Medical gas supply. We carry out commissioning and commissioning
System design medical gases is carried out taking into account the space-planning solutions of the building and existing utilities, the choice of premises for placing the equipment, the method of laying external pipelines. Complex selection technical devices- gas sources, compressors and vacuum stations, shut-off and control valves, life support consoles, instrumentation depends on the characteristics and needs of the healthcare facility.
Medical gas pipelines
Pipeline networks are used for transportation and continuous supply of medical gases and provision of vacuum to the treatment areas of patients and the use of equipment - ventilators, anesthesia and respiratory equipment, surgical instruments. Bandwidth systems and source capacity must meet the facility's flow requirements. Pipe materials are selected based on compatibility with the transported gas and are corrosion resistant.
Outdoor piping
External pipeline networks are used only for centralized oxygen supply and are laid in two ways. The first option is open on supports / overpasses and building facades. The second option is underground in trenches, tunnels or sleeves made of steel / asbestos-cement pipes.
Internal piping
The pipeline route is selected based on the location of the building's utilities and fire safety requirements. The control unit with bit ramps is located in a separate room with windows, which is located on optimal distance from the entry points of external networks and is equipped with supply and exhaust ventilation, monitoring and alarm systems.
Internal pipelines for supplying medical gases:
- They have high mechanical strength in each section, withstanding a pressure of 1.2 higher than the maximum for a given zone.
- Pass separately from elevator shafts, electrical wiring or at a distance of at least 50 mm from it.
- They are grounded in the immediate vicinity of the point of entry into the building.
- Protected from physical impact and damage, contact with corrosive materials.
- Fixed on supports to prevent deflections, distortions and accidental movements.
- They are laid in the space above the ceiling, under the ceilings and behind the panels of wall and partition structures.
Pipeline sections are joined together by soldering or welding. Threaded connections are used in places of reinforcement insertion, installation of equipment, instrumentation.
Shut-off and medical fittings
Insulation of individual sections of pipelines for maintenance purposes, building up to increase the length of the network or shutting off in emergency situations is performed by means of shut-off main valves, which are located on each riser and branch. Terminals and accessories are located downstream of the local shut-off valve.
These include:
- Chamber valves for use as shut-off valves when supplying medical gases to equipment.
- Flowmeters for dosing medical oxygen, equipped with humidifiers.
- Rotamers with humidifiers for regulating the flow rate and humidification of medical oxygen supplied to the patient.
- Vacuum regulators for connection to the outlet and smooth regulation of the flow rate and the degree of vacuum.
- Ejection suction for connection to the compressed air line and aspiration in the absence of a vacuum supply system.
- Valve systems with separate types of locks for connecting medical equipment and equipment to medical gas supply networks.
Control and shutdown units, monitoring and signaling equipment are responsible for shutting off the flow, visually monitoring the pressure of the working medium and alerting about adverse / emergency situations. Gas manifolds work with any medium, provide automatic switching between primary and backup sources. The alarm signal is sent to the alarm unit and dashboard.
Life support or medical gas consoles
Life support consoles are the terminal elements of medical gas supply systems. They are located in the working area of personnel or in the immediate vicinity of patients to supply 10 or more gases - oxygen, nitrous oxide, compressed air, carbon dioxide and vacuum, allow duplicating sources. If necessary, combinations of gases are used, the ratio of which in the mixture is adapted for a specific task.
The main types of life support systems:
- Ceiling modules for operating rooms. They have a swivel arm and a coverage area of 3400, are divided into two types depending on the purpose of application and supplied gases. Surgical systems are equipped with valves for nitrous oxide, 5 and 7 bar compressed air, oxygen and vacuum. In the anesthesia consoles, the high-pressure air is replaced by anesthetic gases evacuation.
- Wall-mounted resuscitation modules for patients. Placed in intensive care units, intensive care units, after operating rooms awakening. Equipped with valve systems for supplying oxygen, nitrous oxide, compressed air and providing vacuum and other gases, the amount and type of which is determined at the design stage of the medical gas supply system.
- Wall-mounted ward modules for patients. They are used in cardiology, pulmonary, pediatric and other departments. They are completed with valves for medical gases, which are determined by the customer during design.
After the completion of the installation of the medical gas supply system, tests and commissioning are carried out.
