NCJIMCARE &

OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 1 of 19
1. Objective:
1.1.
1.2.
1.3.
1.4.
1.5.
1.6.
1.7.
1.8.
1.9.

NCJIMCARE & OPJICACRE has a documented procedure to govern

procurement, handling, storage, distribution, usage and replenishment of medical
gases.
Medical gases are handled in a safe manner.
Medical gases are stored in a safe manner.
Medical gases are distributed in a safe manner.
NCJIMCARE & OPJICACRE Medical gases are used in a safe manner.
The safety issues of the medical gases are addressed at all levels.
In case of failure, alternate sources for medical gases, vacuum and compressed
air are provided.
The organization tests these alternate sources monthly. The result of these tests
will be documented.
There is an operational, inspection, testing and maintenance plan for piped
medical gas, compressed air and vacuum installation. This will be as per
manufacturers recommendations.

2. Scope:
2.1 Across the hospital.
3. RESPONSIBILITY
3.1.
3.2.
3.3.

Bio-Medical Engineering Department

Purchase Department
All user departments

4. Procedure:
4.1

Procedure for Objective:-1.1. NCJIMCARE & OPJICACRE has a documented

procedure to govern procurement, handling, storage, distribution, usage and
replenishment of medical gases.
The following medical gases are procured and used at NCJIMCARE & OPJICACRE
a. Oxygen
b. Carbon dioxide
c. Nitrogen
d. Nitrous oxide
e. Air

4.1.1. Procurement:- The medical gases compressed in cylinders are procured through
centralized purchase department from authorized medical gas companies (Modi Gas
Agency(Hisar) & Jindal Stainless (Hisar) Ltd. MOU) and delivered to the site
according to ISI specification.

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 2 of 19

Procurement of Medical Gases

Name of
Medical Gas

S. No.

Compressed Oxygen
(Gas)
Compressed Oxygen
(Liquid)

a.
b.
c.

Carbon dioxide

d.
e.
f.

Nitrogen
Nitrous oxide(Eye OT)
Helium (For IABP
Machine)

g.

Air tanks

4.1.

Suppliers

MOU

Certification
No. of
suppliers

Type & No. of cylinders

purchased
Big

Small

Gupta Brothers,Hisar

51

46

JSL

Vacuum flask- 1

Modi Gas Agency,Hisar

RAJESH GUPTA
9996322100, 91-1662277221

Gupta gas,Delhi
-9810017082
Gupta Brothers,Hisar

Biomed Experts Pvt.Ltd.

Self Compressed Air

6
2

Procedure for Objective:-1.2. Medical gases are handled in a safe manner.

4.1.1. NCJIMCARE & OPJICACRE Specific Handling Procedures of medical gases.
Gas cylinders must be secured at all times to
prevent tipping.

a. Before using a cylinder, slowly "crack" the valve to clear dust or dirt, being
sure the opening is not pointed toward anyone. Suitable precautions should
be taken when toxic or flammable gases are involved. Do not stand in front of
the regulator gauge glass when opening the valve.
b. Never use a cylinder without a regulator. Always use the correct pressure
regulator.
c. After attaching the regulator, and before the cylinder is opened, check the
adjusting screw of the regulator to see that it is released. Never permit the
gas to enter the regulator suddenly.
d. Never try to stop a leak between a cylinder and regulator by tightening the
union nut unless the valve has been closed first.
e. REJECT ANY REGUALTOR IF IT IS LEAKING.
f.

Never strike an electric arc on a cylinder.

g. Never use a damaged cylinder.

h. Never force a cap or regulator.
4.1.2. NCJIMCARE & OPJICACRE Specific procedure of LOADING AND
UNLOADING of medical gases.

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 3 of 19

Loading Gas Cylinder on trolley

a. Do not horizontally roll over empty or full cylinder on the floor.
b. Always use rubber mat while moving cylinder one place to another place or during
loading or unloading.
c. Wear steel toe capped shoes and gloves.
d. Undo securing bars on trolley and slide it near the cylinder
e. Unhook chain from rack and place palm of hand on top of cylinder neck, get a firm
grip.
f. Tilt cylinder slightly forward so it rests on the rim of the base and use the other hand
to rotate cylinder milk churning it from rack to trolley
Pushing trolley and unloading gas cylinder
a. Fasten securing bars on the trolley
b. Place one foot on the axle and tilt the trolley back so it balances comfortably on the
wheels
c. Keeping back straight, push trolley and set it down in front of the laboratory bench
d. Remove cylinder from trolley, milk churning it into its new position and clamp it
securely to the bench using chains, or straps.

