Equipment for medical gas supply systems. Design and installation. Development of estimate documentation and approval of a project that has a feasibility study
Systems 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 equipment, and the method of laying external pipelines. Selection of the complex technical devices- sources of gases, 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 supply pipelines
Pipeline networks are used for transportation and continuous supply of medical gases and providing vacuum to areas of patient treatment and the use of equipment - ventilators, anesthesia-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.
External pipelines
External pipeline networks are used only for centralized oxygen supply and are laid in two ways. The first option is openly on supports/overpasses and building facades. The second option is underground in trenches, tunnels or sleeves made of steel/asbestos-cement pipes.
Internal pipelines
The pipeline route is selected based on the location of the building’s utilities and requirements fire safety. The control unit with discharge ramps is located in a separate room with windows, which is located on optimal distance from the points of entry of external networks and is equipped supply- exhaust ventilation, monitoring and alarm systems.
Internal pipelines for supplying medical gases:
- They have high mechanical strength in each section, withstanding a pressure 1.2 times higher than the maximum for a given zone.
- They are located 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 influences and damage, contact with corrosive materials.
- They are fixed on supports to prevent deflections, bending and accidental displacements.
- They are laid in the ceiling space, under ceilings and behind panels of wall and partition structures.
Pipeline sections are joined together by soldering or welding. Threaded connections are used in places where fittings are inserted, equipment is installed, and instrumentation is installed.
Shut-off and medical valves
Isolation of individual sections of pipelines for the purpose of maintenance, extension to increase the length of the network or shutting off in emergency situations is carried out using main shut-off valves, which are located on each riser and branch. Terminal devices and additional equipment are located after the local shut-off valve.
These include:
- Room valves for use as shut-off valves when supplying medical gases to equipment.
- Flow meters for dosing medical oxygen, equipped with humidifiers.
- Rotamers with humidifiers to regulate the flow and humidification of medical oxygen supplied to the patient.
- Vacuum regulators for connection to the outlet and smooth regulation of flow and degree of vacuum.
- Ejection suction units 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 alarm equipment are responsible for shutting off the flow, visually monitoring the pressure of the working medium and warning about unfavorable/emergency situations. Gas manifolds work with any media and provide automatic switching between main and backup sources. The alarm signal is sent to the alarm unit and monitoring panel.
Life support or medical gas supply consoles
Life support consoles are the terminal elements of medical gas supply systems. They are placed in the personnel work area or in close proximity to patients to supply 10 or more gases - oxygen, nitrous oxide, compressed air, carbon dioxide and providing vacuum, allow duplicating sources. If necessary, combinations of gases are used, the ratio of which in the mixture is adapted to the specific task.
Main types of life support systems:
- Ceiling modules for operating rooms. They have a rotating arm and a coverage area of 3400, and are divided into two types depending on the purpose of use and the supplied gases. Surgical systems are equipped with valves for nitrous oxide, compressed air at 5 and 7 bar, oxygen and vacuum. In anesthesia consoles, high-pressure air is replaced by the removal of anesthetic gases.
- Wall-mounted resuscitation modules for patients. Placed in intensive care units, intensive care units, and postoperative recovery rooms. They are equipped with valve systems for supplying oxygen, nitrous oxide, compressed air and providing vacuum and other gases, the quantity and type of which are determined at the design stage of the medical gas supply system.
- Wall-mounted ward modules for patients. Used in cardiology, pulmonology, pediatric and other departments. They are equipped with valves for medical gases, which are specified by the customer during design.
After completing the installation of the medical gas supply system, testing and commissioning are carried out.
Before commissioning a centralized medical gas supply, pipelines are checked for mechanical integrity and absence of leaks, flow rate at nominal pressure and performance, and dispersed contamination. Systems with oxygen generators and concentrators, dosing devices and compressors - on the quality of air used for breathing and the operation of surgical instruments. Local shut-off valves are tested for complete 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 particular gas is confirmed by installing and fixing a nipple of a certain type. This eliminates the possibility of errors in connecting to the network and supplying medical gas or vacuum.
Medical gas supply systems are put into operation after testing to confirm their compliance with requirements and certification. The health facility is provided with inspection reports, instructions for the operation of each component, management and maintenance.
