Central Gas supply in a hospital

1. Dr A.K.Khandelwal

2. Centralised medical gas pipeline system is a vital and
integral part of a modern hospital, with emphasis on safety,
reliability and purity of the gases.
The central piped medical gas system is one of the newer
types of hospital plumbing systems to be introduced into
the delivery of direct patient care.
Medical Gas piping is needed for oxygen, nitrous oxide,
medical air, nitrogen, carbon dioxide, vacuum and
anesthesia waste exhaust.
Dr A.K.Khandelwal

3. Piping medical gas from a central location directly to outlets at
the points of patient use provides high level of safety unheard of
in the past.
The direct piping method removes obsolete, bulky and dangerous
pressurized cylinders from the patient's bedside.
Also, these piped systems provide easier quality control and
pressure regulation because all gases are delivered from
centralized pumps, compressors or cylinder manifold systems.
The piping is designed and installed under strict national
regulations
Dr A.K.Khandelwal

4. ADVANTAGES OF CENTRALISED MEDICAL
GAS DELIVERY SYSTEM
FOR PATIENTS:
No distressing sign of oxygen cylinder at bed
side.
Elimination of noise produced by their
movement.
Protection of sterile areas from contamination
caused by use and movement of cylinder.
Uninturrupted and clean gas supply at desired
locations
Dr A.K.Khandelwal

5. FOR HOSPITAL STAFFS:
Instant availability of gas.
Clean, safe and reliable delivery of gases.
Continuous flow of gases when and where required.
Minimal accident hazards due to mishandling of
cylinders.
Dr A.K.Khandelwal

6. FOR HOSPITAL ADMINISTRAOR:
Easy purchase of gases in bulk quantities at
favorable term.
Economy on purchase of cylinders.
Fewer breakages
Minimum damages to building due to handling of
cylinder.
Rationalization in ordering, storing and
transporting.
Dr A.K.Khandelwal

7. Oxygen System:
Oxygen System Shall consists of the followings:-
Liquid Oxygen System (optional)-
Oxygen Manifold System with Automatic Control Panel
Oxygen Emergency supply system
Dr A.K.Khandelwal

8. Oxygen Manifold
It is the central supply room consists of cylinder manifold
and a control panel.
The manifold may be as small as two banks of 2 cylinders
each or as large as two banks of 20 cylinders each.
The control panel consists of primary and secondary
pressure regulators to ensure delivery of gas to the pipe
line at required pressure.(61PSI)
Dr A.K.Khandelwal

9. MANIFOLD ROOM
Dr A.K.Khandelwal

10. Normally a change over two to three times a week is
acceptable.
More frequent change indicate requirement for a bigger many
fold.
It is preferable that this room is located on the ground floor
and should have easy access to delivery vehicles. It should be
well ventilated and lit. For ease of handling of cylinders the
floor level should be at a height of one meter from the ground
level.
Dr A.K.Khandelwal

11. Oil or oil mist and other hazardous material should not
contaminate the surrounding atmosphere. No grease, oil
or naked flame should be used in the near vicinity and the
area should be a ‘No Smoking’ zone.
It should never be used to house compressed air and
vaccum unit
Dr A.K.Khandelwal

12. Fully Automatic Oxygen Control Panel
The Oxygen Control Panel shall be of microprocessor based
Digital Display Type..
Panel shall be Fully Automatic and shall switch over
from “Bank in Use” to ‘Reserve Bank’ without
fluctuation in delivery line pressure and without the
need of external electrical power.
The control panel incorporates six coloured LED’s,
Green for Bank in use,
Amber for Bank ready and
Red for Bank empty.
Dr A.K.Khandelwal

13. Alarm System
Two kinds of alarm are usually incorporated in system in
the centralized medical gas system.
One monitor the pressure it becomes red when pressure is
low.
The other alarm is remote signal lamp. It is preferably both
visual and audible.
Dr A.K.Khandelwal

14. Distribution piping
Copper pipes should be solid drawn, seamless, deoxidized, non
arsenical, half hard, tempered and degreased copper pipe
conforming to standards BS EN 1057.
When whole system is in place, pipe lines should be subjected to
a test pressure of 150 psi or one and a half times the working
pressure for 24 hours by means of oil free air or nitrogen to check
if it can withstand the required pressure as well as any
leakage..This test is called pressure lock test.
The isolation Valves will be made of Chromium plated brass and
Non Lubricated Ball type. All Valves shall be pneumatically
tested for twice the working pressure and Factory Degreased for
medical gas service Dr A.K.Khandelwal

15. Piping shall be protected against physical damage, corrosion
etc
Piping shall not be installed in kitchens or electrical
switchgear rooms. Avoid areas/corridors where movement of
equipment may cause physical damage. If unavoidable
protective shields to be used.
Correct size piping is one of the most important aspects to be
considered in designing system for central for medical gas
delivery system
Dr A.K.Khandelwal

16. Dr A.K.Khandelwal

17. Separate rooms are recommended for housing the Gas Control
Panels and other equipment. The room where Gas Control Panels
are kept is known as Manifold Room.
It is preferable that this room is located on the ground floor and
should have easy access to delivery vehicles. It should be well
ventilated and lit. For ease of handling of cylinders the floor level
should be at a height of one meter from the ground level.
A separate room called Plant Room should be used compressors
and vacuum pumps. This room should be in close proximity of the
Manifold Room.
Oil or oil mist and other hazardous material should not
contaminate the surrounding atmosphere. No grease, oil or naked
flame should be used in the near vicinity and the area should be a
‘No Smoking’ zone.
Dr A.K.Khandelwal