4.1.3. Transporting Cylinders

a. For cylinders that are threaded to accept protective valve caps, the valve caps shall
be secured in place before transporting.
b. Avoid dropping and striking cylinders together. The cylinder should not be lifted by
the cap.
c. Use a cradle for hoisting, never a lifting magnet or sling.
d. Use a suitable hand truck with the cylinder firmly secured. Avoid dragging, sliding or
rolling cylinders.
e. Cylinders must be secured in a positive fashion with straps or chains while being
transported to and when in, motor vehicles.
f. All the intra-hospital transfer of cylinders will be done the cylinder transport trolley.

4.2.

Procedure for Objective:-1.3. Medical gases are stored in a safe manner.

4.2.1. NCJIMCARE & OPJICACRE Storage Procedure for medical gases.
a.

Cylinder storage areas should be prominently posted with the names of the
gases to be stored. No Smoking sign should be displayed.

Hindi poster

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 4 of 19

4.3.

A.

b.

When gases of different types are to be stored at the same location,

cylinders should be grouped by type of gas and Cylinders should be
properly labeled.

c.

Storage rooms should be dry, cool, and well ventilated. Cylinders should not
be stored at temperatures above 51 degrees C. (125 degrees F.) or near
radiators or other sources of heat. Cylinders shall not be stored near highly
flammable or combustible substances.

d.

Cylinders stored in the open must be protected against weather extremes.

e.

Cylinders shall be protected from any object that will produce a cut or other
abrasion in the surface of the metal. Do not store near elevators or in
locations where heavy moving objects may strike or fall on them.

f.

For cylinders that are threaded to accept protective valve caps, the valve
caps shall be secured in place when stored.

g.

Do not store gas cylinders with pressure regulator.

h.

Empty and filled cylinders shall be marked and kept separately.

i.

Cylinders shall be stored in an upright position.

j.

The valve protection cap should not be removed until the cylinder is
secured and ready for use.

Procedure for Objective:-1.4. Medical gases are distributed in a safe manner.

4.3.1. Distribution of Medical Gas Cylinders in NCJIMCARE & OPJICACRE as per
annexure: Liquid oxygen

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 5 of 19

Level Gauge
KG X 100

Pressure
Gauge

When tank is full, reading is

around 65 Kg.; Calc ulate
daily average c onsumption.
When 5 days supply is in stoc k
: reorder

Pressure Ga ug e for inner

vessel. Keep pressure for inner
2
vessel at 8 kg/c m for line
2
pressure to be at 4.5 kg/c m .

7KL = 7000 L VICC Storage Tank

M1
Supply (IN) of
liquid oxygen

B3

Lower filling
valve

Drainage

M2

M3

Upper filling
valve

Pressize r
INLET Valve
(Used to
adjust the
pressure at
vesse l level
2
8 kg/cm

FOR FILLING
NOT TO BE TOUCHED

V1

V2

Vaccum Valve
DO NOT TOUCH

B2
Over Flow
Valve
(during
filling of
liquid
oxygen)

M4

Out Valve to
Manifold

Purge Valve
(Out from
Tank)

M
Lower Filling Valve
For Filling cylinder
with attac hement
DO NOTTOUC H

Vent

(2 in number)

