Dr A.K.Khandelwal

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

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

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

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

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

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

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

MANIFOLD ROOM

Dr A.K.Khandelwal

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

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

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

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

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

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

Dr A.K.Khandelwal

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

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

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

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

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

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

Ceiling Pendents

Dr A.K.Khandelwal

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

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

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

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

Vacuum (suction) systemVacuum system shall be stack mounted ---------------- cfm capacity. (as per

requirement of the hospital)

Dr A.K.Khandelwal

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

Compressor Air machineDryer of Unit to remove moisture

Dr A.K.Khandelwal

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

Dr A.K.Khandelwal

Oxygen cylinders available

SizeCubic meter

Quantitycc

Price of Empty

Refill chargeRs

0.75 750 4500 70

1.5 1500 5000 80

7 7000 7500 125

10 10000 8000 180

Dr A.K.Khandelwal

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

Dr A.K.Khandelwal