Assembly and installation of medical gases. Equipment for medical gases. Key points for installing a honey pipeline. gases

Systems medical gases- oxygen, carbon dioxide, compressed air, argon, nitrous oxide, helium, vacuum and removal of anesthetic mixtures are used in institutions of various specifics and are inextricably linked with the daily processes of treatment and patient care. Their design and creation requires the use of modern equipment and advanced technologies.

Grace Engineering understands the needs of clients and offers effective, proven solutions that are responsible for patient safety and the smooth functioning of any facility - hospital wards, operating rooms, intensive care units.

We supply equipment for medical gases from leading manufacturers in the industry, ensuring autonomy, supply stability, reliability of use and economic benefits.

  • Medical bridge, ceiling and wall consoles with horizontal and vertical installation. Optimal for placing equipment, equipped with quick-connect gas connectors with different locks, low-current and standard sockets, direct and additional light lamps.
  • Oxygen concentrators, compressors, vacuum stations, cylinder ramps. Necessary for the round-the-clock production and supply of medical gases and vacuum, provision of anesthesia and respiratory stations, mechanical ventilation, operating rooms and intensive care units.
  • Group valves or shut-off and control valves. Mandatory for the medical gas distribution system, they allow you to cut off distribution areas and control pressure.

Equipment for medical gases is selected based on the customer’s needs, operating conditions and economic feasibility. It is certified, approved for use in medical practice and meets the requirements of regulatory documents.

Medical gases used in the operating room include oxygen, nitrous oxide, air and nitrogen. Vacuum is also necessary for the work of both the anesthesiologist (for the system for removing waste medical gases) and the surgeon (for suction), so technically the vacuum line is designed as an integral part of the system medical gas supply. If the gas supply system, especially oxygen, is disrupted, 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 structure of all these elements in order to prevent and eliminate leaks in the system and notice in time that the gas supply is depleted. The gas supply system is designed depending on the hospital’s maximum demand for medical gases.

Sources of medical gases

Oxygen

A reliable supply of oxygen is absolutely essential in any surgical field. Medical oxygen (purity 99-99.5%) is produced by fractional distillation of liquefied air. Oxygen is stored in compressed form at room temperature or in a frozen liquid state. In small hospitals, it is useful to store oxygen in high-pressure oxygen cylinders (H-cylinders) connected to the distribution system (Figure 2-1). The number of cylinders in storage depends on the expected daily needs. 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 - a measure of pressure , psi, 1 psig ~ 6.8 kPa).

Rice. 2-1. Storage oxygen cylinders high pressure (H-cylinders) connected to the distribution system (oxygen station) (1USP - USP compliant)

For large hospitals more economical system storage of liquefied oxygen (Fig. 2-2). Since gases can be liquefied under pressure only if their temperature is below the critical temperature, liquefied oxygen must be stored at a temperature below -119 0C (critical temperature

Rice. 2-2. Liquefied oxygen storage facility with reserve tanks in the background

Oxygen). Large hospitals may have a reserve (emergency supply) of oxygen in liquefied or compressed form in the amount of daily requirements. In order not to be helpless in case of damage to the hospital 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-cylinders of oxygen (Table 2-1). As oxygen is consumed, the pressure in the cylinder decreases proportionally. If the pressure gauge needle reads 1000 psig, the E-cylinder is half used and contains approximately 330 L of oxygen (at normal atmospheric pressure and temperature of 20 0C). At an oxygen flow rate of 3 l/min, half a cylinder should be enough for 110 minutes. The oxygen pressure in the cylinder must be checked before connecting and periodically during use.

Nitrous oxide

Nitrous oxide, the most common gaseous anesthetic, is 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 the distribution system. When emptying one group of cylinders automatic device connects the next group. Keep a large number of Liquid nitrous oxide is only advisable in very large medical institutions.

Since the critical temperature of nitrous oxide (36.5 0C) is above room temperature, it can be stored in a liquid state without complex system cooling. If liquid nitrous oxide is heated above this temperature, it can change 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 container. Nevertheless everything gas cylinders are equipped with emergency safety valves to prevent explosion under conditions of sudden pressure increase (for example, unintentional overfilling). The safety valve releases at 3300 psig, whereas the E-cylinder walls can withstand much higher loads (>5000 psig).

