Medical Gases and Oxygen Production

Medical Gases

• Oxygen (O2) supports combustion and is stored in green tanks.
• Air supports combustion and is stored in yellow tanks.
• Heliox is a mixture of helium and oxygen, used for respiratory distress.
• Carbon Dioxide (CO2) is used for medical purposes and is stored in gray tanks.
• Nitric Oxide (NO) is used to treat pulmonary hypertension and is stored in brown tanks.

Medical Oxygen Production

• Bulk/Liquid Oxygen This method involves producing liquid oxygen in large quantities, then storing it in large tanks.
• Homecare/Oxygen Concentrators These devices extract oxygen from the air and deliver it to patients.

FDA Purity Standard

• Medical oxygen must meet the FDA purity standard of 99.5%.

Gas Cylinder Markings and Labeling

• Gas cylinders are labeled with the type of gas, the volume, and the pressure.
• Cylinders are routinely tested every 5 to 10 years.

Gas Cylinder Types

• Small Cylinders (E and H cylinders): Use a pin index safety system with a ** yoke valve**.
• Large Cylinders : Use a threaded valve.
• Cylinder Valve Outlet Cleaning: Use a cylinder valve outlet brush, also referred to as a "pigtail brush."

Cylinder Pin Positions

• Pin index safety systems prevent misconnections with different types of gases.
• Pin positions are standardized to match the valve on the cylinder.

Air/Oxygen Cylinder Measurement

• Gas cylinders are measured in Liters (L) or cubic feet (ft³).
• Liquid cylinders are measured in Liters (L) or US Gallons (gal).

Cylinder Conversion Factors

• E Cylinder: 660 Liter (L) or 23.2 ft³
• H Cylinder: 3,000 Liter (L) or 106 ft³
• Liquid Oxygen Cylinder: 125 gal (Liquid Oxygen)

Safety Indexed Connector Systems

• The pin index safety system prevents misconnections of different types of gases.
• Small Cylinders (E & H) use Type 1 safety index connectors.
• Large Cylinders use Type 3 safety index connectors.

Bulk Oxygen Gas Supply Systems

• Alternating System: Consists of two large cylinders, with one providing the primary supply and the other acting as a reserve.
• Cylinder Manifold System with Reserve Supply: Includes a manifold that connects multiple cylinders, with one or more as reserves.
• Bulk Gas with Reserve: Uses a bulk oxygen tank and a reserve cylinder for emergency situations

Zone Valves

• Zone valves are used to control the flow of oxygen to specific areas of a facility, typically used in hospitals.
• Station outlets provide connection points for medical equipment.

Regulating Gas Pressure and Flow

• Reducing Valve: Reduces the high pressure of the gas cylinder to a safer working pressure.
• Flowmeter: Measures the flow rate of oxygen delivered to the patient.
• Regulator: Controls the pressure of the gas delivered to the patient.

Flow Control Devices

• Gravity-Dependent Devices: Rely on the force of gravity to deliver oxygen.
• Gravity-Independent Devices: Do not rely on gravity to deliver oxygen, allowing for more accurate flow and delivery.

Flow Restrictor

• A flow restrictor limits the flow of oxygen delivery to a specific rate.

Bourdon Gauge

• A bourdon gauge measures the pressure of the gas in the cylinder.

Thorpe Tube

• A Thorpe tube is a type of flowmeter used to deliver oxygen, and is the most commonly used.
• A Thorpe tube can be compensated or uncompensated.

General Goals and Clinical Objectives of Oxygen Therapy

• The primary goal of oxygen therapy is to improve oxygen levels in the blood and tissues.
• Oxygen therapy can be used to treat a wide variety of conditions, including respiratory failure, hypoxemia, and cardiac arrest.

Assessing Need for O2 Therapy

• Documented Hypoxemia: Oxygen therapy is indicated when a patient has a low blood oxygen level (hypoxemia).

Precautions and Possible Complications and Hazards of O2 Therapy

• Oxygen therapy is a safe and effective treatment, but precautions and potential hazards should be considered.
• Possible Complications: Oxygen toxicity, airway fire, and barotrauma.

Oxygen Toxicity

• Affects primarily the lungs.
• Exposure: Prolonged exposure to high concentrations of oxygen can lead to oxygen toxicity.

Alveolar Oxygen Equation

• The alveolar oxygen equation can be used to calculate the partial pressure of oxygen in the alveoli.

Oxygen Therapy Delivery Systems

• Low Flow Oxygen Delivery Systems: Deliver low flow rates of oxygen, < 4 L/min.
• Reservoir Oxygen Delivery Systems: Include a bag or reservoir that allows the patient to inhale oxygen directly.
• High Flow Oxygen Delivery Systems: Deliver high flow rates of oxygen, > 4 L/min, to provide precise oxygen delivery with increased humidity.
• Flow and FiO2 ranges for all O2 delivery system types:*
• Nasal Cannula: Flow: 1-6 L/min, FiO2: 24-44%.
• Simple Face Mask: Flow: 5-10 L/min, FiO2: 35-60%.
• Partial Rebreathing Mask: Flow: 6-10 L/min, FiO2: 40-70%.
• Non-Rebreathing Mask: Flow: 10-15 L/min, FiO2: 60-80%.
• Venturi Mask: Flow: 4 - 8 L/min, FiO2: 24-50%.
• High-Flow Nasal Cannula: Flow: 20-60 L/min, FiO2: 21-100%.

High Flow Devices Include:

• High flow nasal cannula: delivers heated and humidified oxygen directly to the nasal passages.
• Non-invasive ventilation (NIV) uses positive pressure to help improve ventilation and oxygenation.

This quiz explores the various types of medical gases, their uses, and storage methods. It covers important topics like oxygen production, FDA purity standards, and gas cylinder labeling. Test your knowledge on medical gases and their applications in healthcare.