Safety Valve

Pressure Regulator
Valve to Vaporizer

SV-2

Pipe Line Safety Valve

Procedure for Objective:-1.5. NCJIMCARE & OPJICACRE Medical gases are used in a
safe manner.
NCJIMCARE & OPJICACRE USES PROCEDURE OF CYLINDERS
a. If a cylinder is found to be faulty (e.g. faulty valve operation, damaged valve outlet or
minor leaks from valve) the cylinder must be isolated in the cylinder store and marked
faulty and the supplier contacted for advice.
b. When using medical gas cylinders it is most important that no part of the cylinder valve
or equipment is either lubricated or contaminated with oil or grease.
c. Special care is needed with the use of hand creams as these could provide sufficient
contamination to the medical cylinder valve surface when handling the cylinder to cause
an ignition when the valve is turned on.
Before use ensure that:

a. The correct cylinder is selected for the application and where a regulator is required,
check that the cylinder product and filling pressure are compatible with the selected
regulator
b. Only correctly designed valve spindle keys are used to open the cylinder valve
c. The cylinder contents are checked to ensure that sufficient gas is available for the
required use (contents may be determined by reading the gas regulator pressure
gauge)

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 6 of 19
d. The cylinder is in date.
The cylinder should be prepared for use as follows:
a. Remove the disposable seal by pulling the tear tag and discard.
b. For cylinders fitted with bull nose outlet valves, remove the cap from the valve. Outlet
by pulling forward and leaving to one side.
c. For cylinders fitted with pin-index valves, remove the disposable seal and outlet clip
and discard.
d. Check for signs of oil or grease on the cylinder valve. If either is discovered do not
use.
e. Check that the regulator or equipment to be attached to the cylinder is appropriate for
the cylinder to be used.
f. Ensure that the regulator or equipment to be attached to the cylinder is also free of oil
or grease.
g. Check that the o ring or sealing washer is in good condition. Replace if it shows any
signs of wear or damage.
h. Only reasonable force should be used to attach a regulator to the cylinder. Never use
excessive force as this may damage the valve outlet threads
i. Open the cylinder valve slowly with a standard valve key or hand wheel. Fully open
the valve and then close a quarter turn to enable subsequent users to distinguish
between and open and closed valve
j. Leave the spindle key in the valve so that it may be closed in an emergency
k. Ensure that the equipment operating instructions are available. Cylinders should be
checked regularly while in use to ensure that they have sufficient content and
that leaks do not occur.
Checks must be made to avoid leaks of gas while using gas cylinders. The
procedure for checking is as follows:
a. Listen for hissing sound from cylinder connections.
b. Close the cylinder valve and verify the leak by noting any fall in the regulator pressure
gauge reading.
c. Tighten connections and check for leaks again.
d. If a leak is still present, do not attempt to use sealing or jointing compounds to stop
leak but notify the supplier as soon as possible to obtain advice. Do not use the
cylinder.
After use ensure that:
a. The cylinder valve is closed immediately, using a correctly designed cylinder valve
key with moderate force only.
b. That excess gas from the equipment regulator and connecting hoses are vented by
opening the equipment flow control valves for a few seconds.
c. After venting, the control valves are closed.
d. The equipment connectors are removed from the cylinder using the correct tool or
manually.
e. On cylinders fitted with bull nose valves, the valve outlet protection is replaced to
protect the valve outlet from contamination.
f. The cylinder valve is closed.
g. All empty cylinders are returned to the appropriate place in the cylinder store.

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 7 of 19

4.4.

Procedure for Objective:- 1.6. The procedures for medical gases address the
safety issues at all levels.
4.4.1. All cylinder storage areas, outside and inside, must be protected from
extremes of heat and cold and from access by unauthorized persons.
4.4.2. Valve safety covers must be left on until pressure regulators are attached.
4.4.3. Cylinders are not stored near elevators, in corridors, or in locations where
heavy objects may strike or fall on them.
4.4.4. Storage areas must be posted as NO SMOKING areas
4.4.5. Storage cabinets should be labeled FLAMMABLE- KEEP FIRE AWAY.
4.4.6. Metal cabinets (for intra-hospital transport trolley) must be constructed of
steel sheet that is at least No 18 gauge. They must be double-walled with a
1.5 inch air space, and they must have joints that have been riveted, welded,
or otherwise made tight.
4.4.7. Cylinders shall not be stored in damp areas, near salt or corrosive chemicals,
fumes, heat or where exposed to the weather. Cylinders shall not be stored
longer than one year without use.
4.4.8. Formal training is providing before use of the liquid nitrogen dispensing
facility. All personnel handling liquid nitrogen should receive instruction in its
use from the experienced personnel prior to the handling of liquid nitrogen.
The training record should be maintained.

4.5.