Before commissioning the centralized medical gas supply, pipelines are checked for mechanical integrity and absence of leaks, flow rate at nominal pressure and productivity, dispersed contamination. Systems with oxygen generators and concentrators, dosing devices and compressors - for the quality of the air used for breathing and the operation of surgical instruments. Local shut-off valves are tested for full closure and leakage, terminal equipment, monitoring and alarm systems are tested for correct operation and performance of their functions.
The specificity of the system for a specific gas is confirmed by the installation and fixation of a specific type of nipple. This eliminates the possibility of errors in the connection to the network and the supply of medical gas or vacuum.
Medical gas supply systems are put into operation after testing, confirming their compliance with the requirements, and certification. The health facility is provided with inspection reports, instructions for the operation of each component, management and maintenance.
Customer:
Total area: 63421.9 m2; Federal State Institution “Central Military Clinical Hospital named after P.V. Mandryka "of the Ministry of Defense Russian Federation»
Type of work performed:Supply of a complex medical gas supply module with medical gas sources on a turnkey basis
The amount of the executed contract:Contract term:Implementation date 2017
| Institution name | Completed work |
|---|---|
Delivery of operating modules for complex equipment of the intensive care unit of GBUZ KO "KOKOD" as part of the implementation of measures aimed at improving the system of medical care for patients with oncological diseases |
|
Federal state state-financed organization | Delivery of medical equipment in the module |
State budgetary institution | Supply of a set of clean rooms (medical air-conditioned module) for four operating rooms of the interdistrict perinatal center with a complex of works on installation and commissioning for GBUZ SO "TGKB No. 5" |
State Budgetary Healthcare Institution of the Kaluga Region "Kaluga Regional Clinical Oncological Dispensary" | Overhaul of premises for placing medical equipment in building No. 2 of GBUZ KO "KOKOD" as part of the implementation of measures aimed at improving the system of providing medical care to patients with oncological diseases |
State budgetary institution of health care of the Kaluga region "Kaluga Regional Perinatal Center" | Implementation of a set of works for the supply of a complex of clean rooms to the "Perinatal Center" facility in Kaluga |
GBUZ SO "Samara City Clinical Hospital No. 1 named after NI Pirogov" | Overhaul (preparation of premises for the placement of high-tech medical equipment) of the operating unit of the 1st surgical building (7th floor, technical floor) GBUZ SO "Samara City Clinical Hospital No. 1 named after N.I. Pirogov" |
GUZ "City Clinical Hospital of Emergency Medical Aid No. 25" | Supply of medical equipment (complex of clean rooms (air-conditioned medical module) for operating rooms) |
State Treasury Institution of the Volgograd Region "Capital Construction Management | |
Medical Center FGU "TsVKG im. P.V. Mandryka " | Supply of the Medical Gas Supply Module |
Design, supply, installation and commissioning of medical gas supply
Design of turnkey medical gas supply systems
The group of companies, which includes AntenMed LLC, is an expert on technological medical gases - oxygen, nitrous oxide, cyclopropane for anesthesia, argon, compressed air, carbon dioxide used in different systems life support of modern medical institutions.
They are used in surgical, pulmonological, neonatological and burn departments, in anesthesiology, angiography and endoscopy, and modern technologies ensure the efficient functioning of health care facilities.
