Egan's Fundamental Chapter 37

Name the three gases categorized as nonflammable

Nitogen, Carbon Dioxide and Helium.

Most therapeutic gases will support combusion. Name three gases in this category.

oxygen, helium/oxygen, nitrous oxide

Describe the four basice step of fractional distillation process.

Atmospheric air is filtered to remove pollutants, water and Co2.
Purified air is then liquefied by compression and cooled by rapid expansion.
Heated in distillation chamber so nitrogen escapes first.
Stored in cryogenic storage in liquid form;
/or convert

What purifty level is required for medical grade oxygen?

99.0%

Used to treat to hiccups.

Carbon Dioxide

The "D" in (DISS) stands for

Diameter

A device that controls both pressure and flow

Regulator

Agency that classifies cylinders

Department Of Transportation. (DOT)

Chemical named for this light gas

HE

This meter controls the volume of gas per unit of volume

Flowmeter

Neddle_______________ adjust the flow in a Thorpe tube

Valves

Type of "distillation" that produces oxygen

Fractional

Gas used in treatment of severe asthma

Heliox

Valve that lowers gas pressure

Reducing valve

Low density gas

Helium

DISS (Diameter-Index Safety System)

*Low pressure safety system
Found at outlets of pressure-reducing valves , outlets of central piping systems, &
inlets of blenders, flowmeters, vents.

Pipe with many connections used to link gas cylinders together

Manifold

Gas delivered in a yellow cylinder

Air

This valve shut off the gas in case of a fire

Zone

PISS (Pin-Index Safety System)

*Your mom told you not to say this, but it really is a safety system.
*For small cylinders (up to & including size E) & their attachments
*Cylinders have yoke type connection
*Exact positions of pins & pinholes vary for each gas
**2 - 5 for oxygen
**1 - 5

Gas delivered in a blue cylinder

Nitrous Oxide or

The "P" in PISS means

Pin

Gas that makes up 20.95% or 21% of air

Oxygen

Fixed open, variable pressure measuring or mettering device. Also it is most appropriate for transport.-

Bourdon Gauge

Rear end: also a safety system

ASSS (American standard safety system)

Just say "NO

Nitric Oxide

Agency that sets standards for gas purity

FDA

Sets standards for design, construction, placement and use of bulk oxygen system

NFPA

Gas with only one oxygen molecule

Oxide

Slang term for cylinder

Tank

second half of gas made by heating limestone in contact with water

Dioxide

Name the two method of seperating oxygen from air and what concentration is produced.

a. Molecular device-90%
b. Vaccum -40%

what device is used to produce medical grade air for hospital and home?

Hospital-Air copressor system
Home-oxygen concentrator

Most medical grade carbon dioxide is used for what purpose?

Diagnostic purpuse

What is Heliox and what is it used for?

gas mixed oxygen and helium and use for severe airway obtructions

what is the primany medical use for nitrous oxide.

Use as an anesthetic agent

Describe two hazards of using nitric oxide

1. Can cause chemical pneumonitis and
exposeure to high concentration of nitric oxide 2. can cause methemoglobinemia.

Give the chemical symbol for each of the following:
Oxygen
Air
Carbon Dioxide
Helium
Nitrous Oxide
Nitric Oxide

O2
Air
CO2
He
N2O
NO

Because cylinder color is only a guideline, how do you actually determine what gas is in a tank?

careful inspection of label.

What is the best way to determine the actual oxygen concentration in a cylinder?

Analyze gas before administrating it.

Name two gases that can be stored in the liquid state at room temperature.

CO2 and N2O

Explain why the pressure in a gas-filled cylinder is different than of a liquid-filled cylinder.

Gas is compressed into the cylinder to fill it whereas , liquid is filled to specific level and gas is released from the liquid to pressurize the tank.

Describe the methods for measuring the contents of a gas-filled and the liquid-filled cylinder.

(a) Gas is directly proportional to it volume of pressure which can be read by a guage to read it's pressure.
(b) The measuered pressure is the vapor pressure above the liquid. This pressure bears no relation to the amount of liquid remaining.

Write the formular for calculating the cylinder factor for a gas-filled cylinder.

cubic feet (filled cylinder) x 28.3/
(pa) Pressure (filled cylinder) in psig

What are the cylinder factor for "E" and "K

E" =.28
K/H=3.14

Write the fourmula for caluclating duration of flow in minute.

duration of flow=contents/flow

Describe a gasous bulk system. Be sure to discuss the manifold, the primary, and reserve banks.

Oxygen is stored in a large tank at low pressure, as the liquid flows through, it is heated up . The liquid is then converted back to a gas pressure. It is then decreased by regulators to 50psi whichi is then send into the hospital

Why do most hospitals use a liquid oxygen system?

It is economical, safe and conveience

Where are the small liquid oxygen cylinders usually used?

They are used for home O2 supply

What is the critical temperature of oxygen? How is is the bulk liquid maintained at this temperature?

-118.6C. Tanks has an inner and outer shell with insulation between the shell.

What is the normal working pressure for a hospital oxygen piping system?

50psi

What are the zone valves? Give two reasons you might neeed to use these valves.

Zone valves are valves that shut off the sections of the hospital.
a. fire; b. maintenance

Gas laws states; If a cylinder overheat, the pressure will rise. Describe the type of pressure release valve usually found in these cylinder sterm.