Customer:
Total area: m2 63421.9; Federal government institution “Central Military Clinical Hospital named after P.V. Mandryka" of the Ministry of Defense Russian Federation»
Type of work performed:Supply of an integrated medical gas supply module with turnkey sources of medical gases
Executed contract amount:Contract duration:Implementation date: 2017
| Name of institution | Completed work |
|---|---|
Supply of operating modules for comprehensive equipment of the intensive care unit of the State Budgetary Healthcare Institution KO "KOKOD" as part of the implementation of measures aimed at improving the system of providing medical care to patients with cancer |
|
Federal State state-financed organization | Supply of medical equipment in a module |
State budgetary institution | Supply of a complex of clean rooms (air-conditioned medical module) for four operating rooms of the inter-district perinatal center with a set of installation and commissioning works for the State Budgetary Institution of Health Care "Turkish City Clinical Hospital No. 5" |
State budgetary healthcare institution of the Kaluga region "Kaluga Regional Clinical Oncology Dispensary" | Major renovation premises for placing medical equipment in building No. 2 of the State Budgetary Healthcare Institution KO "KOKOD" as part of the implementation of measures aimed at improving the system of providing medical care to patients with cancer |
State budgetary healthcare institution of the Kaluga region "Kaluga Regional Perinatal Center" | Execution 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 N.I. Pirogov" | Major repairs (preparing premises for the placement of high-tech medical equipment) of the operating block of the 1st surgical building (7th floor, technical floor) Samara City Clinical Hospital No. 1 named after N.I. Pirogov |
State Healthcare Institution "City Clinical Hospital of Emergency Medical Care No. 25" | Supply of medical equipment (clean room complex (air-conditioned medical module) for operating rooms) |
State government institution of the Volgograd region "Capital Construction Administration" | |
Medical Center of the Federal State Institution "TsVKG im. P.V. Mandryka" | Supply of Therapeutic Gas Supply Module |
Design, supply, installation and commissioning of medical gas supply
Turnkey design of medical gas supply systems
The group of companies, which includes AntenMed LLC, are experts in technological medical gases - oxygen, nitrous oxide, cyclopropane for anesthesia, argon, compressed air, carbon dioxide are used in various systems life support of modern medical and preventive institutions.
They are used in surgical, pulmonology, neonatology and burn departments, in anesthesiology, angiography and endoscopy, and modern technologies ensure the effective functioning of healthcare facilities.
Assessment of space-planning solutions of the institution, selection 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 - cylinder ramps, consoles, concentrators, vacuum and compressor stations, instrumentation, pipeline materials
Development estimate documentation and approval of a project that has a feasibility study
Supply and installation of medical gas supply engineering equipment system
Complex engineering equipment- sources, pipeline network and points of consumption duplicated for continuous operation. All elements are selected at the project development stage. Gas supply sources are indicated in the design specifications and are determined based on consumption volumes and specific conditions
Installation of working and reserve ramps for gas cylinders and functional wiring with automatic switching
Installation of vacuum stations with main/backup 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 to produce enriched gas with an oxygen concentration of up to 93-96%
Installation of oxygen generators for use as a source of oxygen with a purity of over 95%
Installation of external and internal networks pipelines from the gas source to points of consumption, control and distribution units with instrumentation and shut-off valves
Supply of medical equipment for gas supply systems
We select or make recommendations on equipment for direct supply of medical gases and power 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 rooms, intensive care wards, maternity wards 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 are only European manufacturers proven by decades of impeccable work at our facilities.
We install medical wall consoles for intensive care wards with different amounts and the type of connectors and gas valves, which can be designed for one or more beds
Project for centralized supply of the facility: “Surgical building, 5th floor. Major overhaul of the operating block" of the Kaluga Regional Clinical Hospital (hereinafter referred to as the "Block") with oxygen, nitrous oxide, compressed air at a pressure of 4.5 and 8 bar, carbon dioxide, as well as providing consumers with vacuum was carried out in accordance with the architectural, construction and technological parts project and the Customer’s instructions in accordance with modern requirements for equipping hospitals with medical gases.
1. Centralized oxygen supply.
Oxygen at a pressure of 4.5 bar for the Unit is supplied to operating rooms (general, urological, traumatological, orthopedic, neurosurgical, thoracic, septic), small operating rooms and recovery rooms.
