MEDICAL GASES

MEDICAL GASES

1. MEDICAL GASES DR.MAHESWARI JAIKUMAR [email protected]

2. DEFINITION Medical gases are gases used in medical procedures A medical gas is defined as one that is manufactured, packaged, and intended for administration to a patient in anesthesia , therapy, or diagnosis.

3. Medical gases are considered prescription drugs because their use as drugs is unsafe without the supervision of a licensed practitioner or by properly instructed emergency personnel .

4. Medical gases are gases used in medical procedures. Some are used for treatment, some for anesthesia , and some for driving medical devices and tools.

5. There are 7 kinds of gases commonly used: oxygen , nitrogen , nitrous oxide , argon , helium , carbon dioxide and compressed air (medical air) & medical vaccum

6. PURPOSE OF MEDICAL GAS Medical gases are used within hospital settings for many purposes. Oxygen, used to provide supplemental oxygen to the  respiratory system  ; in dentistry in combination with  nitrous oxide  ; and as an emergency standby.

7. Nitrous oxide, used as an anesthetic agent in surgery; mixed with oxygen to help patients relax during dental procedures; and in cryosurgery (the use of extreme cold to destroy tissue).

8. Nitrogen, used to provide pneumatic pressure in medical equipment; to prevent combustion and other chemical reactions; and as a component of many gas mixtures.

9. Carbon dioxide, used to inflate areas of the body for "keyhole" surgery (small incisions made to accommodate surgical instruments ); mixed with air or oxygen to stimulate breathing; and in cryosurgery or testing tooth sensitivity in dentistry.

10. Medical air, used in administering breathing treatments and as a mixing component for other respiratory gases.

11. Helium, used in breathing mixtures for patients with impaired lung functions.

12. WHERE MEDICAL GAS IS USED The departments that use medical gases in hospitals include operating rooms, pre-communicators, recovery rooms, debridement rooms, obstetrics and gynecology wards, ICU wards, and general wards.

13. POINTS TO CONSIDER Medical gas systems are commonly  color coded  to identify their contents. Emergency shut-off valves, or zone valves, are often installed in order to stop gas flowing to an area in the event of fire or substantial leak, as well as for service.

14. COLOUR CODED

15. Cont....... Valves may be positioned at the entrance to departments, with access provided via emergency pull-out windows.

16. OXYGEN Oxygen is the most basic gas for life, and it is used medically to supplement oxygen to oxygen-deficient patients. Direct inhalation of high purity oxygen is harmful to the human body.

17. Long-term use of oxygen concentration generally does not exceed 30-40%. Ordinary patients breathe oxygen through oxygen flowmeter ; critically ill patients breathe oxygen through the ventilator. Oxygen is also used in high-pressure tanks to treat diving, gas poisoning, and for drug nebulization .

18. Oxygen may be used for patients requiring supplemental oxygen via mask. A large storage system of liquid oxygen at the hospital which is evaporated into a concentrated oxygen supply, pressures are usually around 345–380  kPa (50.0–55.1 psi)

19. This arrangement is described as a  vacuum insulated evaporator  or bulk tank.   In small medical centers with a low patient capacity, oxygen is usually supplied by a manifold of multiple high-pressure cylinders.

20. In areas where a bulk system or high-pressure cylinder manifold is not suitable, oxygen may be supplied by an  oxygen concentrator . However, on site production of oxygen is still a relatively new technology.

21. NITROUS OXIDE Inhalation of a small amount of nitrous oxide has an anesthetic and analgesic effect, but a large amount of inhalation can suffocate people.

22. Medically, a mixture of nitrous oxide and oxygen is used as an anesthetic agent, and anesthesia is inhaled by the patient through a closed manner or a ventilator.

23. Nitrous oxide  is supplied to various surgical suites for its anaesthetic functions during preoperative procedures. It is delivered to the hospital in high-pressure cylinders and supplied through the Medical Gas system.

24. Some bulk systems exist, but are no longer installed due to environmental concerns and overall reduced consumption of nitrous oxide. System pressures are around 345  kPa (50.0 psi), 4 bar (400  kPa ; 58 psi) UK.

25. CARBON DIOXIDE Medically , carbon dioxide is used to inflate the abdominal cavity and colon for laparoscopy and colonoscopy. In addition, it is also used for laboratory culture of bacteria (anaerobic bacteria ).

26. Carbon dioxide can be made into dry ice by applying pressure (5.2 atmospheres) and cooling (-56.6°C below). Medical dry ice is used for cryotherapy to treat cataracts and vascular diseases.