Evaluation of space-planning decisions of the institution, the choice of premises for location technical equipment
Selection of solutions for external networks and internal systems, taking into account the existing engineering infrastructure and safety rules
Selection of engineering and medical equipment - balloon ramps, consoles, concentrators, vacuum and compressor stations, instrumentation, pipeline materials
Development of estimate documentation and approval of a project with a feasibility study
Delivery and installation of a system of engineering equipment for medical gas supply
Complex engineering equipment- sources, pipelines and points of consumption duplicated for continuous operation. All elements are selected at the stage of project development. Sources of gas supply are indicated in the design specification and are determined based on consumption volumes and specific conditions
Installation of workers and backup ramps for gas cylinders and functional wiring with automatic changeover
Installation of vacuum stations with main / standby pumps and antibacterial filters for the vacuum source
Installation of compressors for the production of compressed air with different pressure for medical equipment with pneumatic drive
Installation of oxygen concentrators for producing enriched gas with oxygen concentration up to 93-96%
Installation of oxygen generators for use as a source of oxygen with a purity of over 95%
Installation of outdoor and internal networks pipelines from the gas source to consumption points, control and distribution units with instrumentation and shut-off valves
Supply of medical equipment for gas supply systems
We carry out the selection or give recommendations on equipment for the direct supply of medical gases and power supply to the doctor's workplace / patient's bed in accordance with terms of reference, project or specification and customer requirements
We install suspended medical ceiling consoles for operating units, intensive care units, delivery rooms with different configurations, which provide easy, safe and convenient connection of equipment
We carry out commissioning works and commissioning
Among our partners in medical equipment for medical gas supply systems, only proven by decades of flawless work at our facilities are European manufacturers
We install medical wall consoles for resuscitation wards with different amounts and the type of connectors and gas valves that can be designed for one or more beds
Today, every successful medical institution has in its arsenal a modern medical equipment... This is due not only to the prestige of institutions, but also to the need to apply new methods of treatment, which are sometimes impossible without innovation. An important milestone in the development of equipment for medical structures is assigned to medical gas systems. Medical gas systems are designed according to the profile of the institution and the volume of gas consumed.
What is Medical Gas Supply?
Medical gas systems represents a network of gas pipelines, gas supply sources, medical consoles. Medical gas supplies are used in operating theaters and intensive care units, and oxygen is available in wards and emergency rooms.
The gas pipeline system is designed so that medical staff and patients do not have direct contact with the main gas supply. Cylinders or other containers with gas are located in special storage areas, which can be located both in the basement and outside the building in specially equipped places.
Medical gas systems and features of their operation
Medical gas supply systems require increased attention to safety. In order to prevent danger, modules of control and shutdown valves are installed on the gas pipeline in order to quickly disconnect the building from the gas supply in the event of an explosion hazard.
To control the amount of gas supplied to each specific module, electronic monitors are installed to monitor the state of the gas supply system.
The quality of the medical gas supply system depends on the manufacturer, on the properties of the materials used in its manufacture, as well as on the efficiency and quality of the medical gas supply installation. Therefore, if a decision is made to install a medical gas system, it is worth giving preference to experts in the design and installation of gas supply systems. This guarantees the absence of operational problems, as well as the possibility of effective maintenance of the gas supply system in the future.
The operating room uses medical gases such as oxygen, nitrous oxide, air and nitrogen. The vacuum is also necessary for the work of both the anesthesiologist (for the medical waste gas removal system) and the surgeon (for the suction), therefore, technically, the vacuum connection is solved as an integral part of the medical gas supply system. If the gas supply system, especially oxygen, is broken, then the patient is in danger.
The main components of the gas supply system are gas sources and centralized distribution (gas delivery system to the operating room). The anesthesiologist must understand the device of all these elements in order to prevent and eliminate leaks in the system, to notice the depletion of the gas supply in time. The gas supply system is designed according to the hospital's maximum medical gas needs.
Sources of medical gases
Oxygen
A reliable oxygen supply is absolutely essential in any surgical field. Medical oxygen (purity 99-99.5%) is produced by fractional distillation of liquefied air. Oxygen is stored compressed at room temperature or frozen liquid. In small hospitals, it is advisable to keep oxygen in storage in high pressure oxygen cylinders (H-cylinders) connected to a distribution system (Figure 2-1). The number of cylinders in storage depends on the expected daily requirements. The distribution system contains reducers (valves) that reduce the pressure in the cylinder from 2000 psig to the operating level in the distribution system - 50 ± 5 psig, as well as an automatic switch on a new group of cylinders when the previous one is emptied (psig, pound-force per square inch is a measure of pressure , psi, 1 psig ~ 6.8 kPa).
Rice. 2-1. Storage oxygen cylinders high pressure (H-cylinders) connected to a distribution system (oxygen station) (1USP - USP)
For large hospitals more economical system storage of liquefied oxygen (Figure 2-2). Since gases can only liquefy under pressure if their temperature is below the critical
Rice. 2-2. Liquefied oxygen storage with back-up tanks in the background
Oxygen). Large hospitals may have a reserve (emergency supply) of oxygen in liquefied or compressed form in the amount of the daily requirement. In order not to be helpless in the event of damage in the stationary gas supply system, the anesthesiologist should always have an emergency supply of oxygen in the operating room.