Total and point oxygen consumption were calculated according to the “Manual
on the design of medical institutions" to SNiP 2-08-02-89 and are given
in table 1:
Medical gaseous oxygen GOST 5583-78 is used in medical institutions.
Oxygen at a pressure of 4.5 bar is supplied to the Block’s consumers from the existing oxygen-gasification station based on two VRV 3000 gasifiers.
The total oxygen consumption by the Unit's consumers is 40,050 l/day. (Oxygen output from one cylinder with a capacity of 40 liters is 6000 liters. Thus, the Block’s theoretical need for oxygen is ~ 6.7 cylinders per day).
The connection of the Block's consumers to the oxygen supply system is carried out in the corridor of the 5th floor to the existing riser. Taking into account the presence of an existing input unit into the housing, the design does not provide for a secondary reduction unit.
From the connection point, oxygen is supplied to consumers through a horizontal pipeline in the suspended ceiling through control disconnect boxes.
In operating rooms (general, urological, traumatology, orthopedic, neurosurgical, thoracic, septic) and small operating rooms, ceiling consoles are installed for the anesthesiologist and surgeon and additional wall consoles are placed, duplicating the set of medical gases from the ceiling. .
In the awakening wards, individual ceiling systems type "B.O.R.I.S."
The terminal devices (valve systems) included in the consoles for oxygen must have an individual input geometry in accordance with the DIN EN standard, which will eliminate errors when connecting the equipment.
The valves must be provided with quick-release connections that allow connection to be made within a few seconds.
The designed oxygen pipelines should be installed from copper pipes in accordance with GOST 617-2006. Install a shut-off valve at the outlet from the riser for technological shutdowns of equipment and testing of pipelines for strength and density.
The mounted ceiling and wall mounting consoles must be supplied with electrical cables, designed for the connected load specified in the task (determined by the TX section based on the characteristics of the connected equipment).
All oxygen supply system equipment must operate around the clock, have appropriate color markings and explanatory notes in Russian.
Before installation, pipes must be degreased in accordance with STP 2082-594-2004 "Cryogenic equipment. Degreasing methods."
The entire volume of medical gases intended for installation of the system must be degreased.
It is recommended to degrease oxygen pipelines using the following aqueous cleaning solutions (Table 2).
Used to prepare solutions drinking water according to GOST 2874-82. The use of water from the recycling water supply system is unacceptable.
The outer surface of the ends of pipes for a length of 0.5 m is degreased by wiping with napkins soaked in a cleaning solution, followed by drying in the open air.
After installation, the pipelines must be tested pneumatically for strength and tightness. Pipelines must be tested for strength and tightness in accordance with SNiP 3.05.05-84 and PB 03-585-03.
The test pressure value should be taken in accordance with table. 3
During pneumatic testing, the pressure in the pipeline should be increased gradually with inspection at the following stages: upon reaching 30 and 60% of the test pressure - for pipelines operated at an operating pressure of 0.2 MPa and above. During the inspection, the pressure rise stops.
Leak locations are determined by the sound of air leaking in, as well as bubbles when covering welds and flange joints with soap emulsion and other methods. Defects are eliminated by reducing overpressure to zero and turning off the compressor.
The final inspection is carried out at operating pressure and is usually combined with a leak test.
If during testing of equipment and pipelines defects made during production are identified installation work, the test must be repeated after the defects have been eliminated.
Before starting pneumatic tests installation organization Instructions for the safe conduct of test work in specific conditions must be developed, with which all test participants must be familiarized.
The final stage of individual testing of equipment and pipelines should be the signing of their acceptance certificate after individual testing for comprehensive testing.
The compressor and pressure gauges used during pneumatic testing of pipelines should be located outside the security zone.
Special posts are installed to monitor the security zone. The number of posts is determined based on the conditions so that the security of the zone is reliably ensured.
The pipelines, after all tests have been carried out, are purged with oil-free air or nitrogen, and before commissioning - with oxygen and released outside the building.
Pipelines must be purged under pressure equal to the working pressure. The duration of purging should be at least 10 minutes. During purging, devices, control and safety valves are removed and plugs are installed.
During pipeline purging, fittings installed on drain lines and dead-end sections must be completely open, and after purging is completed, they must be thoroughly inspected and cleaned.
