Design and installation of medical gas supply. Medical gas supply from VNIIMIRT Medicine. Installation of working and reserve ramps for gas cylinders and functional wiring with automatic switching
Today, every successful medical institution has modern medical equipment in its arsenal. 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. Systems medical gases 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.
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 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. However, all gas cylinders are equipped with emergency safety valves to prevent explosion under conditions of sudden pressure increase (eg 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 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.
Medical gas systems - 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.
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.
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 of premises for the placement of 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 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 - balloon 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 that provide easy, safe and convenient connection of equipment
We carry out commissioning works and commissioning
Among our partners medical equipment for medical gas supply systems, only European manufacturers proven over decades of flawless operation at our facilities
We install medical wall consoles for intensive care wards with different quantities and the type of connectors and gas valves, which can be designed for one or more beds
