
• Recently has had excellent results with premature
  babies

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Nitrogen

• N2
• Used as lab gas (liquid) for freezing tissue

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Carbon Monoxide

• CO
• Used in Pulmonary Function Lab
• Very diffusible used to test how easily gas
  will pass through the lung membranes

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Cyclopropane

• Strictly an anesthesia gas

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Ethylene Oxide

• Used to gas sterilize medical equipment
• Useful for equipment that cant handle high
  temperatures or immersion in water

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Oxygen Storage

• Tanks Liquid
• Tanks - Gas

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Tank Sizes and Capacities

• Large Cylinders
• Small Cylinders

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Oxygen Tank Sizes
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H Cylinders

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

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E Cylinders

• Small and lightweight (15 pounds)
• PISS Pin Index
• Yoke connection

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Types and colors of cylinders

• Air - Yellow
• Oxygen - Green Intl (White)
• Helium - Brown
• CO2 - Grey
• Nitrogen - Black
• Nitrous Oxide-Blue
• Do NOT trust the color of the tank as sole
  indicator of its contents

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Labels The only sure way
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Other Oxygen Tank Markings
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Regulation of cylinders

• D.O.T
• O.S.H.A.
• F.D.A.
• B.M.D.

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Recommending Agencies

• C.G.A.
• N.F. P.A.
• A.N.S.I.
• I.S.O

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Bulk Supply Systems

• Liquid Oxygen

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Bulk Oxygen Systems

• Large capacity
• Liquid oxygen
• Small system (or back up)
• Nitrous Oxide
• Bank of H cylinders

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Large Oxygen Supply System
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Small Bank of Cylinders
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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

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Go figure
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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

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Liquid Oxygen
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Bulk Oxygen Supply System
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Home Liquid Oxygen
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Low Pressure Safety Systems

• Diameter Index Safety System
• Quick Connect

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Wall (low pressure) systems

• D.I.S.S.
• 50 P.S.I
• The MJC lab has these
• Quick connect
• A newer better system

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DISS (and Dat)
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DISS Wall Outlet
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Different Quick Connects
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More Quick Connects
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Flowmeters

• Thorpe Tube is most common
• Can use Bourdon Gauge

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Other Safety Features

• Zone Valves

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Zone Valve System
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Zone Valves
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Cylinder Connections(High Pressure)

• American Standard Safety System
• Pin Index Safety System
• Key Index Safety System

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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.

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Cylinder connections

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

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American Safety Standard System
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Pin Index System
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Pin Index System
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Pin Index Numbering
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Tank Duration

• How long will they last

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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

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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

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Thanks for listening