To protect equipment and pipelines from static electricity the latter must be reliably grounded in accordance with the “Rules for protection against static electricity in the chemical, petrochemical and oil refining industries”.
Grounding devices for protection against static electricity should generally be combined with grounding devices for electrical equipment. Such grounding devices must be made in accordance with the requirements of Chapters I-7 and VII-3 of the Electrical Installation Rules (PUE).
The resistance of a grounding device intended solely for protection against static electricity is allowed up to 100 ohms.
Pipelines must be continuous throughout their entire length. electrical circuit, which within the facility must be connected to the ground loop at least at two points.
Workers who have undergone training and passed tests are allowed to make permanent connections from non-ferrous metals and alloys. Welding of pipelines made of non-ferrous metals is allowed to be carried out at an ambient temperature of at least 5 °C. The surface of the ends of pipes and pipeline parts to be connected must be processed and cleaned in accordance with the requirements of departmental regulations and industry standards before welding.
The bending radii of pipes should be R = 3 Dn (Dn - outer diameter). Various (flange and threaded) connections may only be used when connecting pipelines to fittings, equipment and in places where instrumentation is installed.
Where they pass through ceilings, walls and partitions, pipes are placed in protective cases (sleeves) made of water and gas pipes. The space between the pipe and the case is sealed with sealant.
The edges of the case (sleeve) should be placed at the same level with the surface of the walls, partitions and ceilings.
Lay pipelines:
- in operating rooms, recovery rooms ("Clean Rooms" zone) - at a height of 100 mm below the level of overlap with a soft pipe without solder seams.
Install oxygen pipelines in a space free from other communications.
The laying of oxygen pipelines before installation is coordinated with electricians, and the installation of pipelines is carried out only after the installation of ventilation, sanitary and electrical equipment is completed.
2. Centralized supply of nitrous oxide.
Nitrous oxide at a pressure of 4.5 bar for the Block is supplied to operating rooms (general, urological, traumatological, orthopedic, neurosurgical, thoracic, septic) and small operating rooms.
Estimated nitrous oxide costs are shown in Table 4:
In medical institutions, medical nitrous oxide (liquefied gas) VFS 42U-127/37-1385-99 is used.
Nitrous oxide with a pressure of 4.5 bar is supplied to the consumers of the Unit from a discharge cylinder ramp located in the nitrous oxide unit room (No. 5.15, 5th floor). Ramp capacity: 12 cylinders (2 groups of 6 cylinders). There is a block for automatic switching of ramp arms. According to the previously existing Manual for the Design of Healthcare Facilities (to SNiP 2.08.02-89*) Part 1, the room in which nitrous oxide cylinders are located can be located in a room with window openings on any floor of the building, except the basement (preferably closer to the site highest consumption. The room must be equipped with exhaust ventilation. Category of premises in accordance with SP 12.13130.2009 - D.
The total consumption of nitrous oxide is 11,340 l/day. (The yield of nitrous oxide from one cylinder with a capacity of 10 liters is 3000 liters. Thus, the Center’s need for nitrous oxide is ~ 3.8 cylinders per day).
In rooms provided with nitrous oxide, waste narcotic gases are removed using the ejection method using compressed air. Exhaust gas is discharged outside the building locally from each room through a designed pipeline system with release into the atmosphere.
From the discharge ramp, nitrous oxide is supplied to consumers through a horizontal pipeline located in the suspended ceiling through control disconnect boxes. Nitrous oxide flow valves are installed in the same consoles to which oxygen is supplied (see section 1).
The terminal devices (valve systems) included in the consoles for nitrous oxide must have an individual input geometry in accordance with the European standard DIN EN, which will eliminate errors when connecting the equipment.
All equipment of the nitrous oxide supply system must operate around the clock, have appropriate color coding and explanatory notes in Russian.
The designed nitrous oxide pipelines should be installed from copper pipes in accordance with GOST 617-2006.
After installation, nitrous oxide pipelines must be tested pneumatically for strength and tightness.
Pneumatic testing should be carried out with medical air and only during daylight hours.
The test pressure value should be taken in accordance with table. 5
The nitrous oxide pipeline, after all tests have been carried out, is purged with oil-free air or nitrogen, and before commissioning - with nitrous oxide and released outside the building.