Procedure for Objective:- 1.7. Alternate sources for medical gases, Vacuum and
compressed air are provided for, in case of failure.
4.5.1. In case of failure Alternate of medical gases available in hospital at
compressor room through Stand by compressor for Vacuum and compressed
air.
4.5.2. In case of oxygen tank supply failure Oxygen manifold is available at near
emergency department and 35 Big Oxygen cylinders available for oxygen
manifold and 25 small cylinders.

4.6.

Procedure for Objective:- 1.8.The organization regularly tests these alternate

sources.
4.6.1. Pressure drop test to ensure that there is no leakage in the system.
4.6.2. Valve tightness and correct valve zoning.
4.6.3. Satisfactory mechanical operation and non-interchangeability of each terminal
outlet by means of probes (pin indexed).
4.6.4. Anti-confusion test for checking cross connection.
4.6.5. Flow rate and pressure at each terminal outlet.
4.6.6. Change over mechanism of Gas Control panels.
4.6.7. Satisfactory performance of compressors, vacuum pumps and WAGD (Waste
Anesthetic Gas Disposal).
4.6.8. Performance of alarm system.
4.6.9. The complete system should be purged with nitrogen followed by oxygen.
Finally the complete system should be purged with working gas.

4.7.

Procedure for Objective:- 1.9. There is an operational, inspection, testing and

maintenance plan for, piped medical gas, compressed air and vacuum installation.

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 8 of 19
4.7.1. Daily, weekly, monthly and annual maintenance schedule. Annexure
4.7.2. Uniform colour coding of medical gas pipelines and gas cylinder. Annexure
Annexure:List of distributed Medical Gas Cylinders in NCJIMCARE & OPJICACRE
LOCATION

LOCATION
Eye Ward
PICU
NICU
General Ward
ENT Ward
Burns Ward
H.D.U.
Surgical
Deluxe Room
Gen. Ward
Pediatrics
Emergency
Maternity
Ortho Ward
Dental
TOTAL

O2
(SMALL)

O2
(BIG)

MAIN ICU
DYE CARE
HDU NEURO

O2
48
4
13

3
6
11
19
10
10
2
164

4
4
11
3
3
2
87

ROOM-67

3
3
2
40

NITROUS
OXIDE

HELIUM

Make
Parkodex
EMICO
EMICO
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex

Cancer Building Distribution Point

Air
21
3

CSSD
MINOR OT

CO2

N.C. Building Distribution Point of PGMV

O2
Air
Vacuum
NO2
PGMV
7
5
17
8
9
48
24
24
18
9
3
3
5
5

2.
Location

NITROGEN
(BIG)

Vacuum
21
4
13
1
2
1

NO2

Make
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 9 of 19
ROOM-68
ROOM-57
ROOM-59
GASTROLOGY
PRE OPERATIVE
POST OPERATIVE
MED.EAST
MED.WEST
NEW HDU-1
NEW HDU-2
GENERAL WARD
MED HDU-2
MED.HDU-3
OT -1
OT -2
OT -3
OT -4
OT -5
OT -6
OT -7
OT -8
OT -9
OT -10
TOTAL

1
1
1
8
6
28
18
8
11
8
15
10
2
2
2
2
4
2
2
2
2
2
203

2
2
2
2
4
2
2
2
2
2
47
3.

Location

O2

Air

2
3
36
4
4
22
22
20
2
3
22
20
18
22
20
18

1
2

ROOM-506

CT SCAN
ECONOMY
OT -1
OT -2
CTVS ICU
HCW
CCU-1
CATH LAB
POST OP CATH LAB
MED ICU-2
MED ICU-3
HDU GESTRO
ICU-1
ICU-2
HDU NEUROLOGY

8
11
2
13
7
1
1
1
1
4
1
1
1
1
1
114

1
1
1
1
1
1
1
1

Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex

Cardiac Building Distribution Point

ROOM-509

MRI

1
1
1
1
8
6

4
4
22
11
10
1
1
11
10
9
11
10
9

Vacuum
1
1
2
4
4
22
22
10
1
2
11
10
9
11
10
9

NO2
1
1
36

Make
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex
Parkodex

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 10 of 19
TOTAL

5.

