MEDICAL GASESManufacture, Storage, Transport + DeliveryFirst Year Respiratory Therapy

MJCRsCr 220

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RsCr 220*Composition of the AirWe breathe earths atmosphere composed of:Nitrogen (78%)Oxygen (21%)Carbon Dioxide (0.03%)Argon and trace gases (0.93%)Neon, Xenon, Krypton and Deon

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How Oxygen is producedFractional DistillationPhysical SeparationNitrogen Molecular sieveSemi-Permeable membrane

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Fractional DistillationLarge Manufacturing Facility

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RsCr 220*Fractional Distillation for liquid O2

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RsCr 220*Fractional DistillationAtmospheric air is filtered of pollutants, carbon dioxide and waterAir is compressed and cooled to a liquidThen it is slowly heated and the nitrogen boils off.Liquid oxygen remains

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Physical SeparationMolecular SieveSemi-Permeable Plastic Membrane(in the home)

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RsCr 220*Molecular SieveComposed of inorganic sodium aluminum silicate pelletsThese pellets absorb the nitrogen and water vapor from the airProduces up to 90% mixture

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RsCr 220*Oxygen Concentrator

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RsCr 220*Semipermeable MembranePulls air through membraneOxygen passes through faster than nitrogenCan produce 40% mixtureGood for long-term low flow oxygen

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RsCr 220*Oxygen concentratorSemi-permeable membrane

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RsCr 220*Physical SeparatorsWill produce concentrations for nasal cannula but only at low flowsUsed in oxygen concentrators IN THE HOME

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RsCr 220*Home Concentrator

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Medical GasesOxygen, Carbon Dioxide, Helium, Nitrous Oxide, Nitric Oxide, Nitrogen, Carbon Monoxide

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RsCr 220*Properties of Common GasesChemical symbolMolecular weightColor, odor, tastePhysical stateCritical temperature, boiling pointCombustion characteristics

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RsCr 220*Oxygen02Molecular Weight 32Colorless, odorless, tastelessSlightly heavier than airDensity of 1.29 g/LNonflammable but supports combustion

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RsCr 220*Compressed AirIs the same mixture of nitrogen, oxygen, carbon dioxide and argon.Is piped in to all modern hospitalsUsed to power pneumatically powered equipmentSome situations (patients are C02 retainers) when oxygen is contraindicated

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RsCr 220*Carbon DioxideC02Colorless and OdorlessDoes not support combustionUsed in fire extinguishersMore soluble in liquids than oxygenEasier transporting in blood then oxygenUsed to treat hiccups (singulation)

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RsCr 220*HeliumHeOdorless, tasteless, non-flammableSecond lightest of gasesCombined with oxygen (heliox) to reduce work of breathing with swollen upper airways

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RsCr 220*Nitrous OxideN20Nonflammable but supports combustionUsed as an anesthesia in OR (laughing gas)Always mixed with oxygen (Entonox) and other anesthesia agents

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RsCr 220*Nitric OxideN0Is nonflammable but supports combustionUsed experimentally in low concentrations (ppm) for pulmonary vasodilationRecently has had excellent results with premature babies

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RsCr 220*NitrogenN2Used as lab gas (liquid) for freezing tissue

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RsCr 220*Carbon MonoxideCOUsed in Pulmonary Function LabVery diffusible used to test how easily gas will pass through the lung membranes

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RsCr 220*CyclopropaneStrictly an anesthesia gas

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RsCr 220*Ethylene OxideUsed to gas sterilize medical equipmentUseful for equipment that cant handle high temperatures or immersion in water

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Oxygen StorageTanks LiquidTanks - Gas

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Tank Sizes and CapacitiesLarge CylindersSmall Cylinders

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RsCr 220*Oxygen Tank Sizes

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RsCr 220*H Cylinders2200 psiA.S.S.S safety systemThreaded connectionNeed to be safety chained and in a secured dolly for moving

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RsCr 220*E CylindersSmall and lightweight (15 pounds)PISS Pin Index Yoke connection

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RsCr 220*Types and colors of cylindersAir-YellowOxygen-Green Intl (White)Helium-BrownCO2-GreyNitrogen-BlackNitrous Oxide-BlueDo NOT trust the color of the tank as sole indicator of its contents

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RsCr 220*Labels The only sure way

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RsCr 220*Other Oxygen Tank Markings

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Regulation of cylindersD.O.TO.S.H.A.F.D.A.B.M.D.

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RsCr 220*Recommending AgenciesC.G.A.N.F. P.A.A.N.S.I.I.S.O

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Bulk Supply SystemsLiquid Oxygen

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RsCr 220*Bulk Oxygen SystemsLarge capacityLiquid oxygen

Small system (or back up)Nitrous OxideBank of H cylinders

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RsCr 220*Large Oxygen Supply System

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RsCr 220*Small Bank of Cylinders

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RsCr 220*Liquid vs GasInsulated LiquidSolid metal - GasLarge continuous demand LiquidSmall portable Liquid or tank

Tanks act differently if they contain gas or liquidNo accurate gauge on liquid tank content

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RsCr 220*Go figure

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RsCr 220*Liquid OxygenConstantly losing oxygen despite insulationNeeds 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

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RsCr 220*Bulk Liquid Oxygen supply

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RsCr 220*Bulk OxygenSupply System

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RsCr 220*Home LiquidOxygen

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Low Pressure Safety SystemsDiameter Index Safety SystemQuick Connect

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RsCr 220*Wall (low pressure) systemsD.I.S.S.50 P.S.IThe MJC lab has theseQuick connectA newer better system

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RsCr 220*DISS (and Dat)

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RsCr 220*DISS Wall Outlet

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RsCr 220*Different Quick Connects

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RsCr 220*More Quick Connects

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RsCr 220*FlowmetersThorpe Tube is most commonCan use Bourdon Gauge

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Other Safety FeaturesZone Valves

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RsCr 220*Zone Valve System

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RsCr 220*Zone Valvesfor bulk O2 supply

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Cylinder Connections(High Pressure)American Standard Safety SystemPin Index Safety SystemKey Index Safety System

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RsCr 220*RegulatorsThey decrease internal tank pressure down to a working pressure (50psi)They read and display the internal tank pressureThey meter out the precise flow for patient use.

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RsCr 220*Cylinder connectionsA.S.S.S. (American Standard)H cylindersHigh pressure, large tanks

P.I.S.S. (Pin Index)E cylindersHigh pressure, small tanks

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RsCr 220*American Safety Standard System

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RsCr 220*Pin Index System

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RsCr 220*Pin Index System

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RsCr 220*Pin Index Numberingfor small cylinders

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Tank DurationHow long will they last

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RsCr 220*Cylinder Duration CalculationsYou can memorize size of tank then calculate how long it will last

Or use:Conversion factors3.14 for H cylinders0.28 for E cylinders

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RsCr 220*Liquid Oxygen DurationConvert pounds to litersMultiply by 860 to get volume of gaseous oxygen (Liters)Divide by the liter flow (L/min)Convert minutes to hours and minutes

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RsCr 220*Thanks for listening

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