Protection of equipment and nitrous oxide pipelines from static electricity is carried out similarly to the protection of oxygen pipelines (see Section 1).
Lay the nitrous oxide pipeline:
- in the corridors: behind suspended ceiling, and in places of lowering - openly (in the electrical box);
- in operating rooms ("Clean Rooms" zone) - at a height of 100 mm below the level of overlap with a soft pipe without solder seams.
Installation of nitrous oxide pipelines should be carried out in a space free from other communications.
The laying of nitrous oxide pipelines before installation is coordinated with electricians, and the installation of pipelines is carried out only after the installation of ventilation, sanitary and electrical equipment is completed.
3.Centralized compressed air supply.
Compressed air with a pressure of 4.5 bar for the Unit is supplied to operating rooms (general, urological, traumatological, orthopedic, neurosurgical, thoracic, septic), small operating rooms and recovery rooms.
Compressed air with a pressure of 8 bar for the Unit is supplied to the operating rooms (trauma and orthopedic) and the dismantling and washing rooms of the NDA in accordance with the instructions of the technical specifications section.
Compressed air quality must meet the requirements of GOST 17433-80 (for the presence of solid particles and foreign impurities - correspond to pollution class “0”, dew point taking into account the location of the compressor equipment + 30C).
Compressed air with a pressure of 4.5 bar in the project performs two functions:
- serves for the operation of anesthesia-respiratory equipment;
- serves to remove narcotic gases.
Compressed air with a pressure of 8 bar in the project performs two functions:
- serves to ensure the operation of pneumatic surgical instruments;
- used when servicing NDA.
Due to the lack of Russian standards for calculations centralized system compressed air, this calculation was carried out according to European standards.
The calculated compressed air costs are given in Table 6:
Compressed air at a pressure of 4.5 bar and 8 bar is supplied to consumers of the Unit from the designed compressor station based on 4 compressors located in the basement (rooms 4 and 5) in accordance with the requirements of the Rules for the design and safe operation of pressure vessels PB 03-576-03 and the Rules for the design and safe operation of stationary compressor units, air ducts and gas pipelines.
Category of premises in accordance with SP 12.13130.2009 - B4.
It is proposed to use BOGE (Germany) SC 8 compressors.
Each compressor unit provides the calculated consumption of the Unit’s medical premises in compressed air at pressures of 4.5 bar and 8 bar. Overall dimensions of the compressor LxWxH 830x1120x1570 mm. The capacity of each compressor is 0.734 m3/min at a maximum pressure of 10 bar, power consumption is 5.5 kW (~3x400 V). Receivers 500 l galvanized. Basic control and monitoring system, control voltage 24 V. For air drying, refrigerated air dryers DS 18 are used. Dew point +3°. The air treatment system ensures air purification from microparticles down to 0.01 microns in size, and from oil up to 0.003 mg/m3. BOGE filters (Germany) are accepted for installation
The total compressed air consumption is:
- pressure 4.5 bar - 490 l/min;
- pressure 8 bar - 555 l/min.
From the compressor room, compressed and purified air is supplied to consumers through designed risers and branches through control shut-off boxes.
Compressed air flow valves in rooms are installed in the same consoles to which oxygen is supplied (see Section 1).
Quantity terminal devices in each room is determined by the technical specifications.
In rooms provided with compressed air at a pressure of 8 bar, waste air is removed from pneumatic tools. Exhaust air is removed outside the building locally from each room through a designed piping system with release into the atmosphere.
In the NDA washing rooms, shut-off valves are used as terminal devices.
The terminal devices (valve systems) included in the consoles for compressed air of each pressure have an individual input geometry in accordance with the European standard DIN EN, which will eliminate errors when connecting the equipment.
All compressed air supply system equipment must operate around the clock, have appropriate color coding and explanatory notes in Russian.
The designed compressed air pipelines should be installed from copper pipes in accordance with GOST 617-2006. Install on branches from the riser shut-off valves for technological shutdowns of equipment and testing of pipelines for strength and density.
After installation, compressed air pipelines must be tested pneumatically for strength and tightness.
Pipelines must be tested for strength and tightness in accordance with SNiP 3.05.05-84 and PB 03-585-03. Pneumatic testing should be carried out with medical air and only during daylight hours. The test pressure value should be taken in accordance with table. 7
The testing procedure is similar to testing oxygen pipelines (see Section 1).