Small cylinder-fusible plug relief valve
Large cylinder-spring loaded relief valve

Name the three basic indexed safety system for medical gas.
(both names- the abbreviation and meaning.

a. ASSS (American standard safety system)
b.DISS (Diameter-Index Safety System)
c .PISS (Pin-Index Safety System)

A large cylinder of O2 is describe as follows: CGA-540 0903-14NGO-RH Ext. Explain what this means.

CGA connection thread and number540 0.903 thread diameter of outlet -14 thread per sq in RH right hand thread

What tpye of cylinder uses pins and holes for the safety connection system?

Small cylinder.

What system was established to prevent accidental interchange of low-pressure medical gas connectors?

Diameter Index Safety System [DISS]

What is the purpose of the quick-connect system.

Allow quick access to a bulk supply of O2

Describe the action of the following devices.
Reducing Valve
Flowmeter
Regulator

Reducing valve-reduction of gas pressure
Flowmeter- control gas flow to patient
Regulator-control pressure and flow of gas

Describe the normal way the preset reducing valve is used in respiratory care.

Preset to only give out the amount of pressure set by manifold

Describe the normal way the Adjustable reducing valve is used in respiratory care.

used on high pressure system to regulator from high to low presure to sytem.

Describe the normal way multiple-stage reducing valve is used in respiratory care.

Reducing high pressure in multiple stage.

What two hazards can be created when you open a cylinder attached ot a high pressure reducing valve?

gas undergo rapid decompression followed by recompression.

Two advantages of flow restrictors.

a. Low cost; can be
b. Can be used in any postion

Two disadvantages of flow restrictors.

a. accuracy varies
b. can not be used with high- resistance equipments

What is the cheif advantage of the Bourdon-type flowmeter?

Operates under variable pressures.

How will indicated flow campare to actual flow when a Bourdon flowmeter meets up with downstream resistance?

Bourdon will read higher pressure than the actual flow reading

What is Bourdon gauges and what does it actually measure?

*Always used in combination with adjustable pressure-reducing valve
*Uses fixed open but operates under variable pressures
*Not gravity dependent; ideal for patient transport
*Not accurate when pressure distal to orifice changes.
It measures pressure of a

What does Thorpe tube actually measure?

It measures true flow of oxygen.

What happened to the flow in a compensated Thorpe tube when you connect to a 50 psi gas source?

it jumps and returns to zero as the Thorpe tube is pressurized.

What are the characteristics of Oxygen? (O2)

*Colorless, odorless, transparent, & tasteless
*Has density of 1.429 g/L
*3.3 ml of O2 dissolves in 100 ml of water
*Nonflammable but greatly accelerates combustion
*Oxygen concentrators pull ambient air through semipermeable plastic membrane

What are the characteristics of Air?

*Colorless, odorless.
*21% oxygen, 78% Nitrogen, 1% trace gases
*Medical grade air is produced by filtering cooling and compressing ATM air.
*Must be dry, pollutant and free of oil
*Has density of 1.29 g/L.

What are the characteristics of Carbon Dioxide? (CO2)

*Colorless & odorless gas
*Does not support combustion
*Usually is produced by heating limestone in Common uses for CO2 mixtures
***Calibration of blood gas analyzers
***Diagnostic purposes in clinical laboratory
Mixtures of O2 & 5-10% CO2 have therapeuti

What are the characteristics of Helium? (He)

*Odorless, tasteless, nonflammable, & chemically & physiologically inert
*Has density of 0.1785 g/L; much less than air
*Commercially produced from natural gas through liquefaction to purity standards of at least 99%
*Must always be mixed with at least 20

What are the characteristics of Nitric Oxide? (NO)

*Colorless, nonflammable, toxic gas that
supports combustion
*Exposure to high concentrations alone can
cause methemoglobinemia, which can cause
tissue hypoxia
*FDA approved for use in treatment of term &
near-term infants with hypoxic respiratory
failure

What are the differences between gas-filled cylinders and liquid-filled cylinders?

In a gas-filled cylinders the volume of gas in cylinder is directly proportional to its pressure, whereas with the liquid-filled cylinders, the pressure does not relate to amount of liquid remaining and only weight of cylinder indicates amount of gas insi

Write the formular for calculating the duration of flow. Content/flow?

Pressure (psig) x Cylinder factor / Flow (L/min

Alternating supply system or cylinder manifold system. (A type of Bulk O2 supply system)

*Consists of large (normally H or K size) cylinders of compressed O2 banked together in series
*When pressure in primary bank decreases to set level, control valve automatically switches over to reserve bank.

Cylinder supply system with reserve supply.
(A type of Bulk O2 supply system)

*Consists of primary supply, secondary supply, & reserve supply
*When primary gas supply is depleted by demand, this supply system automatically switches to secondary supply.

Bulk gas system with reserve.

*Most commonly used in large health facilities for economical, safety, & convenience reasons
*Small volume of liquid O2 provides very large amount of gaseous O2 & minimizes space requirements.

NFPA standards:

1. Must be stored 50 feet from wood frame
buildings.
2. Must be 25-50 feet from the hospital.
3. Must be fenced.
4. Must have a reserve backup.
5. Must have safety release valves.

American Standard Safety System (ASSS)

*For large cylinders & their attachments
*Prevents accidental misconnections

Three ways to tell a compensated flowmeter:

1. look at label. Calib at 50 psig
2. Ball jump
3. Position of needle valve.

Reducing valve

is used to reduce gas pressure to useable level

Flowmeter

is used to control flow to patient

Regulator

s used to control both pressure & flow

3A

Cylinder made of carbon steel

3AA

containers are manufactured with alloy steel