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Wesson Building Medical Air Compressor

This article discusses the failure and replacement of a medical air compressor at the Wesson Building, as well as the next steps taken to address the issue. It includes details of the failure event, replacement planning, concerns with current state, and proposed next steps.

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Wesson Building Medical Air Compressor

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  1. Wesson Building Medical Air Compressor Failure, Replacement, and Next Steps Emily Bonazelli Clinical Engineer

  2. Overview • Wesson Building • Neurology and Sleep Center • Wound Care Hyperbaric Medicine • Labor and Delivery • NICU • One Medical Air Compressor

  3. Medical Air Compressor Failure Event • Saturday, January 28, 2017 • 7:45 PM • Engineering made aware of no pressure alarms on the medical air compressor • Low air pressure alarms on 6 ventilators in NICU • All air/oxygen blenders alarm loss of air (<20 psi) • NICU called security and CE on-Call

  4. Medical Air Compressor Failure Event • Saturday, January 28, 2017 • 8:30PM • Engineering discovers the source of the leak and restores system pressure • Ventilators reestablish air pressure • CE on-call arrives at the Wesson Building • CE on-call reaches out to Supervisors • CE Supervisors reaches out to CE Respiratory specialist • CE Supervisor reaches out to Respiratory Manager to identify possible air tanks and regulators

  5. Medical Air Compressor Failure Event • Saturday, January 28, 2017 • 9:30PM • CE Supervisor and CE Respiratory Specialist arrive on scene • CE and NICU staff begin disconnecting all ventilators and blenders not in use to help relieve stress on compressor • Medical Air Compressor Vendor arrive on site • 10:15PM • CE discuss medical air compressor with Engineering • CE reconnects ventilators and blenders to test compressor • 11:30 PM • CE checks with clinical staff before heading home

  6. Root Cause Analysis

  7. Replacement Planning • Monday, January 30, 2017 – Thursday, February 2, 2017 • Engineering, CE, and Clinical Staff worked to determine the following: • Shutdown time frame • NICU evacuation site • Amount of medical air tanks needed to sustain NICU, LDRP, and Hyperbaric through the shutdown

  8. Replacement Planning • Shutdown time frame • Tuesday, February 7th at 9 am • Will take about 8 hours • NICU evacuation site • Dedicated four rooms on Infants and Children's unit • Amount of medical air tanks needed to sustain NICU, LDRP, and Hyperbaric through the shutdown • Medical air tanks were ordered to set up a tank farm to back fill medical air • Location of tank farm

  9. Replacement Planning • Monday, February 6, 2017 • CE and Clinical staff rounded in NICU to determine how many patients are on blenders and vents • CE set up four rooms on Infants and Children’s including NICU code cart • Engineering set up tank farm • Hard stops included: baby needing or on an oscillator

  10. Replacement • Tuesday, February 7, 2017 • 7:30 AM • CE and Clinical staff rounded in NICU to determine how many patients are on blenders and vents • 8:00 AM • Emergency operations center opened • 9:00 AM • Shut down begins • Running of tank farm • 2:13 PM • Switched to secondary tank farm • 3:30 PM • Medical Air Compressor replacement installed and functioning

  11. Replacement • Pressure checks every 2 hours • Every step was communicated to the EOC

  12. Concerns with Current State • Wesson Building usage of Medical Air • >6000 hours of runtime for all three compressors in 2 years • HOF medical air compressor has a runtime of 500 hours in 6 years • Replaced Medical Air Compressor with same model • Needed a high pressure line for hyperbaric chamber • Know single point of failure

  13. Medical Air Usage • Hyperbaric chambers were replaced and no longer needed a high pressure line • 1 blender at every bedside in NICU • 1-2 blenders in every LDRP room • Blenders remain on at all times

  14. Next Steps • Continue to discuss blender usage in the Wesson building • Add a second Triplex compressor • Requires second medical air shutdown • Currently scheduled for the end of April

  15. Questions?

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