Protection of equipment and compressed air pipelines from static electricity is carried out similarly to the protection of oxygen pipelines (see Section 1).
The qualification requirements for solder welders are similar to the requirements for oxygen pipeline welders (see Section 1).
Lay the compressed air pipeline:
- in corridors: behind a suspended ceiling, and in places of lowering - openly (in an electrical box);
- in operating rooms, recovery rooms ("Clean Rooms" zone) - at a height of 100 mm below the ceiling level.
Installation of compressed air pipelines should be carried out in a space free from other communications.
The laying of compressed air pipelines before installation is coordinated with electricians, and the installation of pipelines is carried out only after the installation of ventilation, sanitary and electrical equipment is completed.
4. Centralized supply of vacuum.
Vacuum in the Block is provided in operating rooms (general, urological, traumatological, orthopedic, neurosurgical, thoracic, septic), small operating rooms and recovery rooms.
The calculation of the vacuum system was carried out according to Russian standards.
The Block's consumers are provided with vacuum from a designed vacuum station based on a duplex central vacuum unit on a horizontal air collector; LxWxH no more than 2300x1000x1900; Q not less than 2x40 m³/hour; W no more than 2x3 kW, manufactured by Medgas-Technik (Germany), located in the basement (room 47). Supply voltage ~ 380, three-phase, 50 Hz. The air pumped out from the vacuum pipeline, before entering the air collector, passes through a filter system and only then is discharged outside the building at a height of at least 3.5 m from the ground level.
Category of premises in accordance with SP 12.13130.2009 - D.
From the vacuum station premises, vacuum is supplied to consumers through the designed riser and branches through control disconnect boxes.
Vacuum flow valves in rooms are installed in the same consoles to which oxygen is supplied (see Section 1).
The number of terminal devices in each reconstructed room is determined by the technical specifications.
The terminal devices (valve systems) included in the consoles for vacuum have an individual input geometry in accordance with the European standard DIN EN, which will eliminate errors when connecting the equipment.
All equipment of the vacuum supply system must operate around the clock, have appropriate color markings and explanatory notes in Russian.
Vacuum pipelines should be installed from copper pipes in accordance with GOST 617-2006. Install shut-off valves on a branch from the riser for technological shutdowns of equipment and testing of pipelines for strength and density.
After installation, vacuum pipelines must be tested pneumatically for strength and tightness.
Pipelines must be tested for strength and tightness in accordance with SNiP 3.05.05-84 and PB 03-585-03.
Pneumatic testing should be carried out with medical air and only during daylight hours.
The test pressure value should be taken in accordance with table. 8
The testing procedure is similar to testing oxygen pipelines (see Section 1).
After all tests have been completed, vacuum pipelines are purged with oil-free air or nitrogen and released outside the building.
Installed vacuum pipelines must be subjected, in addition to pneumatic testing, to a vacuum test.
After creating a vacuum of 400 mmHg. Art. the vacuum line is disconnected from vacuum installation, after which the vacuum drop should not exceed 10% within two hours.
Protection of equipment and vacuum pipelines from static electricity is carried out similarly to the protection of oxygen pipelines (see Section 1).
The qualification requirements for solder welders are similar to the requirements for oxygen pipeline welders (see Section 1).
Lay the vacuum pipeline in the reconstructed area:
- in corridors: behind a suspended ceiling, and in places of lowering - openly (in an electrical box);
- in operating rooms and recovery rooms ("Clean Rooms" zone) - at a height of 100 mm below the ceiling level.
Installation of vacuum pipelines should be carried out in a space free from other communications.
The laying of vacuum pipelines before installation is coordinated with electricians, and the installation of pipelines is carried out only after the installation of ventilation, sanitary and electrical equipment is completed.
5.Providing carbon dioxide
Carbon dioxide at a pressure of 4.5 bar for the Block is supplied to operating rooms (general, urological, traumatological, orthopedic, neurosurgical, thoracic, septic) and a small operating room.
Since there are no data on carbon dioxide consumption in Russian standards, we will take the carbon dioxide consumption per point equal to 5 l/min, and the duration and simultaneity coefficient by analogy with oxygen.