238

116

129

38

Procedures for Placement and Use of Oxygen Cylinders Outside Designated

Storage Rooms :

5.1.

Cylinder capacities of A (large cylinders) & B/D (small) are used in various areas
besides PGMV.

5.2.

Patient care areas are limited to storing up to 3 oxygen cylinders.

5.3.

When small-sized (B/D) cylinders are in use, they shall be attached to a cylinder
stand or to a therapy apparatus of sufficient size to render the entire assembly stable.

5.4.

An individual cylinder placed in patient room for immediate use by a patient shall not
be required to be stored in an enclosure.

5.5.

Cylinders shall not be chained to portable or movable apparatus.

5.6.

Cylinders shall be protected from abnormal mechanical shock, which is liable to

damage the cylinder, or valve.

5.7.

Cylinders shall not be stored near elevators, or in pathways.

5.8.

Cylinders shall be protected from tampering by unauthorized persons.

5.9.

Free standing cylinders shall be properly chained or supported in a proper cylinder

stand or cart.

Emergencies and Special Procedures

1. In the event of a leak or suspected leak of a toxic or flammable gas, evacuate the building
or area. Immediately notify security and PGMV department if possible. If the leaking source
is a cylinder, carry the cylinder to nearest open space and evacuate the areas.
2. Use soapy water to detect leaks. Connections employing flammable or toxic gases are to
be leak tested. If it is possible to isolate patient care area with the help of isolation valve,
then isolation valve must be closed.
3. Oil, grease or other flammable material is not to be permitted to come in contact with the
valves, regulators, gauges or any fittings of an oxygen cylinder. Oil and grease in the
presence of oxygen under pressure may ignite violently. Do not handle cylinders with oily
hands or gloves. Never use oxygen as a substitute for compressed air.
4. "No Smoking" signs should be placed near flammable gas cylinders.

Fire-suppression equipment using carbon dioxide or dry chemicals should be available.

Spark-proof tools should be used when working with flammable gas cylinders.
5. Wear chemical splash goggles when handling compressed gases, which are irritants,
corrosive or toxic.
6. All gas installation or alteration will be carried out as per the standards.

NCJIMCARE &
OPJICACRE
HISAR

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d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 11 of 19
Testing for Leakage
1. Connect a cylinder of the manifold service gas to the end connection on each end of the
cylinder extension bar using the copper cylinder connection hose assemblies (pigtails)
supplied.
2. Make sure all other outlets are capped with the plug and chain assemblies supplied.
3. Make sure that the high pressure inlet valves of each bank are fully OPEN.
4. Slowly open the two cylinder valves closest to the cabinet, one at a time, to pressurize
the cylinder extension bar and to pressurize the pipeline.
5. All outlets from the pipeline, downstream of the manifold, should be closed and thus there
should be no flow from the manifold.
6. Check for leaks at all cylinder extension joints and at the joints where the pipes were
connected to the pipeline, using a with cotton soaked with water mixed in savlon, which is
compatible with oxygen.
Regulators are gas
specific and not
necessarily
interchangeable!
Always make sure that
the regulator and valve
fittings are compatible.

7. If any leaks are found, the system must be depressurized by bleeding through a
convenient pipeline outlet and the faulty connections must be repaired.
8. The threaded pipe cylinder extension bar connections may be tightened one more turn,
maintaining the horizontal location of the cylinder adapters or a further application of an
oxygen service threaded sealant may be required.
9. If the brazed pipeline connections leak, they must be removed, cleaned and then rebrazed following the proper technique. All repaired joints must be pressure tested as
previously
Medical Gas* means Oxygen, Carbon dioxide, & Nitrous Oxide
PREVENTIVE MAINTENANCE
1. Preventive maintenance schedules are prepared based on manufacturers
recommendations.
2. The availability of necessary spares, consumables, tools and necessary materials to
be ensured through standardization and /or advance planning, through Stores and
guidance by Head Manifold.

NCJIMCARE &
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d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 12 of 19
3. After completion of maintenance (whether preventive or breakdown) the O K report to
be taken from the Head of Anesthesia (in charge of the manifold room).
4. All preventive maintenance jobs done are recorded in PGMV PMS sheet.
Medical Gas cylinder replacement:

Close cylinder valve on all empty cylinder

Disconnect pigtails from cylinder valve outlets, using an appropriate wrench/key.