Most anesthesia machines are equipped with one or two E-oxygen cylinders (Table 2-1). As oxygen is consumed, the pressure in the cylinder decreases proportionally. If the pressure gauge needle points to 1000 psig, the E-cylinder is half full and contains approximately 330 liters of oxygen (at normal atmospheric pressure and 20 ° C). With an oxygen flow rate of 3 l / min, half of the cylinder should be enough for 110 minutes. The oxygen pressure in the cylinder should be checked before connecting and periodically during use.
Nitrous oxide
Nitrous oxide, the most common anesthetic gas, in industrial scale obtained by heating ammonium nitrate (thermal decomposition). In hospitals, this gas is always stored in large high pressure cylinders (H-cylinders) connected to a distribution system. When emptying one group of cylinders automatic device connects the next group. Keep a large number of liquid nitrous oxide is advisable only in very large medical institutions.
Since the critical temperature of nitrous oxide (36.5 ° C) is higher than room temperature, it can be stored in a liquid state without complex system cooling. If liquid nitrous oxide is heated above this temperature, then it can go into a gaseous state. Since nitrous oxide is not an ideal gas and is easily compressed, the transition to the gaseous state does not cause a significant increase in pressure in the vessel. Still all gas cylinders equipped with safety relief valves to prevent explosion in the event of a sudden increase in pressure (for example, unintentional overflow). The relief valve is relieved at 3300 psig, whereas the E-cylinder walls can handle much higher loads (> 5000 psig).
While the nitrous oxide supply interruption is not catastrophic, most anesthesia machines have a reserve E-balloon. Since these small cylinders contain some liquid nitrous oxide, the volume of gas they contain is not proportional to the pressure in the cylinder. By the time the liquid fraction of nitrous oxide is consumed and the pressure in the cylinder begins to drop, approximately 400 liters of gaseous nitrous oxide remain in the cylinder. If liquid nitrous oxide is stored at a constant temperature (20 ° C), it will evaporate in proportion to the flow rate; the pressure remains constant (745 psig) until the liquid fraction is depleted.
There is only one reliable way determine the residual volume of nitrous oxide - weighing the cylinder. For this reason, the mass of an empty cylinder is often stamped on its surface. Nitrous oxide cylinder pressure at 20 ° C should not exceed 745 psig. Higher readings mean either a malfunction of the control pressure gauge, or an overflow of the cylinder (with a liquid fraction), or the presence in the cylinder of any gas other than nitrous oxide.
Since the transition from a liquid to a gaseous state requires energy consumption (latent heat of vaporization), the liquid nitrous oxide is cooled. A decrease in temperature leads to a decrease in the saturated steam pressure and the pressure in the cylinder. At high nitrous oxide consumption, the temperature drops so significantly that the cylinder reducer freezes.
Since high concentrations of nitrous oxide and oxygen are potentially dangerous, the use of air in anesthesiology is becoming more common. Air cylinders meet
TABLE 2-1. Characteristics of medical gas cylinders
13 depends on the manufacturer.
Medically approved and contain a mixture of oxygen and nitrogen. Dehydrated but non-sterile air is pumped into the stationary distribution system by compressors. The compressor inlet should be located at a significant distance from the outlet of the vacuum lines to minimize the risk of contamination. Since the boiling point of air is -140.6 0C, it is in a gaseous state in cylinders, and the pressure decreases in proportion to the flow rate.
Although compressed nitrogen is not used in anesthesiology, it is widely used in the operating room. Nitrogen is stored in high pressure cylinders connected to a distribution system.
The vacuum system in the hospital consists of two independent pumps, the power of which is regulated as required. Conclusions to users are protected from foreign objects entering the system.
Delivery system (distribution) of medical gases
Through the delivery system, medical gases are transported to operating rooms from a central storage location. The gas distribution system is assembled from solid-drawn copper pipes. The ingress of dust, grease or water into the pipes must be prevented. V operating system delivery is displayed in the form of ceiling hoses, a gas water heater or a combined hinge bracket (Fig. 2-3). The outlets of the wiring system are connected to the operating room equipment (including the anesthesia machine) using color coded hoses. One end of the hose is inserted through a quick-connect connector (its design varies depending on the manufacturer) into the corresponding outlet of the wiring system. The other end of the hose is connected to the anesthesia machine through a non-interchangeable fitting, which prevents the possibility of incorrect connection of the hoses (the so-called safety system with a typical index of the diameter of the nozzles).