Carbon dioxide with a pressure of 4.5 bar is supplied to the consumers of the Unit from a discharge cylinder ramp located in the nitrous oxide unit room (No. 5.15, 5th floor). Ramp power 4 cylinders (2 groups of 2 cylinders). There is a block for automatic switching of ramp arms. The room must be equipped with exhaust ventilation. Category of premises in accordance with SP 12.13130.2009 - D.
The total consumption of carbon dioxide is 9,450 l/day. (The output of carbon dioxide from one cylinder with a capacity of 40 liters is 12500 liters. Thus, the Block’s need for carbon dioxide is ~ 0.8 cylinders per day).
From the discharge ramp, carbon dioxide is supplied to consumers through a horizontal pipeline located in the suspended ceiling through control disconnect boxes. Carbon dioxide flow valves are installed in ceiling-mounted surgical/endoscopic and backup consoles.
The terminal devices (valve systems) included in the consoles for carbon dioxide must have an individual input geometry in accordance with the European standard DIN EN, which will eliminate errors when connecting the equipment.
All equipment of the carbon dioxide supply system must operate around the clock, have appropriate color coding and explanatory notes in Russian.
The designed carbon dioxide pipelines should be installed from copper pipes in accordance with GOST 617-2006.
After installation, carbon dioxide pipelines must be tested pneumatically for strength and tightness.
Pipelines must be tested for strength and tightness in accordance with SNiP 3.05.05-84 and PB 03-585-03.
Pneumatic testing should be carried out with medical air and only during daylight hours.
The test pressure value should be taken in accordance with table. 10
The testing procedure is similar to testing oxygen pipelines (see Section 1).
The carbon dioxide pipeline, after all tests have been carried out, is purged with oil-free air or nitrogen, and before commissioning - with carbon dioxide released outside the building.
Protection of equipment and carbon dioxide pipelines from static electricity is carried out similarly to the protection of oxygen pipelines (see Section 1).
The qualification requirements for solder welders are similar to the requirements for oxygen pipeline welders (see Section 1).
Lay the carbon dioxide pipeline:
- in corridors: behind a suspended ceiling, and in places of lowering - openly (in an electrical box);
- in operating rooms ("Clean Rooms" zone) - at a height of 100 mm below the ceiling level.
Installation of carbon dioxide pipelines should be carried out in a space free from other communications.
The laying of carbon dioxide pipelines before installation is coordinated with electricians, and the installation of pipelines is carried out only after the installation of ventilation, sanitary and electrical equipment is completed.
Transportation of cylinders on the street is carried out using a trolley for transporting gas cylinders. The cylinder is lifted to the floor in an elevator. When transporting, avoid dropping or knocking the cylinder. It is forbidden to carry the cylinder while holding it by the valve.
DWG format.
Design engineer Trostin
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), therefore, technically, the vacuum line is designed as an integral part of the medical gas supply system. 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 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 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. It is advisable to store large quantities of liquid nitrous oxide only 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 system
The delivery system delivers medical gases to operating rooms from a central storage location. Gas wiring mounted 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 signal 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.
Equipment medical institutions special attention is always given. Doctors use equipment whose operation has been thought out to the smallest detail: each “gear” rotates 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 the volume of gas consumption to the specifics of the personnel’s activities. However, all medical gas supply systems have the same operating principle.
Purpose of medical gas supply systems
Medical gas supply systems are needed for life support for patients and for organizing the workspace of staff. They are used in intensive care units and operating rooms, wards, and therefore are an important link in ensuring the functioning of any hospital.
The design of medical gas supply occurs in such a way that patients and hospital employees do not have direct contact with the installation site of the system. Most often, the area for the location of gas tanks and their control system are basements, specially equipped places.
Medical gas supply is installed taking into account the required safety requirements. Modules of control and shutdown valves are installed on the main gas pipeline line to prevent an emergency. Using this mechanism, you can quickly turn off the gas supply in case of 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 help prevent emergency situations or promptly respond to their occurrence.
The professionalism of the workers who install these systems is also important. In this case, you need to trust only specialists in this field with extensive experience.
Preliminary design of medical gas supply must take into account the operating features of the equipment, customer requirements and the conditions and parameters of the premises where 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 take risks - 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.
