PIPE
DREAMS – Planning A Medical Gas Shutdown
Fred Evans, CEO
Medical Gas Management, LLC
A
few weeks ago I received a call from a staff member at a hospital who was
literally in a state of panic. He told me a contractor was on site to
change out the bulk oxygen storage tank. The replacement tank had been
trucked in, a crane was set up to remove the old and set the new tank and
an installer was there with a torch and gas to connect the system. The
problem was that 12 surgeries were scheduled that day and no provisions
had been made for the shutdown. I drove to the hospital, surveyed the
situation and postponed the shutdown. MGM is now in charge of the
project.
A
discussion of the problems at this site will fill another article, but
this month and next, I’ll review the major steps in planning and
executing a successful medical gas shutdown.
A
shutdown is a major event in a hospital, but it need not be an
overwhelming task. It can be accomplished with minimized downtime and
risk to patients through proper planning, effective communication and
coordination of services. To prepare for the shutdown, it is vital to
understand the three stages involved: the project definition and
preparation prior to shutdown, the actual shutdown and modification of
the medical gas piping system and the re-certification of the system
after re-pressurization.
Planning starts with defining
the scope of the project and producing a written shutdown procedure to
accomplish the task. It requires an "as constructed" drawing of
the piping system. The drawing is used to determine how extensive a
shutdown is required, to identify the areas that will be affected, to
locate valves required for shutdown and estimate downtime. It is a good
idea to have a medical gas specialist review the piping system to be sure
it continues to meet code requirements and to initiate any necessary
modifications.
Scope of the shutdown falls
into one of three categories:
1.
The complete shutdown – usually done to tie-in a future line
to the main or for modifications to the bulk supply or source
equipment.
2.
Riser shutdown – usually done for modifications to an area of
the hospital supplied by a single branch (or riser) off the main line.
Frequently this involves service, replacement or movement of zone
valves.
3.
Zone shutdown – usually done when desired remodeling and
repairs are downstream of specific zone isolation valves.
Valves required to isolate the
construction area must be located and tested for internal leakage prior
to shutdown. Leaky valves can contaminate adjacent zones and can prevent
plumbers from achieving the gas concentrations within the pipeline
required for brazing. Once the extent and duration of the shutdown is
determined, the services that will be affected meet with the contractor
to schedule the date and time for the project. This, too, is the time to
define the method for supplying alternate medical gases to the patients.
The contractor and service personnel determine the equipment, manpower
and alternative gas that will be needed.
The
number of patients affected by the shutdown will determine the selection
of the alternative gas supply. For a limited number of patients,
individual cylinders and regulators may be the most effective.
Back-feeding portions of the medical gas piping by closing valves at the
riser, branch lines for zones, will accommodate a larger number of
patients but may require installation of inlets prior to the shutdown. A
combination of a liquid oxygen truck, Liquid Dewars (stainless steel
containers filled with liquid oxygen) and high-pressure cylinders
manifolded together in a "six pack" may be used when high peak
flow and high volume use are anticipated. The alternative gas supply must
be ordered, distributed according to plan and tested prior to use.
Besides the volume of gas, attention to the equipment needed to vaporize
liquid and regulate pressure, as well as the fittings required to connect
to the pipeline are essential for a successful shutdown.
Next
month:
Shutdown and Modification and Re-Certification of the
System.
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MGM
Technician, Jeff Pepper,
Credited with Saving the Life of a Patient
On a
recent assignment at a hospital in Alaska, Jeff Pepper, an MGM technician
was credited by the hospital and the project contractor, for saving the
life of an infant in the neo-natal unit.
According to hospital personnel
and the contractor in charge, all precautions and shut down procedures
were followed in preparation to disengage the oxygen system. Prior to
interruption, Jeff became aware that a demand still existed on the
system. He insisted on another check of the patients to verify that
everyone had been removed from the system. During this additional
inspection, hospital staff located an infant dependent on the oxygen
system for life support. The infant was placed on a temporary oxygen
supply and the shut down continued as planned.
Jeff
doesn’t see himself as a hero. He says that, as an MGM technician,
he was just doing the work he has been trained to do. Congratulations,
Jeff, for your role in preventing a potential tragedy. We appreciate your
dedication to your work and your thorough understanding of medical gas
systems.
Once
again, the need for proper medical gas system diligence is
demonstrated.
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Facilities Forum
Need an answer to a medical
gas system problem? Send or e-mail (medgas@ionet.net) your questions to us
and we’ll do our best to answer it in Facilities
Forum.
Q: Should the master
alarms be upgraded when we replace source equipment?
A: If the new source
equipment provides additional required signals that were not previously
monitored, they will need to be wired to both master alarm panels in
parallel. A new medical air system may include signals for dew point
high, carbon monoxide high, high temperature and lag compressor among
others. When switching from a cylinder reserve to a liquid reserve,
signals will be needed for reserve liquid level low and reserve low
pressure. If there are multiple sets of air compressors and vacuum pumps
serving different areas of the facility, each set must report to the
master alarms. Should the old panels not have enough slots to handle the
required signals, replacement or additional master alarm panels will be
needed.
Q: Can area alarms be
monitored by the master alarms?
A: It is possible to
send all of the area alarm signals throughout the hospital to the master
alarm panels. That would use a large number of modules to accomplish
this, however. Another approach would be to send all area and master
alarm signals to a computer based building management system. This is in
addition to the two required master alarm panels in a hospital. The Amico
Information Management System is one example that monitors area and
master alarms and manifolds through two wire twisted pairs connections.