Send empty cylinders for refilling

Medical Gas Monitoring :

Check Medical gas system as per Medical gas system daily checklist in every shift.

Maintain a pressure of 60 psi /4 Bar within gas pipelines for O2, Medical air and N2O

In case pressure goes down below safe zone (3.5 Bar) Control panel Gas specific
alarm automatically starts.

Rectify the problem and update complaint tracker.

In case of emergencies like compressor shutdown, manifold shutdown etc, take

immediate actions and emergency bank to be ON in this situation.

BREAKDOWN MAINTENANCE
1. In any event of breakdown manifold engineer is informed who logs the requirement of
maintenance / repair in format of Breakdown Slip (Mr. Anand Contact No.
09996781181)
2. After completion of maintenance / repair, an O K report is taken from the Head of
Department / Manager Engineering
3. All breakdown repair jobs done are recorded in History Card maintained for each
equipment / devices.
4. Instruments / devices which are given in AMC (Annual Maintenance Contract) are
given to AMC Company for maintenance. A report of failure / break down is taken
from company for monitoring purposes.
CALIBRATION OF DEVICES

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 13 of 19

The pressure gauges in the Central Manifold panel are to be calibrated and
maintained.

Agency to do the calibration: Internal by BME department with the help of pressure
calibrator. Verification of pressure calibrator will be done by: ____________.

Frequency of calibration: Yearly.

Status no.

Items to be calibrated: Oxygen regulator (ISO11197:2004.), air regulator, auto

change over, flow meter (ISO15002:2008.), anesthetic gas scavenging disposable
system.

Air purity is checked at the level of one terminal outlet from OT & ICU at least
once in a year.
The name of equipment, type, serial number, location, applicable calibration
requirements, date of calibration done and calibration due date to be documented.
The calibration status to be updated periodically.
Calibration Record / Status
Frequency

Due

Done

Due

Done

Due

Done

Date

Date

Date

Date

Date

Date

Yearly

Agency

will

Signature
done

in

Documentation
indicate whether
calibration

is

house

or

through external sources. Calibration requiring an outside agency - a contract or

purchase order will be issued.

Where required Calibration agency is provided with necessary facilities and support
to carry out calibration in the hospital itself.

Such instruments that are to be calibrated at an outside location are collected and
sent to the identified calibration agency.

The following is checked when calibration is done 1. Physical condition of instrument /test equipment.
2. Calibration report verification.

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 14 of 19
3. Calibration certificate to be obtained from calibration agency and after
verification marked as OK. /Not OK.
4. Sticking of calibration sticker

Calibration history is maintained and calibration certificates filed.

BME preserves the machines accuracy and fitness for use. If equipment is out of
calibration or is otherwise not fit for use, it should be withdrawn from use.

ANNEXURE
BREAKDOWN SLIP/ REGISTER
Breakdown Slip No.

Department:

Date:
Time:

Equipment/ Instrument Name

Equipment/
Instrument Code No.
Equipment/ Instrument Location
Nature of Breakdown
Time Required / Due Date
Actual Time Consumed

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 15 of 19
Signature of concerned Head
Date :
Received Signature of Maintenance concerned Section
Remarks:

Head

Time

Signature of concerned Section Head /In-charge

PREVENTIVE MAINTENANCE SCHEDULE AND RECORDS

Cleaning
Date

There is no
dust or
contaminants
at cylinder
outlet

Visual checks

Body & base of

the cylinder
should be clean
of dirt & other
contaminants

Check cylinder is
correct type and
marked oxygen

Check all parts

are fitted tightly
and correctly

Function
checks
Before use,
Close
ensure cylinder
cylinder
is filled and flow
valve after
is present
each use

Remarks

Daily Check points

1
2
3
4
5

Cleaning
Date

1
2
3
4
5

Clean cylinder, valve and

flow meter with damp
cloth

Visual checks
Check for leakage: hissing
sound or reduction in
pressure

Function
checks
Remove valve dust
Check flow can
with brief, fast oxygen
be varied using
flow
flow control

Remarks

Weekly Check points

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 16 of 19
CALIBRATION RECORD & HISTORY
(List of Instruments)
Sl.
No
.