Although an interruption in the supply of nitrous oxide is not catastrophic, most anesthesia machines have a backup E-cylinder. 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 remains in the cylinder. If liquid nitrous oxide is stored at a constant temperature (20 0C), it will evaporate in proportion to consumption; at the same time, until the liquid fraction is depleted, the pressure remains constant (745 psig).

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 marked on its surface. The pressure in a nitrous oxide cylinder at 20 0C should not exceed 745 psig. Higher readings mean either a malfunction of the control pressure gauge, or an overflow of the cylinder (liquid fraction), or the presence of some other gas in the cylinder other than nitrous oxide.

Since the transition from a liquid to a gaseous state requires energy (latent heat of evaporation), liquid nitrous oxide cools. A decrease in temperature leads to a decrease in saturated vapor pressure and 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 increasingly common. Air cylinders meet

TABLE 2-1. Characteristics of medical gas cylinders

13depends on the manufacturer.

Medical requirements 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 must 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 the 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 the distribution system.

The vacuum system in a hospital consists of two independent pumps, the power of which is adjusted as needed. Outputs to users are protected from foreign objects entering the system.

Medical gas delivery (distribution) system

The delivery system delivers medical gases to operating rooms from a central storage location. Gas wiring is installed from seamless copper tubes. It must be impossible for dust, grease or water to get inside the tubes. IN operating system delivery is carried out in the form of ceiling hoses, a gas water heater or a combined hinged 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 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 standard pipe diameter index).

Rice. 2-3. Typical medical gas supply systems: A - geyser, B - ceiling hoses, B - combined bracket. One end of the color-coded hose is inserted through a quick-connect connector into the corresponding outlet of the centralized distribution. 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 fittings and pipes for different medical gases are different (the so-called safety system with a standard pipe diameter index)

E-cylinders containing oxygen, nitrous oxide and air are usually attached directly to the anesthesia machine. To prevent incorrect connection of cylinders, manufacturers have developed standard safe connections between the cylinder and the anesthesia machine. Each cylinder ( sizes A-E) has two sockets (holes) on the valve (reducer), which are connected to the corresponding adapter (fitting) on ​​the bracket of the anesthesia machine (Fig. 2-4). The interface between the port and the adapter is unique for each gas. The connection system may be inadvertently damaged if multiple spacers are used between the cylinder and the device bracket, preventing proper mating of the socket and adapter. The standard safety 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 indicate automatic switching 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 between a cylinder and an anesthesia machine (standard connector diameters, indexed pin contact)

Rice. 2-5. Appearance monitor panel that controls pressure in the gas distribution system. (Courtesy of Ohio Medical Products.)

Despite multiple levels of safety, alarm indicators, and rigorous regulations (as directed by the National Fire Protection Association, the Compressed Gas Association, and the Department of Transportation), tragic accidents still occur in operating rooms as a result of gas supply failures. Mandatory inspections of medical gas supply systems by independent experts and the involvement of anesthesiologists in the control process can reduce the frequency of these accidents.


MAIN POINTS FOR INSTALLING THE MEDICAL PIPELINE. GAS

  • Internal medical gas pipelines are installed from copper pipes in accordance with GOST using fittings (bends, tees, etc.) using solder. Before soldering, pipeline joints must be cleaned, degreased and washed.
  • Pipeline fastening methods are being developed installation organization. Before installation, installed pipes and fittings must be cleaned, washed and degreased in accordance with industry standards. All pipelines after installation (in sections) must be tested pneumatically for strength and tightness.
  • Before testing, the pipelines are purged with air or nitrogen that does not contain oil or fat impurities. After completion of the test, the pipelines are dried by blowing for 8 hours with heated air or nitrogen.
  • After soldering and installation work After installing fittings and equipment and connecting them to the installed pipelines, repeated comprehensive tests of the entire installed system of centralized supply of medical gases are carried out, with the entire system being flushed with a special solution to remove residual scale, oxides, dust and disinfect the internal surfaces of the system.
  • After repeated comprehensive tests to remove residual flushing liquids, it is necessary to carry out a thorough purge with dry compressed air at a speed of at least 40 m/s, and immediately before putting the system into operation, purge with the appropriate gas and release it into the atmosphere.
  • To protect pipelines from static electricity the latter must be reliably grounded in accordance with the “Rules for protection against static electricity in the chemical industry”.