Rice. 2-3. Typical medical gas supply systems: A - gas water heater, B - ceiling hoses, C - combined bracket. One end of the color-coded hose is inserted through the quick-connect connector into the corresponding outlet of the centralized wiring. The other end of the hose is connected to the anesthesia machine through a non-interchangeable fitting of a certain diameter. The non-interchangeability of connections for supply systems is based on the fact that the diameters of nozzles and nozzles for various medical gases differ (the so-called safety system with a typical index of nozzle diameter)
E-cylinders with oxygen, nitrous oxide and air are usually attached directly to the anesthesia machine. In order to avoid incorrect attachment of balloons, manufacturers have developed standard safe connections of the balloon to the anesthesia machine. Each cylinder ( sizes A-E) has two sockets (holes) on the valve (reducer), which are mated with the corresponding adapter (fitting) on the anesthesia machine bracket (Fig. 2-4). The mating between port and adapter is unique for each gas. The connection system can be inadvertently damaged if multiple shims are used between the cylinder and the device bracket, preventing proper mating of the socket and adapter. The typical safe connection mechanism also does not work if the adapter is damaged or the cylinder is filled with any other gas.
The status of the medical gas supply system (source and distribution of gases) must be constantly monitored using a monitor. Light and sound indicators signal an automatic switch to a new group of cylinders and pathologically high (for example, a broken pressure regulator) or low (for example, depletion of gas reserves) pressure in the system (Fig. 2-5).
Rice. 2-4. Diagram of a typical safe connection of a balloon to an anesthesia machine (standard connector diameters, indexed pin)
Rice. 2-5. Appearance the panel of the monitor that controls the pressure in the gas distribution system. (Courtesy of Ohio Medical Products.)
Despite multiple levels of safety, alarm indicators, meticulous regulations (as mandated by the National Fire Protection Association, the Compressed Gas Association and the Department of Transportation), disruptions to the gas supply in operating rooms still cause tragic accidents. Mandatory inspections of medical gas supply systems by independent experts and the involvement of anesthesiologists in the monitoring process can reduce the frequency of these accidents.
Equipment medical institutions special attention is always paid. Doctors use equipment, the work of which has been thought out to the smallest detail: each "gear" turns at its own frequency and the slightest failure can lead to dangerous consequences.
Medical gas supply is an important area that requires a special approach. Gas supply systems are placed taking into account the profile of the medical institution: everything is taken into account, from gas consumption volumes to the specifics of personnel activities. However, all medical gas supply systems operate in the same way.
Purpose of medical gas supply systems
Medical gas supply systems are needed for the life support of patients, the organization of the workspace of the staff. They are used in intensive care units and operating rooms, wards, therefore they are an important link in ensuring the functioning of any hospital.
Medical gas supply is designed in such a way that patients and hospital staff do not have direct contact with the installation site of the system. Most often, the site for the location of containers with gas and their control system are basements specially equipped places.
Medical gas supply is installed taking into account the safety requirements. Control and shutdown valve modules are installed on the main gas pipeline to prevent an emergency. Using this mechanism, you can quickly turn off the gas supply in the event of a danger.
Design and installation of medical gas supply
New technologies make it possible to monitor the operation of medical gas supply systems using electronic monitors. They allow you to prevent emergencies or quickly respond to their occurrence.
The professionalism of the workers who are engaged in the installation of these systems is also important. In this case, it is necessary to trust only specialists in this field with extensive experience.
The preliminary design of medical gas supply should take into account the peculiarities of the operation of the equipment, the customer's requirements and conditions, the parameters of the premises where the installation will be carried out.
Our company guarantees:
- Use of European materials from leading manufacturers.
- Design and installation of medical gas supply systems by experienced specialists.
- Possibility of full service and post-warranty service.
Don't risk it - entrust the installation of medical gas supply systems to professionals! The Oxygen Service company offers the supply and installation of equipment for healthcare institutions from leading manufacturers. You can order a comprehensive service from us - delivery, installation and subsequent maintenance. All products are certified, and design and installation work is carried out taking into account modern standards and the wishes of the client.