27. Typically used for  insufflation  during surgery, and also used in laser surgeries . System pressures are maintained at about 345  kPa (50.0 psi), UK 4 bar (400  kPa ; 58 psi). It is also used for certain respiratory disorders. It contains 5 percent .

28. ARGON, HELIUM They are colorless , odorless , non-toxic inert gas . Medically used for argon gas knife, gas knife, and other surgical instruments .

29. NITROGEN Nitrogen is a colorless , odorless , non-toxic, non-flammable gas. It is inactive at room temperature and does not react chemically with ordinary metals .

30. Nitrogen is used to drive medical equipment and tools. Liquid nitrogen is commonly used in cryosurgery in surgery, stomatology , gynecology , and ophthalmology.

31. Nitrogen is typically used to power  pneumatic  surgical equipment during various procedures, and is supplied by high-pressure cylinders. Pressures range around 1.2  MPa (170 psi) to various locations.

32. MEDICAL AIR Medical air is  compressed air  supplied by a special  air compressor , through a dryer (in order to maintain correct dew point levels), and distributed to patient care areas by half hard BS:EN 13348 copper pipe and also use isolation ball valve for operating the services of compressed air 4 bar. It is also called medical air 4 bar.

33. In smaller facilities, medical air may also be supplied via high-pressure cylinders. Pressures are maintained around 345–380  kPa (50.0–55.1 psi). Compressed air is used to deliver power to oral surgical instruments, orthopedic instruments, and ventilators.

34. INSTRUMENT AIR/SURGICAL AIR Like nitrogen, instrument air is used to power surgical equipment. I t is generated on site by an air compressor (similar to a medical air compressor) rather than high-pressure cylinders

35. Early air compressors could not offer the purity required to drive surgical equipment. Therefore instrument air is becoming a popular alternative to nitrogen.

36. As with nitrogen, pressures range around 1.2  MPa (170 psi ). UK systems are supplied at 11 bar (1.1  MPa ; 160 psi) to the local area and regulated down to 7–8 bar (700–800  kPa ; 100–120 psi) at point of use.

37. MEDICAL VACUUM Medical vacuum in a hospital supports  suction  equipment and evacuation procedures, supplied by vacuum pump systems exhausting to the atmosphere .

38. Vacuum will fluctuate across the pipeline, but is generally maintained around −75  kPa (−560 mmHg; −22  inHg ), −450 mmHg (−60  kPa ; −18  inHg ) UK.

39. WASTE ANAESTHETIC GAS DISPOSAL/ANAESTHETIC GAS SCAVENGING SYSTEM Waste anaesthetic gas disposal, or anaesthetic gas scavenging system, is used in hospital  anaesthesia evacuation procedures .

40. Although it is similar to a medical vacuum system, some  building codes  require anaesthetic gases to be scavenged separately . Scavenging systems do not need to be as powerful as medical vacuum systems, and can be maintained around −50 to −65  kPa (−380 to −490 mmHg; −15 to −19  inHg ).

41. MEDICAL GAS MIXTURES There are many gas mixtures used for clinical and medical applications. They are used for patient diagnostics such as lung function testing or blood gas analysis.

42. Test gases are also used to calibrate and maintain medical devices used for the delivery of anaesthetic gases . In laboratories, culture growth applications include controlled aerobic or anaerobic incubator atmospheres for biological cell culture or tissue growth.

43. Controlled aerobic conditions are created using mixtures rich in oxygen and anaerobic conditions are created using mixtures rich in hydrogen or carbon dioxide. Supply pressure is 4 bar (400  kPa ; 58 psi). Two common medical gas mixtures are  entonox  and  heliox .

44. REFERENCES ^  NFPA 99: Health Care Facilities Code (2015) ^  CSA Z7396.1-17 - Medical gas pipeline systems - Part 1: Pipelines for medical gases, medical vacuum, medical support gases, and anaesthetic gas scavenging systems ^  ISO 7396-1:2016 Medical gas pipeline systems - Part 1: Pipeline systems for compressed medical gases and vacuum ^   http://www.frca.co.uk/article.aspx?articleid=100342 External links[ edit ] British Compressed Gases Association  website:  Department of Health (United Kingdom)  HTM02-01 Medical Gas Pipeline Systems Part A: Design, installation, validation and verification British Compressed Gases Association  website:  Department of Health (United Kingdom)  HTM02-01 Medical Gas Pipeline Systems Part B: Operational Management

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