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Medical Gas Systems

Medical Gas Systems. 210a. Medical Gases. Oxygen – O 2 Air Carbon dioxide – CO 2. Medical Gases. Helium – He Nitrous oxide – N 2 O Nitric oxide - NO. Chemical and Physical Properties of Therapeutic Gases.

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Medical Gas Systems

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  1. Medical Gas Systems 210a

  2. Medical Gases • Oxygen – O2 • Air • Carbon dioxide – CO2

  3. Medical Gases • Helium – He • Nitrous oxide – N2O • Nitric oxide - NO

  4. Chemical and Physical Propertiesof Therapeutic Gases • Oxygen and air are life supportive because these gases supports the metabolic production of energy in the carbon-based organisms found on earth. • Atmospheric concentrations are given in percentage values (%), which represent the relative quantities of gases as they are present in the earth’s atmosphere.

  5. Oxygen – O2 (Green tank) • Characteristics • Colorless, odorless, tasteless • Non-flammable • Supports combustion

  6. Oxygen – O2 • Characteristics • Critical temperature • -118.6 °C (-181 °F) • Makes up approximately 21% of air

  7. Oxygen – O2 • Commercially produced through fractional distillation • Physical separation • Used in oxygen concentrators

  8. Fractional Distillation • Atmospheric air is filtered of pollutants, carbon dioxide and water • Air is compressed and cooled to a liquid • Then it is slowly heated and the nitrogen boils off. • Liquid oxygen remains RsCr 220

  9. Molecular Sieve • Composed of inorganic sodium aluminum silicate pellets • These pellets absorb the nitrogen and water vapor from the air • Produces up to 90% mixture RsCr 220

  10. Semipermeable Membrane • Pulls air through membrane • Oxygen passes through faster than nitrogen • Can produce 40% mixture • Good for long-term low flow oxygen RsCr 220

  11. Physical Separators • Will produce concentrations for nasal cannula but only at low flows • Used in oxygen concentrators IN THE HOME RsCr 220

  12. Air (yellow cylinder) • Characteristics • Colorless, odorless, tasteless • Non-flammable • Supports combustion

  13. Therapeutic Gases inRespiratory Care • At normal atmospheric conditions, air is an odorless, colorless, transparent, tasteless mixture of gases and water vapor that is nonflammable and supports combustion. • Air is composed of about 78% nitrogen and 21% oxygen by volume. • Compressed air may be referred to in medical settings as room air or ambient air.

  14. Therapeutic Gases inRespiratory Care • Compressed air is supplied in cylinders that are color coded yellow. • Piped compressed air is commonly provided in hospital medical gas systems for use in areas such as the operating room and intensive care units. • Smaller, portable air compressors are available for hospital or home use.

  15. Air • Produced by filtering and compressing atmospheric air • Must be dry • Must be free of oil

  16. Therapeutic Gases inRespiratory Care • Carbon dioxide (CO2) is a colorless, transparent, odorless to pungent, and tasteless or slightly acid-tasting gas with a specific gravity of 1.522, making it heavier than air. • CO2 is nonflammable and does not support combustion or animal life. • CO2 is a by-product of animal metabolism and the burning of carbonaceous fuels.

  17. Carbon Dioxide – CO2 • Characteristics • Colorless, odorless • Does not support combustion • Cannot support life • Grey cylinder

  18. Carbon Dioxide – CO2 • Produced by heating limestone in contact with water • Critical temperature above room temperature; stored as liquid in cylinder

  19. Carbon Dioxide – CO2 • Used in the past in mixtures with oxygen (90% O2 with 10% CO2, 95% O2 with 5% CO2); current use is limited

  20. Carbon Dioxide – CO2 • Current CO2 mixtures used primarily in membrane oxygenators and for calibration of analyzers

  21. Helium – He • Characteristics • Second lightest of gases • Odorless, tasteless • Non-flammable • Brown cylinder

  22. Helium – He • Characteristics • Good conductor of heat, sound, and electricity • Inert • Cannot support life

  23. Helium – He • Produced through liquefaction • When used therapeutically, must be mixed with at least 20% O2 (Heliox) • http://www.youtube.com/watch?v=nripiMQt0ls

  24. Helium – He • Used to manage severe airway obstruction to decrease work of breathing

  25. Therapeutic Gases inRespiratory Care • Nitric oxide (NO) is a colorless, tasteless gas with a slight metallic odor. This nonflammable and non-life-supporting gas supports combustion and is toxic. • Nitrogen (N2) is the major component of the atmosphere, 78% by volume. • Nitrogen gas is responsible for the blue color of the sky on earth.

  26. Nitrous Oxide – N2O • Characteristics • Colorless • Slightly sweet odor and taste • Supports combustion • Cannot support life

  27. Nitrous Oxide – N2O • Produced by thermal decomposition of ammonium nitrate

  28. Nitrous Oxide – N2O • Critical temperature above room temperature; stored as liquid in cylinder • Used as an anesthetic agent

  29. Nitric Oxide - NO • Characteristics • Colorless • Non-flammable • Supports combustion

  30. Nitric Oxide - NO • Produced by oxidation of ammonia at high temperature in the presence of a catalyst

  31. Nitric Oxide - NO • Respiratory irritant capable of causing chemical pneumonia and pulmonary edema

  32. Nitric Oxide - NO • High concentrations can cause methemoglobin to form • Used in term and near-term infants for the treatment of persistent pulmonary hypertension

  33. Cylinders • Markings • Sizes/oxygen contents • D – 12.6 cu.ft./356 L • E – 22 cu.ft./636 L • G – 186 cu.ft./5260 L • H/K – 244 cu.ft./6900 L

  34. H Cylinders • 2200 psi • A.S.S.S safety system • Threaded connection • Need to be safety chained and in a secured dolly for moving RsCr 220

  35. E Cylinders • Small and lightweight (15 pounds) • PISS – Pin Index • Yoke connection RsCr 220

  36. Types and colors of cylinders • Air - Yellow • Oxygen - Green – Int’l (White) • Helium - Brown • CO2 - Grey • Nitrogen - Black • Nitrous Oxide-Blue Do NOT trust the color of the tank as sole indicator of it’s contents RsCr 220

  37. Other Oxygen Tank Markings RsCr 220

  38. Bulk Oxygen Systems • Large capacity • Liquid oxygen • Small system (or back up) • Nitrous Oxide • Bank of H cylinders RsCr 220

  39. Large Oxygen Supply System RsCr 220

  40. Small Bank of Cylinders RsCr 220

  41. Liquid vs Gas • Insulated – Liquid • Solid metal - Gas • Large continuous demand – Liquid • Small portable – Liquid or tank • Tanks act differently if they contain gas or liquid • No accurate gauge on liquid tank content RsCr 220

  42. Go figure RsCr 220

  43. Liquid Oxygen • Constantly losing oxygen despite insulation • Needs pressure and insulation for cold temperature (-118oC) • Low pressure (200 psi) • Large system has vaporizers fins to help with heat transfer when liquid turns to gas (frozen year round) • Small system is great for mall shopping RsCr 220

  44. Wall (low pressure) systems • D.I.S.S. • 50 P.S.I • The MJC lab has these • Quick connect • A newer “better system” RsCr 220

  45. DISS RsCr 220

  46. DISS Wall Outlet RsCr 220

  47. Flowmeters • Thorpe Tube is most common • Can use Bourdon Gauge RsCr 220

  48. RsCr 220

  49. Zone Valves RsCr 220

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