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 Volume 2, Issue 3 © 2001 Medical Gas Management, LLC |
Main IndexIN THIS ISSUE |
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Medical Gas Management, LLC
When
rooms with medical gas outlets and vacuum inlets are reclassified to
another use, like an office or storage area, be cautious in deciding what
to do with the your medical gas system. Our inspections find outlets
behind pictures, clocks, office partitions, bookshelves, file cabinets,
and even covered over inside a wall.
Medical gas outlets are under pressure. The outlets have
‘O’ rings and seals to prevent leaks and over time, if outlets
are not maintained, they can leak. Without proper conversion, abandoned
medical gas outlets are a potential fire hazard and can cost thousands of
dollars in wasted gas.
The following are recommendations for converting a patient
treatment room to another use.
• Cut and cap all medical gas lines to the
outlets/inlets.
• Remove the faceplate or install a blank electrical
cover plate over the outlet/inlet (this would prevent someone from
attempting to use it).
• If using Chemetron outlets, and the room may be
converted back to patient use in the future, you can remove the faceplate
and purchase a blank plug and then use a blank cover plate over the
outlet/inlet.
Due to remodeling demolition, it is always a risk to enclose or
abandon live medical gas lines in walls and partitions. If an entire
zone is taken out of service you may want to cut and cap the medical gas
lines in the ceiling between the zone valve box and the outlet. However,
be sure to cap both ends of the line using Nitrogen as a purge gas for
possible reconnection at a future time.
If an outlet is left in the wall without pressure, it would be
appropriate to label each outlet “OUT OF SERVICE.” Zone valve
boxes taken out of service, should have the handles removed or secured,
and labeled “OUT OF SERVICE.”
Hopefully, with an understanding of the risks associated with
abandoning medical gas outlets/inlets, converting them to non-use will be
included in your next renovation project.
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Evaluation or Certification?
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Medical Gas Management, LLC
Many times when MGM is contacted by a facility for services, the person initiating the call does not fully understand the type of service needed or the difference between a Certification and a Systems Evaluation. We are often asked to perform an Annual Certification. I’ll try to take some of the mystery out of these common services.
Certification
When a healthcare facility is newly constructed, or remodeled, or expanded the system must be tested before it is ever used for patient treatment. The NFPA 99,1999 document requires verification by certification that “All provisions of this document be adhered to and that the system’s integrity has been achieved or maintained”. This verification process is required to be performed by competent individuals experienced in medical gas pipeline testing. Although this does not preclude a facility from having competent staff members test the system, it usually excludes them because of experience, availability or lack of the specialized equipment required to perform this tedious task.
The nationally recognized certifiers organizations, Medical Gas Professionals in Healthcare Organization (MGPHO), Piping Industry and Progress in Education (PIPE), and the American Society of Sanitary Engineers (ASSE) all require a minimum of two years field experience before a Verifier can make application for testing and earn credentials as a Certified Verifier.
Certification of a medical gas system is a detailed process performed on systems which are generally unoccupied by patients. The certification process involves a variety of tests including verification of pressures, flowrates, purity of gas, specific gas adaption, materials, valve control verification, alarm function testing, operation of gas and vacuum source equipment and delivery devices, all culminating in a surety that the medical gas system will be safe for the administration of these vital commodities to the patient. This is to be accomplished by a documented procedure with all testing recorded and certified.
Systems Evaluation
A comprehensive Systems Evaluation usually takes place at some time after the facility is occupied and most often with the medical gas systems in normal use and operation. All medical gas system components are inspected and tested.
The objective of an evaluation is to determine through testing and inspection, that the system is currently meeting the facility’s needs, is or is not in good repair, meets the demand of the code to which it was built and licensed, and does not present an identified or distinct patient safety hazard or life safety issue.
An evaluation often includes performance testing of a system to determine if it is suitable for expansion. Increasing the demand on a system originally designed to a given capacity may render it out of compliance with codes, standards and specifications and may result in decreased performance of respiratory, anesthesia or other critical care devices.
Annual Certification
Some healthcare facilities mistakenly believe the Joint Commission on Accreditation of Healthcare Organizations requires medical gas systems to be “certified” annually. JCAHO does not require annual certification! The organization requires that facilities have an organized, written plan of medical equipment and utility maintenance management with documentation that verifies the program is being executed.
When an annual certification is requested, the facility usually means an Annual Evaluation. This service is performed with the system in operation. It involves the random testing of available outlets and inlets in every zone and in each gas and vacuum, random testing for particulates and gaseous purity, inspection and testing of all alarms and source equipment, and complete inspection for system identification.
A phone call to MGM will determine the right service for your needs.
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New
Medical Gas Standards Available
Corky
Bishop, P.E. |
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The 2001 edition of NFPA 50 Bulk Oxygen Systems at Consumer Sites is now available. It includes information on distances from outside hazards to the bulk site and safety precautions concerning liquid oxygen. The publication is available from the National Fire Protection Association for $21.00. NFPA members can purchase the standards at a 10% discount. Call (800) 344-3555.
The Fall 2001 NFPA Report On Proposals is available. NFPA 99 Health Care Facilities is included in this report. Comments concerning these proposals may be submitted to the committee by anyone for consideration in the next edition. The deadline for submitting comments is March 31, 2001. This standard will be voted on by the general membership at the Fall Meeting in Dallas, Texas and should be published in the spring of 2002. Comment forms are available in the ROP with instructions and mailing address. This report is free.
The second edition of the ASSE 6000 has been published and should be available for purchase around mid March. This document from the American Society of Sanitary Engineering describes testing procedures for medical gas installers, inspectors and verifiers. There are also checklists for inspection of source equipment. The cost will remain at $45 with a 25% discount to ASSE members. Call (440) 835-3040.
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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: When an area alarm
panel alarm is called in, we don’t get adequate information from the
caller. They usually tell us it’s an oxygen alarm even if it is
medical air, vacuum or another system. They never say if it is high or
low priority. By the time we get there, the alarm may have reset. How do
we solve this continuing problem?
A: Patient safety, health and recovery is directly related
to the knowledge and training of the caregiver. Standardized training of
engineering and nursing staff enables them to “be on the same
page”. Whether engineering and nursing staff meet to discuss medical
gas systems, or MGM assists you with one of our training programs, a
clear understanding of the system is vital to patient safety and system
management. Proper labeling of the system is essential, but knowledge is
the key to pro-active care giving and preparedness.
Q: Why can’t we run our vacuum pumps at 30” hg
so they won’t have to run as much?
A: Simply put, the efficiency of a pump is relative to its
displacement at 1 atmosphere. When that space (cylinder or valve) is
occupied by 1/2 the atmosphere (15” hg) it has to run twice as long
to move the same amount of air. Following that principal, at 20” hg,
the pump has to run 3 times as long, at 25” hg, 6 times as long,
etc. The idea is to utilize the pump at its maximum efficiency while
maintaining the vacuum necessary to guarantee meeting the
caregiver’s demand.
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Beyond
The Walls…
Pick-Up Sticks?
This interesting conglomeration
of piping and wiring resembles the children’s game “Pick-Up
Sticks”. It was uncovered in the ceiling of a healthcare facility.
So many lines run through the space that conduit pipe was installed
across the span, as a brace, to keep the ceiling from falling in.
The medical gas lines in this maze do not meet NFPA code, and it
is doubtful that other lines in this space would pass inspection.
MGM has seen this problem before and we know how to correct it.
If there are “pick-up sticks” in your ceiling or walls, give us
a call. We can untangle the chaos.