Turnkey medical gas supply system. Design and installation. Installation of compressors for the production of compressed air with different pressures for medical equipment with pneumatic drive

Medical gas systems are closely related to daily healing processes, as they are used in almost all areas modern medicine- surgery, cryosurgery, anesthesiology, pulmonology, endoscopy, diagnostics, calibration medical equipment and many others. Timely, reliable supply and installation of a high-quality medical gas system is the key to the effective functioning of medical institutions.

Medgases used in modern medicine

  • oxygen;
  • nitrous oxide;
  • carbon dioxide;
  • vacuum;
  • compressed air.

System range medical gas supply includes gaseous and liquid forms of medical oxygen, nitrogen, carbon dioxide, helium and pure gases, gas mixtures used in various fields of medicine. A significant part of the medical assortment is gas equipment, used in hospital centralized gas supply systems.

Main stages of creating a medical gas supply system

  • consulting in the design of a gas supply network;
  • completing equipment for installation on site;
  • direct installation of medical gas supply networks;
  • commissioning works.

The complex of medicinal gases includes

Equipment used to create a modern gas supply system

  • A gas distribution manifold with ramps is installed in an oxygen station (nitrogen station, CO2 station). One manifold provides operation for up to 30 cylinders. Multiple manifolds can be installed.
  • Copper pipelines: connected to each other by soldering, mounted using modern adjustable clamps.
  • Alarm consoles: the central zone console is installed in the fitting room in the hospital building, zone consoles are installed in the rooms of the nurses on duty in the departments.
  • Gas valves (oxygen, compressed air, nitrogen).
  • Ward consoles, operating rooms and resuscitation consoles are installed in post-resuscitation wards, resuscitation rooms and above operating tables.
  • Control valves are installed in each department of the hospital.
  • Gas adapters are used to connect gas consumers.

Our highly qualified specialists, established supply channels, wide information base on parts, units and devices allow us to obtain necessary equipment on time.

Network installation

Installation of medical gas supply networks must be carried out by a specialized organization, which guarantees the successful functioning of the system medicinal gases after commissioning. High professional level specialists, equipped with modern tools, extensive experience working with a variety of medical equipment helps our company’s specialists quickly, efficiently and timely install the system within the walls of a medical institution.

At any time, our technical specialists provide free consultations on all issues related to the operation and maintenance of medical gas supply systems.

Medical Gas Systems Development Process

The creation of a medical gas supply system begins with design work for a specific medical institution, taking into account the needs, existing communications and development prospects. The project is carried out by a group of specialists from our organization in accordance with current regulatory documents

An oxygen concentrator is used as the main source of oxygen, the performance of which is selected based on the maximum oxygen consumption in a given medical institution.

A cylinder ramp with two independent arms of 3-5 cylinders each is used as a backup source of oxygen. The oxygen ramp must include a system for automatically switching from one arm to another when the cylinders are empty.

The medical gas supply system must include electronic system control and alarm system, which continuously monitors pressure in pipelines.

In medical premises, final consumption valves should be installed (separately or as part of consoles) with standard instantaneous gas sockets for connecting special final devices (flow meters with humidifiers, nebulizers, respiratory support devices, etc.). Medical gas supply systems must be equipped with a sufficient number of special end devices for a given medical institution.

The design of medical gas systems 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

Insulation of individual sections of pipelines for the purpose of maintenance, extension to increase the length of the network or blocking in emergency situations, is performed by means of 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 located in work area personnel 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 the installation of the medical gas supply system is completed, 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.

Project for centralized supply of the facility: “Surgical building, 5th floor. Major renovation 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 of the 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, traumatological, orthopedic, neurosurgical, thoracic, septic) and small operating rooms, ceiling consoles for the anesthesiologist and surgeon and additionally accommodates wall consoles that duplicate the ceiling ones in terms of the set of medical gases. .
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 the start of 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 when conducting 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 the 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 institutions (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 place of greatest consumption. The room must be equipped with exhaust ventilation. Room category 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 joints.
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 with a pressure of 4.5 bar and 8 bar is supplied to the consumers of the Unit from a designed compressor station based on 4 compressors located in the basement (rooms 4.5) in accordance with the requirements of the Rules for the Design and Safe Operation of Vessels Operating under Pressure PB 03-576-03 and Rules for the design and safe operation of stationary compressor units, air 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, 24 V control voltage. 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 disconnect 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 discharged 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 the 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.
Install compressed air pipelines 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 premises of the vacuum station, 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. 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 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 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.

