Most of us assume that because the hospital is plumbed for vacuum and gasses, everything will work right the first and every time.
Usually, it does, but there is a reason every operating room has multiple outlets and inlets.
Sometimes, things don’t go as planned.
There are 4 avoidable problems you can be watchful of when it comes to your medical gas and vacuum systems equipment.
1. Leaking Outlets and Inlets
Pressurized gases like Oxygen, Nitrogen, Medair, and Instrument air are piped to the OR from the house system under normal circumstances.
Anesthesia gases, CO2, and some exotic gases may come from cylinders near the operating theater.
Plugging into a pressurized outlet can take a little bit of push. It is important that the connections are completely seated, and there is no “hissing” or no cool breeze coming out around the fitting when attached.
Leaking outlets in the OR or in the pipeline circuit can reduce pressures which may still supply the chemicals needed but confuse sensitive anesthesia equipment. Outlets and their seals can wear out, especially when they are plugged and unplugged frequently.
To avoid this problem, healthcare facilities should:
Implement regular maintenance schedules. Ensure that outlets and inlets are inspected and replaced by qualified technicians.
Beyond annual inspections, the best defense is making sure your staff is trained to know the sound and feel of the solid connection to the service line.
Staff should report outlets and inlets that do not function as expected. If staff encounters any leaking or “funny feeling” outlet or inlets, it should be reported before a serious failure occurs. Serious leaks of Nitrous, Oxygen, or anesthesia gases can be hazardous to both staff and patients.
2. Uncooperative Gas Fittings
While an adapter may need a little push, anything causing a second try should be checked. Each type of cylinder gas is identified by color with a label, and the fittings for each gas are designed so they cannot be used with the wrong kind of gas out of the cylinder, the manifold, or the outlet in the wall.
The color codes for medical gas cylinders are as follows:
Color of Cylinder (USA)
Oxygen - Green
Carbon Dioxide - Grey
Nitrous Oxide - Blue
Helium - Brown
Nitrogen - Black
Air - Yellow
When encountering this problem, you should do the following.
If connections cannot be easily attached by hand, never attempt to force them with a wrench. A wrench should only be used to make sure the seated connection is tightly sealed. If you encounter an obstinate connection, try a different cylinder and call facilities to make sure the fitting is correct and not deformed.
Plastic wall connectors are pretty tough, but they can be cracked or cross-threaded by forcing them to fit. A general guideline is that if you cannot start the fitting easily with one hand, make sure it is not deformed and/or replace it.
3. Alarms From Unknown Causes
We all know there are alarms everywhere, and while they can be a distraction, the safety they provide staff and patients is vital. Fluctuations in the pressure of the incoming gases can cause alarms on sensitive procedure equipment. In general, these variations can be overcome by adjusting the machine or changing the outlet driving the device.
If zone alarms (those boxes with lights on the outside wall) are triggered, it generally means there is a fault outside the operating room area or a set of rooms. Caution should be taken to make sure the gases needed for patients are present. Call facilities and make sure standby cylinder gas is available for backup.
4. Procedures Slowed by Low Suction
Poor vacuum is one of the most annoying causes of slow OR procedures.
Vacuum systems tend to be the most problematic because they are not just moving air, but pulling liquids and solids along with the air into the pipeline.
What should you do if you encounter low suction?
If the pressure or volume of the vacuum line is not working as needed, the first thing to check is the suction canisters between the surgery and the vacuum inlet on the wall. If these gravity traps are clear or empty, try changing inlets as obstructions can be at the inlet or in the plumbing of the boom or in the wall.
Gradual occlusion of vacuum lines may not be enough to trigger alarms and still make surgery and patient open time longer. Clogged inlets can be cleared during off hours if they are reported to facilities.
Conclusion
Medical gas and vacuum systems require regular testing and maintenance to keep them operating at optimal levels. We recommend building a better medical gas program for your facility.
Working with a compliance partner like CHT makes it easy to keep your medical gas and vacuum systems operating at peak performance. This will help to keep your patients safe while saving time and valuable resources for your facility.
Have you experienced any problems with your medical gas or vacuum systems? Please share your experiences with us in the comments section below.