18. For ensuring uninterrupted supply two separate banks are used.
Gas from one bank is utilised at any point of time. The other bank
is kept as stand by or reserve.
A control panel installed between the two banks ensures that both
banks are not depleted simultaneously and the control of the
manifold automatically shift the flow of gas from the primary side
to secondary side when the primary bank pressure falls below the
set level. The control panel used should be built in accordance to
the international standards.
Dr A.K.Khandelwal

19. There should be a regulator for each cylinder bank to initially
reduce the cylinder pressure to the two line regulators that
control the final pressure. Both line pressure regulators should be
in service at all times.
The change over from the depleted bank to secondary bank
should be immediate with out fluctuation of line pressure.
Isolation of banks for ensuring on-line servicing is necessary.
The manifold should have intermediate and line pressure relief
valve.
Dr A.K.Khandelwal

20. Before the system is finally handed over the following tests
should be carried out:
1. Pressure drop test to ensure that there is no leakage in the
system.
2. Valve tightness and correct valve zoning.
3. Satisfactory mechanical operation and non-interchangeability
of each terminal outlet y means of probes.
4. Anti-confusion test for checking cross connection.
5. Flow rate and pressure at each terminal outlet.
6. Change over mechanism of Gas Control panels.
7. Satisfactory performance of compressors, vacuum pumps and
WAGD.
8. Performance of alarm system
Dr A.K.Khandelwal

21. TERMINAL UNITS
The pipe line ends in the terminal units:
Wall Outlets- self sealingvalve at outlet point is fixed to
the wall and is encased in a small rectangular shaped boxed
labeled and colored for instant identification.
Its use is established as soon as a safety key plug connector
is inserted in to it. It should be atleast 20 cm away from
electrical fitments.
Dr A.K.Khandelwal

22. Ceiling Pendents :It reduces floor congestion.
Pendants for OT
It accommodate the following:
Up to 10 Gas Service outlets in any desired sequence.
Up to 10 Hospital Grade electrical Outlets (Indian type).
Any Combination of Ground Jacks, Computer Outlets,
communication Devices, Slides and IV Hooks.
Hose for scavenging system.
Dr A.K.Khandelwal

23. Ceiling Pendents
Dr A.K.Khandelwal

24. Pendant for ICU
It accommodates Provision for 5 gas outlets, 8 electrical
outlets, selves with drawer system and side rails,
Examination lamp and basket for suction catheters and
monitor cables.
Quadruple infusion management system
Dr A.K.Khandelwal

25. Gas Outlets
Outlets shall be manufactured with a 165 mm long Copper inlet
pipe stub which is silver brazed to the outlet body. The inlet pipe
stub should be capable of swiveling by 360 degrees. Body shall
be 33 mm diameter one-piece brass construction.
For positive pressure gas services, the outlet shall be equipped
with a primary and secondary check valve and the secondary
check valve shall be rated at minimum 200 psl in the event the
primary cjeck valve is removed for maintenance.
Outlet bodies shall be gas specific by indexing each gas service
to a gas specific dual pin indexing arrangement on the respective
identification modula.
Dr A.K.Khandelwal

26. Safety measures for medical gas delivery system
a.Safety valves provided to be set at 1.5 times the working pressure
b. Locknut provision on regulators for preventing inadvertent high-
pressure settings
c. Two stage regulators for avoiding fluctuation in flow
d. Line pressure alarms for continuous monitoring pipeline pressure
e. Gas specific color-coding in each pipeline
f. Gas specific color-coding on cylinders.
g. Specific color-coding on each outlet
h. Non-interchangeable adaptor for each outlet
Dr A.K.Khandelwal

27. VACCUM UNIT
It is used in treatment are,OT, Surgery ,laboratory
It consist of electrically driven vaccum pump to create a
pressure much lower than atmospheric pressure in reservoir
tank which could be 3 meters in height.This vaccum creates a
suction effect at out lets unit
The reservoir tank stabilizes vaccum pressure in the pipe line
between-305mm to 635mm. Of mercury at all out lets
Dr A.K.Khandelwal

28. Vacuum (suction) system
Vacuum system shall be stack mounted ---------------- cfm capacity. (as per
requirement of the hospital)
Dr A.K.Khandelwal

29. COMPRESSED AIR UNIT
It is used for inhalation therapy, to run ventilators,orthopedic and
dental drills, other Pneumatic tools.
It consists of an electrically driven air compressor.Water is
required for cooling the compressor.Air pressor at compressor is
about 100-118PSI and this reduced to58-61PSI for use at patients
end.
Dr A.K.Khandelwal

30. Compressor Air machine
Dryer of Unit to remove
moisture
Dr A.K.Khandelwal

31. LIQUID OXYGEN SYSTEM
It is economical for superspecility hospital with beds above
200,where weekly oxygen consumtion more than10,000Lt.
The equipment is designed with sufficient safety to store
cryogenic liquid oxygen,transform it to gaseous form and
supply it at a pressor consistent with medical requirement.
The liquid oxygen tank should have capacity for 6 days.
Liquid oxygen is replaced by tanker carrier.
Dr A.K.Khandelwal

32. Dr A.K.Khandelwal

33. Oxygen cylinders available
Size
Cubic meter
Quantity
cc
Price of
Empty
Refill charge
Rs
0.75 750 4500 70
1.5 1500 5000 80
7 7000 7500 125
10 10000 8000 180
Dr A.K.Khandelwal

34. Pressure Monitoring of Filled up Cylinder-
It should be 120-130 kg/Sq cm in Summer.
It should be 120 kg/Sq cm in Winter.
Pressure in Pipe line should be 4kg/Sqcm/60 PSI
Dr A.K.Khandelwal

35. Dr A.K.Khandelwal