Below you can see our options for installing pipelines in medical institutions.

Our company is ready to undertake obligations to carry out the work any complexity and volume, whether it is a small private clinic or 2000 bed hospital. You can find out more about our work on our website in the Portfolio section or call the phone number listed on our website to receive any information you are interested in.

Today, every successful medical institution has in its arsenal a modern medical equipment. This is due not only to the prestige of the institutions, but also to the need to use new treatment methods, which are sometimes impossible without innovation. An important milestone in the development of equipment for medical structures is given to medical gas systems. Medical gas systems are developed in accordance with the profile of the institution and the volume of gas consumed.

What is medical gas supply?

Medical gas systems is a network of gas pipelines, gas supply sources, medical consoles. Medical gas supplies are used in operating rooms and intensive care units, and oxygen is available in wards and emergency departments.

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 either in basements, and outside the building in specially equipped places.

Medical gas systems and features of their operation

Medical gas systems require increased attention to safety. In order to prevent danger, control and shutdown valve modules are installed on the gas pipeline so that, in the event of a danger of explosion, the building can be quickly disconnected from the gas supply.

To control the amount of gas supplied to each specific module, electronic monitors are installed to monitor the condition 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 installation of the medical gas supply. Therefore, if a decision is made to install a medical gas system, it is worth giving preference to experts in the development 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.

No medical institution can do without the following medical gases - medical oxygen O2 (gaseous GOST 5583-78 and liquid GOST 6331-78), carbon dioxide CO2, nitrous oxide N2O. Also, medical institutions often use compressed air and vacuum cylinders. In the course of their work, hospitals also use mixtures of gases. Any clinical case may require its own specific composition of the mixture of medical gases. It is quite common to use mixtures of oxygen and carbon dioxide, oxygen and helium, oxygen and xenon, and other mixtures. The systems for supplying these medical gases from the source to the patient constitute the medical gas supply.

Today we offer a wide range of gas supply services medical institutions. This includes:
- installation of oxygen generators;
- installation of compressed air stations;
- installation of vacuum stations;
- laying of pipeline systems;
- arrangement of communications for the supply of medical gases in medical institutions;
- installation of final equipment for connecting medical gas supply systems to the patient;
- commissioning of installed equipment;
- other related works and services.

System designs we offer medicinal gases meet international standards ISO 7396-1:2007, ISO 10083:2006, ISO 10524-1:2006. They guarantee an uninterrupted supply of the necessary medical gases directly to the patient thanks to the use of following principles:
- duplication of all sources of medical gas supply in case of failure;
- in order to achieve pressure stability at all points of the system, including remote ones), pipes of different diameters are used, as well as pipe routing in the form of a branch;
- it is necessary to eliminate as much as possible sharp installation bends of pipes, as they can lead to unnecessary differences in flow and pressure;
- provision of an automatic control system in case of medical gas leaks from the system or malfunction of the supply system itself;
- the system must be built modularly so that it is always possible to turn off one of the modules without disrupting the supply of other modules, that is, the modules should not depend on each other;
- use sockets for instant connection
- points of consumption must be equipped with instant connection sockets for medical gases DIN standard.

Main components of the system:
1. Centralized sources of medical gases (oxygen, compressed air and vacuum stations).
2. Control equipment.
3. Medical gas pipelines.
4. Systems for creating a workplace (resuscitation and operating modules, ward modules).

Necessary stages of work on medical gas supply.
1. System design.
2. Supply and installation of specialized equipment for the medical gas supply system.
3. Activities for commissioning and debugging of equipment.
4. Warranty and post-warranty maintenance of the installed system.

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