PIPE
DREAMS
Fred Evans, CEO
Medical Gas Management, LLC
During my long drives and
flights to the facilities we serve, I have many hours to reflect over the
last ten years and the remarkable changes in the medical gas system
industry. Manufacturers are bought and sold, companies are down-sized,
service companies change policies to reduce risk and exposure, and
foreign companies move into the United States to take advantage of
opportunities while major manufacturers regroup. On a daily basis, I see
the effects of these mergers and acquisitions on healthcare
facilities.
Medical gas systems are
comprised of source equipment and a series of components; valves, alarms,
outlets and inlets. These components are not always the product of one
manufacturer. Over time when components need to be replaced, a facility
may not be able to locate or even identify the original manufacturer. The
days are long gone when a hospital staff member could call a single
manufacturer to come and repair a complete medical gas system. The
service departments of most manufactures have downsized and now only
manage warranty repairs.
Recently I visited a facility
that had this very typical problem. Their medical gas system included a
Medaes manifold, valves from Puritan Bennett, alarms manufactured by Ohio
Medical and the outlets were a mixture of Oxequip and National Cylinder
Gas products. The vacuum pump was supplied by another vendor, Allied
Healthcare.
With
equipment from six different manufacturers, the maintenance man did not
know where to call for service. Most of the companies had changed names
or had been sold and were doing business under a new name. The equipment
maintenance and service manuals could not be located. The maintenance man
called his oxygen supplier for help. Unfortunately, that was another dead
end. When he was finally referred to Medical Gas Management, he related
his frustrations. He understood he had system problems, but didn’t
know where to turn for help. We came in and checked the system, and found
that it was missing a main shutoff valve, pipe labels, zone valve labels,
required area alarms and a vacuum pump that had not be serviced in many
years.
This
is a true story and is indicative of a situation that can be found
nationwide in both large and small healthcare facilities. Just imagine a
company that could position itself nationally to provide service for
medical gas systems regardless of where the components were
purchased!
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FACILITIES FORUM
A
new, recurring feature is being added to Medical Gas Matters!. The
Facilities Forum will be a dual purpose column and we need your help to
make it a success.
First, think of the column as a
place where you, the reader, can ask a question about your medical gas
system, equipment, or how to solve a problem. We'll do our best to
provide you with the answer. Second, we'll open the column for you to
submit articles or commentary related to the medical gas industry that
would be of interest to our readers.
Submissions must include your
name, your business name and address, and a day time telephone and fax
number. We won't publish your personal information without your
permission, but we may need to contact you for clarification. By mail,
send your questions and articles to:
Gary
Hestilow
Medical Gas Matters!
5600 Philip J. Rhoads Avenue
Bethany, OK 73008
or E-mail to: medgas@ionet.net
Remember, this is your forum so
let us hear from you!
Articles and questions received
become the property of Medical Gas Matters! and Medical Gas Management, LLC By submitting an article or question, you release Medical Gas Management, LLC and Medical Gas Matters! to publish your submission
without recourse, in whole or in part, at our sole discretion. We reserve
the right to edit or reject submissions at our sole discretion.
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TECH
TIPS – Preventive Maintenance
Tom
Evans, VP
Medical Gas Management, LLC
Does
this sound familiar: Your equipment is down (out of service) and you call
a service/repair center from help. When asked, "When was the last
preventive maintenance performed on the unit?" ----Long Silence----
You respond, "Well, we’ve been short of help since our staff
was cut. They won’t approve additional hours so some things gotta go
undone. I keep tellin’ em…"
This
situation happens far too often and when it involves medical gas related
equipment, lack of preventive maintenance can compromise patient safety.
Every manufacturer of every medical gas system component provides
recommended PM intervals and procedures for their equipment.
We
regularly see problems with air compressors that require a 3000 hour
needle bearing lubrication. The compressor has failed because this
maintenance was not done. Stated simply, if the maintenance is not
performed you can expect the equipment to fail.
One
hospital purchased a high quality, state of the art medical vacuum
system. Because the oil and filters were not changed, the unit seized up
and shut down. The result was a repair bill of over $3,000.00. Parts were
not readily available so the down time was 4 weeks. The cost of a rental
vacuum pump was $550.00.
All
of this could have been avoided if the system preventive maintenance had
been performed. A $1,450.00 annual PM contract covering all the medical
gas systems had been proposed, but was rejected by the facility’s
contracting office.
The
Joint Commission on Accreditation of Health Care Organizations provides a
protocol of maintenance for medical gas systems. In the Environment of
Care of Handbook, Chapter 9, Utilities Management, a planned maintenance
program is encouraged. Although the publication misstates that
"valves, inlets, outlets, gauges and other control devices never
need lubrication", they in fact do require lubrication as does any
working mechanical device. The NFPA 99, Appendix C outlines recommended
maintenance tasks.
Preventive maintenance can be
the key to equipment longevity. Calibration for monitoring devices such
as dew point and carbon monoxide monitors is critical to a properly
operating system. As one layman stated, "If you’re going to
drive your car, you gotta’ change the oil."
Medical Gas Management
recommends that a specific medical gas preventive maintenance program be
established for your equipment. Let us help you put together a simple
program to keep your medical gas systems in optimum operating
condition.
No
fooling, your patients will love it.