Location /
Department

Instrument

Identification

Range

Control

Date Of

Due Date Of

Calibration

Calibration

Frequency
Of

Remark & Status.

Calibration

(History)

CALIBRATION STICKER

Calibration Record / Status

Frequency

Due

Done

Due

Done

Due

Done

Date

Date

Date

Date

Date

Date

Manifold Gas Cylinders

Pipeline Service Safety

Half Yearly

Signature

and

1. Pipeline should be seamless

type, non-ferrous, non-arsenic of high quality copper tubing.

2. Exposed oxygen pipeline should not be installed near areas like kitchen, laundry and
rooms where combustible substances are stored.
3. The gas content of the pipeline should be readily identifiable by the colour of the
tubing. Specific color-coding on each outlet.
COLOUR CODE FOR CYLINDERS
Medical Gas
1. Nitrous Oxide
2. Oxygen cylinder
3. Compressed air
4. Carbon dioxide

Colour Code of Cylinders

Blue
Black with white collar
Yellow
Gray

COLOUR CODE FOR GAS PIPELINE

Medical Gas
1. Nitrous Oxide

Colour Code of Pipeline

Blue

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 17 of 19
2. Oxygen Pipeline
3. Compressed air
4. Carbon dioxide
5.Vacuum
6. Nitrogen

White
Black
Gray
Yellow

4. When opening the valve on a cylinder containing an irritating or toxic gas, the user
should position the cylinder with the valve pointing away from them and warn those
working nearby.
5. Safety valves provided to be set at 1.5 times the working pressure.
6. Locknut provision on regulators for preventing inadvertent high-pressure settings.
7. Two stage regulators for avoiding fluctuation in flow.
8. Line pressure alarms for continuous monitoring pipeline pressure.
9. These pressure monitoring units shall be installed in OT, ICU and the gas manifold
room.
10. Non-interchangeable (Pin-Indexed) adaptor for each outlet.
11. The department shall be well equipped with fire extinguishers (ABC) etc in case of
accidents.
12. All medical gas cylinders, valves and manifolds shall have permanent labels bearing
the name of the gas they carry or control

14. Always
read the
label!!

13.
15. Alarm system in medical gas systems, two kind of alarm are incorporated: --one
monitors the pressure of various gases, if abnormal pressure is sensed, the red
warning signal glows with audible alarm. --second alarm is called the remote signal
lamp, which is generally only visible.
Personal Protective Equipment:- As a minimum, operators who handle cryogenic liquids
should be equipped with the following Personal Protective Equipment (PPE): 1. Safety shoes.

NCJIMCARE &
OPJICACRE
HISAR

REFERENCE NO: FMS. 5 a, b, c,

d, e, f.
ESSENTIALDOCUMENTATION
PGMV

DOCUMENT NO:(VERSIONNO:
1) FMS MAN/01(01)
DATE OF ISSUE:

TOTAL PAGE 18 of 19
2. Lab coat or overalls are advisable to minimize skin contact and also trousers over
shoe/boot tops to prevent shoes filling in the event of a spillage.
3. Face shield or safety glasses (Eye protection).
4. Gloves suitable for use with cryogenic liquids.
5. Dry insulated gloves when handling equipment that has been in contact with the
liquid.
TRAINING
Under the Health and Safety at Work Act 1974 it is the responsibility of employers to train
their employees on the recommended safeguards relating to products and equipment used
at work. NCJIMCARE & OPJICACRE training are provided in the following areas of medical
gases:

a. Explanation of medical gases their properties and their clinical uses.

b. Medical gas cylinders identification and labeling.
c. Cylinder storage and handling.
d. Dealing with faulty cylinders and other equipment.
e. Fire and explosion risk associated with medical gases.
f. Practical use of cylinders including the types of valves and used for each type and
size of cylinder, leak tests as well as gas flow meters used to regulate flow of Medical
gas pipeline systems.
g. Training in the handling of liquid nitrogen (if appropriate for role).
h. Training should be provided on a regular basis in line with the statutory and
mandatory training matrix, and personnel records must be maintained.
i. Training can be obtained in a number different ways.