Medical gas is critical to the function of hospitals and many other healthcare facilities. Knowing the most common types of gases, understanding how each is used, and then how to maintain your systems for each gas will ensure your facility's success.
In this article, we discuss five types of medical gas used in hospitals:
- Medical Air - used in the ICU and NICU areas, medical air is supplied by a specific air compressor to patient care areas.
- Oxygen - a medical gas required in every healthcare setting, and is used for resuscitation and inhalation therapy.
- Carbon Dioxide - used for less invasive surgeries
- Nitrogen (Medical Liquid Nitrogen) - a medical gas used for cryosurgery removal of some cancers and skin lesions
- Nitrous Oxide - a medical gas is used in numerous surgical procedures as both an anesthetic and analgesic.
1. Medical Air
Medical Air refers to a clean supply of compressed air used in hospitals and healthcare facilities to distribute medical gas. It is free of contamination and particles, has no oil or odors, and is dry to prevent water buildup in your facility's pipeline.
When a patient is in the operating room, whether it's an emergency or not, a surgeon relies on a medical air compressor to keep the patient comfortable and breathing. Medical air sources shall be connected to the medical air distribution system only and shall be used only for air in the application of human respiration and calibration of medical devices for respiratory application.
What is Instrument Air?
Medical Instrument Air is compressed air purified to meet the requirements of the Instrument Society of America and NFPA as an alternative to Nitrogen. Equivalent to Nitrogen in pressure, dryness, and cleanliness, Instrument Air can support multiple medical applications including driving surgical tools, operating pneumatic brakes and tables, central sterile supply, and laboratory air.
Smaller operations that do not want to have a separate compressors and piping line use pure nitrogen out of cylinders for this purpose.
There are three different compressors that are strongly favored for the distribution of medical air: Scroll, Oil-Less Reciprocating and Oil-Free Tooth Machines. Oil-free and oil-less technology is the preferred method to distribute medical air, because it is the simplest and most cost effective solution.
A scroll compressor works by using one stationary scroll and one moving scroll. The moving one orbits the stationary one to compress the air. The space for the trapped air gets smaller and smaller, decreasing the volume and thereby increasing the pressure.
This compressor type is used in distributing med gas, because required maintenance is minimal, and they operate well in all duty cycles. Scroll compressors are also very clean, quiet, and small, making them ideal for distributing med gas in your hospital or clinic setting.
Scroll compressors are most commonly used for carrying medical gas for anesthesia, to calibrate surgical tools, and to power incubators and ventilators.
Oil-less reciprocating compressors are used to distribute medical air when an intermittent cycle is needed. Installation is inexpensive, noise level is low, and maintenance is cost effective. It is designed to keep oil out of the compression chamber and air stream, and does not add any flammable or toxic contaminants to the air. The med gas typically travels through clean copper piping that leads to your surgical suites and patient rooms to supply medical outlets for ventilators and respirators.
Oil-free tooth compressors, such as the Atlas Copco's ZT-MED featured on their website, prevent oil contamination and the expenses that go with it. There is no risk to your patients, nor risk of damage to your expensive hospital equipment. They operate quietly, are self-regulating, and are easy to maintain.
In addition, Atlas Copco offers a state-of-the-art software tool that assists your hospital engineers, medical specialists, and developers. This tool helps to determine the size and quantity of compressors needed, along with the necessary purifiers and vessels to meet your medical gas flow requirements.
Oxygen is a medical gas required in every healthcare setting, and is used for resuscitation and inhalation therapy. It was introduced in the early 1900's. You can use it for medical conditions such as COPD, cyanosis, shock, severe hemorrhage, carbon monoxide poisoning, trauma, cardiovascular and respiratory arrest, resuscitation, and life support.
3. Carbon Dioxide
Carbon Dioxide is used for insufflating medical gas for less invasive surgeries like laparoscopy, arthroscopy, endoscopy, and cryotherapy, as well as for respiratory stimulation during and after anesthesia. CO2 may be piped in large hospitals, but more likely comes from a tank.
4. Nitrogen (Medical Liquid Nitrogen)
Nitrogen is a medical gas used for cryosurgery removal of some cancers and skin lesions, and also for the storage of tissues, cells, and blood in cryogenic temperatures to avoid oxidation of the samples. It can also be used as part of the medical gas mixture for lung function tests. The pharmaceutical industry uses this medical gas in the manufacture of medications.
Nitrogen as a gas is used to power tools in places where they do not have instrument air. Most of the time it comes from a manifold of cylinders and is piped at pressure with an alarm system at the source and on the use site.
Liquid nitrogen is a couple hundred degrees below zero and freezes tissue on contact. So it could be used in a procedure room (to take off warts, etc) or to freeze tissue samples, but it usually would not be in an OR.. Plus, it comes in gigantically insulated pressurized bottles so it does not evaporate.
5. Nitrous Oxide
Nitrous Oxide is a medical gas commonly known as "laughing gas" and dentists began using it as an analgesic in 1812. Since then, this medical gas is used in numerous surgical procedures as both an anesthetic and analgesic.
There are certain times when this medical gas is contraindicated and patients undergoing those types of procedures are provided with a medical gas warning wristband that alerts your facility's staff not to administer it.
Inspecting Your Med Gas Systems
Your medical gas systems need to be inspected regularly, not only because they are critical to your patients' well-being, but also because those inspections can make the difference between financial success or failure. It is important that you supply your facility's technicians with repair, maintenance, and operational information to keep your medical gas systems both safe and cost effective.
Medical gas, like other medical products, must have a Marketing Authorization (product license) in order to be sold. Equipment must have a CE marking to indicate that it complies with the Medical Devices Directive.
Annual inspections of the following medical gas systems are required:
- Bulk oxygen system
- All central supply systems
- Carbon Monoxide monitor (more often than annually if the manufacturer recommends it)
Periodic inspections are also required for the inlets and outlets, the alarm warning system, as well as for the maintenance programs for all central supply systems.
Additionally, the Joint Commission requires all accredited facilities to inspect, test, and maintain the following:
- Master and area alarms
- Flexible connectors
- Automatic pressure switches
- Shut-off valves
Knowing the differences between the various types of gases and compressors as well as understanding their maintenance requirements is key for facility managers and other staff. Adhering to proper maintenance standards will allow your facility to avoid unnecessary risks and delays. Plus, understanding the types of gases you are using, and how to use them properly, will maintain top patient safety.