DR UNNIKRISHNAN P

SENIOR RESIDENT
NEUROANAESTHESIA
SCTIMST,TRIVANDRUM
 Mr Cylinder

I am a supply tank containing high pressure gas or

gas mixture @ a pressure that can be in excess of
2000psig
We should know how we measure
pressure

Psi = pounds per square inch

Psig = pounds per square inch gauge
Difference between measured pressure and surrounding atm
pressure
Psia = pounds per square inch absolute
Based on a reference point of 0 pressure=perfect vacuum
Psia = psig + local atm pressure
 What does the cylinder contain?

[1]nonliquefied compressed gas.it doesnt liquify @

ordinary temp & pressures <2500psig
E.g. O2,N2,air,Helium
[2]liquefied compressed gas becomes liquid in
ordinary temp & pressures from 25-2500psig
E.g. nitrous oxide,CO2
 Also note that

100 kPa=1000mbar=760mm of Hg=1030cm of

H2O=14.7psi=1atmosphere
 What is Critical Temperature?

It is the temperature above which a gas cant be

liquified, no matter how much pressure is applied;
O2--119 C [so it is a gas in room temp]
N2O36.5 C [so it is a gas+liquid mixture@room
temp;if temp >36.5,then it exist only as gas]
SIZES
Parts of a cylinder
 Parts

BODY-VALVE-PRESSURE RELIEF DEVICE

BODY--Made of steel-molybdenum alloy
MRI compatible:aluminium
VALVEbronze/brass
HANDLE WHEELturned counter clockwise to
open
 Valve-Port /Stem/Seat

Point of exit of gas

Take care
Im not the conical depression and I dont like the
retaining screw.
Stem closes the valve by sealing against the seat
 Packed Valve

Stem sealed by Teflon

Turning the stem causes the seat to turn
So called Direct acting
Withstand high pressures
Opened by 2-3 full turnes
 Diaphragm valve

Stem is separated from seat

Turning the stem moves a metal diaphragm against
the opposing force of a spring acting on seat
Can be opened by 1/2 to 3/4 turns
Less likely to leak
 Pressure Relief Device

Vent the contents into atmosphere if pressure

inside increases to dangerous level
RUPTURE DISC: when pressure increases above
a specific level due to high temperature or
overfilling ;it rupturesrelease contents
FUSIBLE PLUG:when temperature increases
above Yield temperature it melts
 Pressure Relief Valve

Dont confuse with others

I am a reclosing device and prevent discharge of
contents after normal pressures have been restored
More susceptible to leakage
 Conical Depression

Situated above the safety relief device

Receives retaining screw of the yolk
 PIN INDEX SAFETY SYSTEM

Used on cylinders AE
Holes on the valve positioned in an arc below the
outlet port
Pins on the yoke or regulator are positione to fit
these holes
If both are not aligned, port wont seat
 PIN INDEX SAFETY SYSTEM

.
 PRECAUTIONS

Must be tested at least every 5 years

Pressure in a filled cylinder @ 70F cylinder may
not exceed the service pressure marked on the
cylinder [O2,He,He-O2,CO2-O2 are allowed
additional 10%]
 COLOUR CODING

L
Oxygen White shoulder/Black
body
Nitrous oxide Light blue

Medical air Black and white

Suction Yellow

Nitrogen Black

Carbon dioxide Grey

Helium Brown
 MARKINGS

DOT/TC specification number

Service pressure in psi
Serial number
Identifying symbol of the purchaser,user or
manufacturer
Initial qualifying test date
Retest date
5 pointed star after last test date=may be retested every
10 instead of 5 years
+ after test date = cylinder can be charged upto 10%
in excess
 LABELING

L
Tags
 RULES FOR SAFE USE OF
CYLINDERS

Handled only by trained staff

Keep away oils,rubber and other combustible
substances
Never expose to >52C
keep all connections tight
Take care to avoid obstructions to discharge ports
 RULES FOR SAFE USE OF
CYLINDERS

Never interchange parts of cylinder used for one

gas with other
No adapters please
Keep the valve closed when not in use
Valve is most prone for damage
No alterations
Dont use as a roller
Avoid electric contact
 RULES FOR SAFE USE OF
CYLINDERS

Dont drag me..