It can accommodate up to 60 devices. Call Source Engineering at (405)
787-1497 for more information.
Q: How often should we
use a vacuum cleaning solution in our medical gas piping?
A: A liquid cleaning
solution such as VSC 2000 should only be used on an "as needed"
basis. Medical vacuum piping is supposed to be a dry system. When fluids
from suction are ingested into the vacuum system, they quickly evaporate
and coat the interior piping surface. The smaller inside diameter causes
a reduction in flow due to the clog. A cleaning solution can be used to
treat individual problem areas. However, if used as a regular maintenance
procedure, it can do more harm than good by filling low points in the
piping with liquid.
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Medical Gas Installers School 2000
Since January 1, 2000, MGM has
certified over 120 medical gas installers. Here are some comments from
some of our recent students:
“This is one of the most well thought out courses
I’ve ever attended. The instructors actually work as technicians
which is very helpful.”
“From this point, all my employees will be
trained.”
“Information and references will be very helpful in
answering questions and monitoring system maintenance
procedures.”
If you have not attended our school, call 800-732-9035 for information and
reservations. Classes at our Education Center in Oklahoma City will be
held:
July 19 – 21, 2000
September 20 – 22, 2000
November 15 – 17, 2000
Call us for information on hosting a school at your
location.
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ASHE
Conference
Seattle, Washington
July 10 – 11,
2000
Medical Gas Management, LLC is
an exhibitor at the American Society for Healthcare Engineering
Conference and Technical Exhibition in Seattle,
July 10 –11, 2000. Visit us at booth
1117
for information on New Construction Testing and Systems
Evaluations.
Drop
your business card into our fish bowl to be eligible for a 2:30 p.m.
drawing each day for a crisp $100 bill.
See you in
Seattle!
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MGPHO
Meeting
Seattle, Washington
Members of the Medical Gas
Healthcare Professionals Organization will come together for a 2-day
meeting at the Crowne Plaza Hotel in Seattle on
July 8 and 9, 2000.
There are over 100 MGPHO
members and associate members across the United States and Canada.
Members include individuals and corporations engaged in the
certification, verification and testing of medical gas systems. Associate
membership is open to installers, medical gas system designers,
manufacturers, agencies involved in medical gas products and hospital
engineering staff.
MGPHO was created to review and
influence standards for the medical gas industry and to establish
credentials for certifiers and verifiers. A significant step in the
credentials process was achieved in January 2000 when twelve members were
tested by National ITC Corporation and awarded MGPHO
certification.
For
information on becoming a MGPHO member contact:
RMS
George Scott, President
364 Adams Street
Bedford Hills, NY 10507
(914) 666-2990
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New
Faces
Over
the past few months, a number of new employees have joined the staff of
Medical Gas Management and Source Engineering. You may meet one of them
at your facility or speak to them on the telephone. Here’s your
opportunity to put a face with the name. We’ll keep you informed of
New Faces at MGM and Source.
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David Faison
Source Engineering
Inventory Clerk
2/28/00
Bethany, OK
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Danny Loyd
MGM
Technician
2/21/00
Bethany, OK
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David Davis, Jr.
MGM
Technician
3/28/00
Detroit, MI
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Chrissie Madewell
MGM
Accounting
3/31/00
Bethany, OK
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The
Excitement and Challenges of Growth
These are exciting times for our companies. Last year we grew
over 20% and this year looks the same. Growth brings about new challenges
at both staff and management levels.
We
always strive for top quality service to our customers. It takes good
people to do it and we are recruiting and training the best we can find.
Our senior technicians are assuming an additional mentoring role as new
staff joins the team.
As
we grow, we face our biggest challenge at the management level. The top
people here have always been primarily on the front lines serving our
customer needs. In 1999, Fred Evans spent as many hours working at
customer job sites as any other service technician.
It
is hard to manage a growing staff and company from the front lines. Top
management’s role is changing to recruiting, directing and
supervising rather than doing. Growth will result in a much larger staff
of qualified, well-trained and motivated service technicians. Our senior
technicians will have opportunity to take on additional management
responsibilities as team leaders and Project Supervisors.
These transitions can also create problems. New staff and
changing roles can create confusion and frustration for both staff and
customers. Our staff is communicating problems as they arise and we are
dealing with them. We ask our customers to let us know when there are
problems on your side.
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Beyond The
Walls…
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This
pipe was removed from a hospital medical air system. Of concern to the
hospital was the existence of moisture in what should have been a dry
Medical Air system. Even though a dryer was used with the system, the
calcium deposits inside the pipe show evidence of the water.
Of
equal concern to the hospital should have been the following:
• The pipe is painted
green, the color recommended by the NFPA for Oxygen. The color code for
Medical Air is yellow..jpg)
• The system is installed
using iron pipe. NFPA specifies piping material for Medical Air as
copper, bronze or brass.
• The shut off valve used
is a globe valve that does not indicate if the valve is open or closed. A
ball valve is required for Medical Air.
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More Crossed Lines
To
follow up on the story in the February Medical Gas Matters!, MGM
technicians located a crossed line in March and again in April. Even with
the best efforts of installers and facility managers, crossed lines can
happen. For your peace of mind and the safety of your patients, call MGM
to schedule a systems evaluation. If there is a problem, we’ll find
it!
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