Medical Gases

Medical Gases
Medical Gases
• Medical gases refer to those gases which are
required in hospitals for patient care
• The critical nature of medical gases and their
use in all life support equipment and
anaesthetic workstations makes the medical
gas pipeline services the single most
important clinical support service
Medical Gases
Medical gases form the very backbone of a
hospital. Without them it would be impossible
to run a hospital, as they play an essential role
in the functioning of critical care units and key
operational areas like OR, ICUs, HDUs and high
risk procedural areas.
The Medical Gases We Need
• Medical oxygen is the most vital gas that may be
needed by any patient admitted anywhere in the
hospital. Oxygen is used for treatment of a
variety of cardiac, pulmonary and other diseases
• Nitrous oxide is used as an anaesthetic agent in
surgery; mixed with oxygen to help patients relax
during dental procedures; and in cryo-surgery
(the use of extreme cold to destroy tissue).
• Nitrogen is used to provide pneumatic
pressure in medical equipment; to prevent
combustion and other chemical reactions; and
as a component of many gas mixtures.
• Carbon dioxide is used to inflate areas of the
body for laparoscopy surgery, mixed with air
or oxygen to stimulate breathing. Also used for
cryotherapy
• Medical air is used in administering breathing
treatments and as a mixing component for
other respiratory gases.
• Compressed air is used to drive certain
medical equipments like drills, saws and
ventilators.
• Centralised vacuum suction system is used in
lieu of portable suction machines
• Although technically not a gas, vacuum
exhaust for waste anaesthetic gas disposal
(WAGD or scavenging) and surgical suction
must also be provided and is considered an
integral part of the medical gas system
• Patients are endangered if medical gas
systems, particularly oxygen, malfunction. The
main features of such systems are the sources
of the gases and the means of their delivery to
the OR
• If the medical air is not properly treated, it
may also lead to acting as a reservoir of
nosocomial infections
Medical Gas Pipeline System
• The criticality of medical gas lies in its proper
distribution.
• A medical gas pipeline system is designed to provide a
safe and effective method of delivering the required
medical gas from the source of supply through a
pipeline system to the patient via a terminal unit.
• "Each medical gas must be supplied from a separate
system, and it is essential that all parts of each system
are gas specific to ensure that there is no possibility of
cross-connection between any systems
Medical Gas Pipeline System
• The system has to be operational round the
clock, with practically zero down time.
• Failure of system can be fatal and life
threatening if not restored.
• Most of the ventilators are run by medical air in
the hospital.
• In ICU, the patients require oxygen and in OT,
gases like nitrous oxide and carbon dioxide are
uitilised frequently
Manifold
• Manifold is a device which is used for
connecting the outlets of one or more gas
cylinders to the central piping system through a
control panel
• The manifold may be as small as two banks of
two cylinders each or as large as two banks of
twenty cylinders each
• At times the entire pipeline system is referred
to as ‘manifold system’
Manifold Room
• Central supply room, called the manifold room,
consists of a cylinder manifold and a control panel.
• The control panel consists of primary and secondary
pressure regulators to ensure delivery of gas to the
pipeline at the required pressure
• The control panel has pressure gauges to indicate
pressure inside the cylinders
• When the cylinders become empty or gas is not
delivered at the requisite pressure, a warning light
glows on the control panel
Manifold Room
Manifold Room
Location of Gas Supply System
• Due consideration for ventilation, safety, fire
hazard, as well as access has to be provided
• Location should permit access by delivery
vehicles for transportation of cylinders
• Temp. should not be allowed to go beyond
54`C so as to avoid chances of fire
Design and Construction
• Should have lockable doors
• If located outdoors, should have enclosure of
non combustible materials
• If located indoors, should have non
combustible materials on walls, floor, ceilings
and doors
• Fasteners should be provided to secure all
cylinders
Centralised Medical Gas Pipeline System
• A centralised medical gas pipeline system

comprises of the following:
• 1.Source of supply including
- Bulk liquid systems (tanks)
-Cylinder manifolds (banks)
-Medical air compressor
-Medical surgical vacuum producers
-Anaesthetic gas scavenging system
Centralised Medical Gas Pipeline System
• 2.Pipeline distribution system comprising of

-Alarms
-Zonal control boxes
-Line pressure gauges
-Risers etc.
3.Point use delivery connections, including
-panel support boxes
-outlet points
4.Monitoring and control equipment for ensuring safety
Standards
• Being so critical, the medical gas pipeline
system should conform to international
standards and existing rules and regulations
• National Fire Protection Association (NFPA)
USA
• Hospital Technical Memorandum (HTM) UK
• India does not have its own standards for
medical gas pipeline system
Bulk Liquid Systems
• Bulk liquid oxygen tanks are economical especially
for superspeciality hospitals with 200 or more beds
• These systems comprise of
-vacuum insulated evaporator
-vaporiser system
-oxygen delivery control panel assembly
-remote alarm system
The liquid oxygen tank should have capacity for at
least 6 days and should be located outdoors
Emergency Oxygen Supply
• In hospitals having a liquid oxygen tank, this is
planned through a secondary manifold
comprising of two banks of oxygen cylinders
• Should be located at the exterior of the
building
• Similarly the nitrous oxide manifold should be
designed and planned
Anaesthesia Gas Scavenging System
• AGSS is responsible for removal of residual

anaesthesia gases from the OTs
• It comprises of exhauster unit which is a two
stage lateral channel vacuum pump unit with
an impeller
Medical Compressed Air
• The medical compressed air plant provides air
at two pressures, 4-bar and 7-bar
• The machinery comprises of compressors of
adequate capacity, with air inlet filter, silencer,
drains, receiver vessels, filter dryer assembly
and control panel
Colours of Medical Gas Pipelines
• Oxygen: White (In USA it is green)
• Nitrous Oxide: Blue
• Nitrogen: Black
• Carbon Dioxide: Grey
• Vacuum (Suction): Yellow
• Medical Air: Black & White
• AGSS: Purple
Conclusion
• Centralised medical gas pipeline system is a
vital and integral part of a modern hospital,
with the emphasis on safety, reliability, and
purity of gases
• It requires proper coordination between
engineers, hospital administrators and OT
technical staff for successful functioning of the
system
Thank You

Medical Gases

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Medical Gases

• A centralised medical gas pipeline system

• 2.Pipeline distribution system comprising of

• AGSS is responsible for removal of residual

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