Therapeutic gas supply includes the following systems:

  • supply of medical oxygen (hereinafter referred to as oxygen);
  • supply of nitrous oxide;
  • supply of compressed air with a pressure of 4 Bar;
  • supply of compressed air with a pressure of 7 bar;
  • carbon dioxide supply;
  • provision of vacuum;
  • nitrogen supply;
  • provision of argon.

Typical equipment in hospitals using nitrous oxide should include anesthetic gas removal systems.

Each therapeutic gas supply system consists of a source of appropriate gas, pipelines transporting gas, gas consumption points and a gas supply control system.

A necessary condition for the life support systems of a modern hospital is the continuous operation of the equipment, for which all sources included in the therapeutic gas systems are duplicated to make it possible to replace elements without stopping the supply of therapeutic gases to the consumption lines.

Typical equipment of a hospital medical gas supply system should be designed in such a way as to ensure its autonomous operation in different fire compartments in which consumers of therapeutic gases are located.

The centralized oxygen supply system consists of the following elements:

  • source of oxygen supply;
  • external network of oxygen pipelines;
  • internal oxygen supply system.

Medical organizations use medical gaseous oxygen in accordance with GOST 5583-78 and liquid oxygen in accordance with GOST 6331-78.

Depending on the amount of oxygen consumed and local conditions (presence of gaseous or liquid oxygen), the source of oxygen supply can be:

  • oxygen-gasification station;
  • 40-liter oxygen cylinders with a gas pressure of 150 atm.;
  • oxygen generator (concentrator).

If there are more than 10 40-liter oxygen cylinders, they should be placed in a central oxygen point - a separate heated building.

The oxygen ramp is used in medical organizations as the main source when the facility’s oxygen demand is small, and also as a backup when there is a main source of oxygen - an oxygen-gasification station or a central oxygen point.

The total capacity of the cylinders must provide a supply of oxygen for the operation of the treatment and prevention organization for at least 3 days.

The oxygen generator can be placed both inside the building (in a separate room with window openings, located taking into account the places of maximum consumption, on the 1st and upper floors) and outside the building in a special container equipped with lighting, heating and air conditioning systems. The oxygen generator installation includes: air compressor, compressed air preparation unit for the oxygen generator (filters, compressed air dryer), oxygen generator, air and oxygen receivers, control unit.

Installations in containers can be equipped with stations for filling produced oxygen into cylinders, which can be used as backup sources of oxygen.

External networks of oxygen pipelines are laid underground in trenches with mandatory backfilling of the trenches with soil.

External oxygen pipeline networks are made of seamless cold- and heat-deformed pipes made of corrosion-resistant steel GOST 9941-81 with a wall thickness of at least 3 mm.

It is allowed to lay oxygen pipelines above ground along the facades of buildings from copper pipes grade T in accordance with GOST 617-72 or from seamless cold- and heat-deformed pipes made of corrosion-resistant steel in accordance with GOST 8941.

On underground oxygen pipelines when they cross highways, driveways and other engineering structures provide cases made of asbestos-cement pipes for non-pressure pipelines according to GOST 1839-80.

Typical equipment of hospitals with external network oxygen pipelines are carried out in accordance with the requirements of VSN 49-83, VSN 10-83 and SNiP 3.05.05-84.

Oxygen enters the internal system from external networks through an oxygen manifold, combined with pipelines of other therapeutic gases into a control (distribution) unit, where shut-off valves and instrumentation are installed on the oxygen pipelines. On oxygen pipelines, only fittings specifically designed for oxygen should be installed (brass, bronze, stainless steel, lined). The use of steel and cast iron reinforcement is not allowed.

Oxygen supply in standard hospital equipment is provided in the following rooms: operating rooms; anesthesia; resuscitation rooms; pressure chamber premises; maternity wards; recovery rooms; intensive care wards (including children's and newborns); dressings; procedural departments; blood collection rooms; procedural endoscopy and angiography; wards for 1 and 2 beds of all departments, except psychiatric ones; wards for newborns; wards for premature babies.

Medical organizations use medical nitrous oxide (liquefied gas). State Pharmacopoeia of the Russian Federation, 12th edition 2007, part I.

The centralized supply system for nitrous oxide consists of a source of liquefied gas and an internal network of pipelines from the source to the points of consumption. Typical hospital equipment involves supplying nitrous oxide to the following rooms: operating rooms; anesthesia; procedural angiography, endoscopy, bronchoscopy; maternity wards; prenatal wards; burn department wards; intensive care wards (according to design specifications), incl. for children and newborns.