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Great
Snakes Alive!!!
by
Tony Stewart
Not
long ago, an MGM technician tested a pressure outlet in a patient room of
a hospital. After completing the test, he and a hospital staff member
heard a hissing sound coming from the outlet. The staff member implored
the technician to make the hissing stop. It seems the patient in the room
had a deadly fear of snakes and the hissing noise would surely cause him
great anxiety.
The
culprit in this story is not a snake, but a lowly O-ring inside the
pressure outlet. O-rings are found in thousands of products and receive
very little attention until they fail. Their failure can be catastrophic
as in the case of the space shuttle, or an inconvenience like a dripping
faucet.
In a
medical gas system, a faulty O-ring can make it difficult to engage or
disengage adapters. They can cause locking mechanisms to fail, and the
loss of expensive medical gas from a leaking outlet. The noise of a
hissing outlet can be detrimental to the comfort of patient and medical
staff.
O-rings can be replaced, and
inlets and outlets rebuilt without major disruption to a facility. To
extend the life of an O-ring lubricate it with a product safe for use
with oxygen. The number of manufacturers and different styles of outlets
means replacement parts may not be interchangeable. Gas specific adapters
are required for the outlet. Be aware that special tools may be required
and proper training is essential for this task. The next time you hear a
hissing sound from outlet don't look for a snake, there is a worn out
O-ring trying to get your attention.
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Zone
Valve Boxes
by
Corky Bishop
When
you're looking for a new home, a realtor will stress the most important
features of a property are location, location and location. The same can
be said of zone valve boxes in a medical gas system.
One
of the most regularly enforced requirements for certification of a new
medical gas system is the placement of zone valve boxes. These fire
protection valves are to be prominently located on the same floor as the
outlets they control. They should not be hidden behind doors, carts or
shelving.
The
requirement specifies that a wall exist between the outlets and the zone
valves that control them. Many times designers are unaware of this
requirement so it is ignored in the planning for new construction and
remodeling. From a practical viewpoint, if the zone valve boxes are
located inside a recovery room in which a fire breaks out, do you want to
go in there to close the oxygen and medical air valves? It is much less
expensive to fix this problem on a blueprint than it is to tear out newly
constructed walls to relocate the valves.
The
gauges in the zone valve box are supposed to be on the patient side of
the valves. That way, the gauge will show when a zone has been bled down
and it is safe to take an outlet apart for maintenance.
All
zone valves are to be piped directly to the main. They are never to be
piped downstream of another zone valve in series. This practice makes for
an easy shutdown for installation, but creates a dangerous situation
during a fire or maintenance shutdown. The oxygen supply to patients in a
different area of the hospital can be inadvertently turned off when zone
valves are piped downstream in series.
Plan
review and rough-in piping inspections can avoid costly modifications and
delays at the end of a remodel or construction project. Remember, the day
before the State Inspector arrives is not the time for your certifier to
get the first look at a new system.
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Meet
Judy Prejna
Fred Evans is pleased to
welcome Judy Prejna to the staff of Medical Gas Management. Judy is the
new Business Development Manager for the tri-state area of Illinois,
Indiana and Wisconsin. “With over ten years experience in sales and
marketing to hospitals, surgery centers and physician offices, Judy
understands the needs of the health care industry. She shares the
Company’s commitment to patient safety,” said Evans.
Judy
says she looks forward to working with our clients to help them fully
understand all the products and services MGM has to offer. “I feel
we have the best education and technical support programs in the Medical
Gas Industry today. I am proud to be part of MGM’s team of
professionals and share in their mission of providing the safest and most
reliable medical gas systems available.”
You
can contact Judy by phone at (847) 370-5200, by fax (847) 697-3651 or
through the MGM corporate office at (800) 732-9035.
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Crossed Lines Discovered!!
During a recent medical gas
system certification, an MGM technician discovered crossed lines. The
oxygen and nitrous oxide lines crossed, creating a potentially deadly
situation for any patient receiving gases from these lines.
Nitrous oxide is an
anesthetizing gas used in combination with oxygen to put a patient to
sleep. Nitrous oxide must never be administered without the presence of
oxygen. Using these gases in the wrong concentration or attempting to
revive a patient with nitrous oxide, believing it to be oxygen, has
resulted in injury or death. Since nitrous oxide became the choice for
anesthesia and analgesia, far too many such incidents have been
documented
Even
with education, training and experience, mistakes happen. That is why
every facility must protect the patients in its care and itself with
regular inspection and maintenance programs of their medical gas systems.
There is no substitute for testing by qualified systems certifiers. Every
certification document prepared by an MGM technician must state "No
crossed lines are present and the systems tested is safe for clinical use
as intended." This is your assurance that each line was inspected
and verified. If the certification documentation provided by your
certifier does not bear this, or an equivalent statement, be cautious in
accepting less.
It
is indeed fortunate that this facility selected the experienced and
qualified testing of Medical Gas Management to certify its medical gas
system. Are you confident of the qualifications of your medical gas
certifier? Your patients deserve it and the reputation of your health
care facility depends on it.
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Beyond
The Walls…
This
combination bird bath, bird nest and medical air intake filter resulted
from installing the filter up-side-down.
Rain
was captured inside the cap causing the sides to rust out. The birds
found it to be a convenient bird bath and an ideal spot to construct
their nest.
Unfortunately, it did cause a
“fowl” odor in the medical gas system.
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