The supply of nitrous oxide is carried out from two groups of ramps for 10-liter cylinders with nitrous oxide (one group is working, the other is reserve). When the cylinders of the working group are emptied, the nitrous oxide unit automatically switches to the operation of the reserve group. Ramps for cylinders with nitrous oxide are located in the same medicinal gas control room where the medicinal gas control and distribution units are located, i.e. in a room with window openings on any floor of the building, except basements (preferably closer to the place of greatest consumption).

The vacuum supply system consists of a vacuum source - a vacuum station and a pipeline network. Vacuum stations are located in the basement or ground floor under secondary rooms (lobby, wardrobe, linen storage, etc.).

The supply of vacuum network pipelines is provided in: operating rooms; anesthesia; resuscitation rooms; maternity wards; recovery rooms; intensive care wards; dressings; procedural angiography, endoscopy, bronchoscopy; wards for 1 and 2 beds of all departments (as per design specifications), except for psychiatric ones; wards of cardiology and burn departments; wards for newborns; wards for premature babies.

To provide consumers with compressed air, compressed air stations are provided as sources. When placing and installing compressed air stations, you should be guided by the “Rules for the design and safe operation of stationary compressor units, air and gas pipelines.” In medical institutions, compressed air stations can be located in the basement or ground floor under rooms without permanent occupancy (lobby, wardrobe, linen storage, etc.). The supply of compressed air pipelines is provided for operating rooms, anesthesia rooms, intensive care rooms, labor rooms, and dressing rooms; intensive care wards, post-operative wards, wards for patients with skin burns, wards for newborns and premature babies, endoscopy procedures, as well as in inhalation rooms, bathrooms and laboratories.

The use of carbon dioxide is envisaged in operating rooms where laparoscopic and cryogenic techniques are used (cryodestruction devices), as well as in bathrooms and embryological rooms (and other rooms with CO2 incubators). The supply of carbon dioxide is carried out from a two-arm ramp (one arm of the ramp is working, the other is reserve) for 40-liter cylinders with carbon dioxide. Ramps for carbon dioxide cylinders are located in the same therapeutic gas control room where the control and distribution units for therapeutic gases are located and nitrous oxide ramps are located, i.e. in a room with window openings on any floor of the building, except basements (preferably closer to the place of greatest consumption).

Pipelines for therapeutic gases are made of copper pipes grade “T” in accordance with GOST 617-72 using fittings (tees, bends, etc.).

To supply compressed air to inhalers, bathrooms and laboratories, it is possible to use seamless cold- and heat-deformed pipes made of corrosion-resistant steel in accordance with GOST 9941, in laboratories - from galvanized steel water-gas pipes in accordance with GOST 3332.

Copper pipes for laying internal networks medicinal gases must be seamless and fat-free. Copper pipes must be connected to each other by soldering or using pipe fittings that meet the requirements of current standards and have a permit issued in accordance with the established procedure. Where they pass through ceilings, walls and partitions, pipes are placed in protective cases (sleeves) made of water and gas pipes in accordance with GOST 3262-75.

In places where medical gases are consumed, either separate gas valves are installed on the wall, at a height of 1400 mm from the floor, or wall or ceiling panels(consoles) with gas valves installed in them.

Therapeutic gas systems must include automatic regulators that provide:

  • - automatic switching from the working group of cylinders to the reserve one in case of emptying of the working group for cylinder stations of nitrous oxide, carbon dioxide, oxygen;
  • - automatic alarm unit in case of deviation from the set pressure of therapeutic gases;
  • - automatic switching on of backup compressors and vacuum pumps;
  • - alternate activation of compressors and vacuum pumps.

Medical institutions must provide a centralized medical gas supply in accordance with regulatory documents:

  • GOST 12.2.052-81, OST 290.004.
  • GOST 9941-81 Seamless cold- and heat-deformed pipes made of corrosion-resistant steel. technical conditions
  • GOST 617-2006 Copper pipes. Specifications
  • VSN 49-83. Departmental building standards. Instructions for the design of interplant pipelines for gaseous oxygen, nitrogen, argon
  • VSN 10-83 Ministry of Chemical Industry. Instructions for the design of gaseous oxygen pipelines
  • SNiP 3.05.05-84. Technological equipment and process pipelines
  • SNiP 42-01-2002 Gas distribution systems
  • STO 002 099 64.01-2006 Rules for the design of production facilities for air separation products

For several years, WestMedGroup has been designing and commissioning medical and technical gas supply systems, as well as medical valve systems based on equipment of its own production and the French company MIL"S. Our company’s specialists will help you select equipment for gas supply systems depending on the needs of the institution.

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