Take precautions to prevent falling
Remove wrappings before taking into OT
Storage:cool,clean room with adequate ventilation
Secure,safe place. Protect against all extreme
things!
RULES FOR SAFE USE OF
CYLINDERS

NO SMOKING

NO OPEN FLAMES

NO OIL OR GREASE
 RULES FOR SAFE USE OF
CYLINDERS

Small cylinders best stored upright

Dont drape with any material during storage
Should be grouped by contents or sizes
Good segregation between empty and full
Flammable gases should not be stored in an
enclosure containing oxidizing gases
 RULES FOR SAFE USE OF
CYLINDERS

Identify contents by label; Check for DOT

Immediately before fitting, remove the protective
cover
Pressure reducing regulators always used; inspect
them for any damage before connecting
Remove dust and foreign bodies
 RULES FOR SAFE USE OF
CYLINDERS

CRACKINGreduces possibility of flash fire

A sealing washer in good condition should be used
Valve should be opened before bringing the
apparatus to the patient. Flow control valve should
be closed before the cylinder valve is opened
While opening, stand to the side; not in front or
back
Quick opening can generate heatflame
 RULES FOR SAFE USE OF
CYLINDERS

After opening the cylinder, check the pressure

Hissing sound= leak tightenstill leak replace
washer. Localize leak with soap water.
If leak in valve itself,tighten the packing nut by
turning it in a clockwise direction
Even if no hissing sound, check for loss of
pressure when no gas is being used
Valve should be fully open when in use
 RULES FOR SAFE USE OF
CYLINDERS

An empty or near empty cylinder shouldnt be left

on anaesthesia machine
Valve should be closed before removing from a
regulator or yoke
Lower part of the tag removed when cylinder is
empty
Caps replaced before shipment
 HAZARDS

Incorrect cylinder,contents
Incorrect valve
Incorrect color,labelling
Inoperable valve, damaged valve
Suffocation,fires,explosion,thermal injury
Contamination of contents
Overfilling, theft of Nitrous oxide cylinders
 MEDICAL GAS PIPELINE
SYSTEMS

Central supply

Pipings extending to target locations

Terminal units
 RULES FOR SAFE USE OF
CYLINDERS

The maximum amount of oxygen that can be

stored inside a health care facility is 20000 cubic ft
 Design

2 banks of cylinders
Each have its on pressure reducing regulator
Must contain a min of two cylinders
Connected to a common manifold[header]
Check valve in between each cylinder lead &
header
 Design

N
 PRIMARY/SECONDARY
SUPPLY

Primary supply [duty/running] actually is the

portion supplying the system
Secondary supply automatically becomes the
primary, when the latter fails [switch over done by
manifold change over device]
Operating supply is the portion which normally
supplies the piping system [ consists either a
primary OR primary+secondary supply ]
 Reserve Supply

For larger systems

When operating supply fails /emergencies
/maintenance
Activating switch is there for activating reserve
supply
 Pressures

Gases other than Nitrogen @50-55 psig

Nitrogen @160 psig
 Oxygen

Stored as liquid @ low pressures & < --148C[when

large amounts are required] OR
as compressed gas in G or H cylinders
 Nitrous oxide

Be careful against leaks; its an asphyxiant

Regulator can become cold and can freeze
theft
 Medical Air

Air that has no detectable liquid

hydrocarbons, less than 25 ppm gaseous
hydrocarbons,less than 5 mg/m3 of particulates of
1 micron size or greater @ normal atmospheric
pressure and a dew point @ 50 psig of less than
4C
Low levels of nitric oxide found in ambient air may
improve oxygenation in ventilated patients
 PIPED AIR SYSTEM

Employ 2 or more compressors

 INTAKE

Intake location should be free of dirt/fumes

Quality checked periodically
Water content reduced with after cooler/dryer
Monitored for carbon monoxide
N.B. Other gases: CO2, Nitrogen
 PIPED DISTRIBUTION
SYSTEM

MAIN LINES: pipes connecting the source to

risers or branch lines or both
RISERS: vertical pipes connecting the main line
with branch lines on various levels of the facility
BRANCH LINES: they service a room or group
of rooms on the same level of the facility
Flexible hoses used only in exposed areas..Why?
 PIPED DISTRIBUTION
SYSTEM

Pressure relief valves set @50% above the normal

line pressure. Close automatically when excess
pressure relieved
Shut off valves isolate areas of the system in the
event of a problem and allows for repair.
[1]Manual @ accessible areas installed in boxes
[2]Service: only for authorized personnel
Emergency Oxygen Supply Connector: T fitting
for connecting auxiliary source of O2
 PIPED DISTRIBUTION
SYSTEM

Master Alarm System: monitor the pressure in the

main line
When switch over from primary to secondary
supply
When reserve supply is reduced to a certain level
When reserve is below that is required to function
When pressure in main line increase or decrease
Area Alarm Systems: e.g. PACU,ICUs
 TERMINAL UNITS

BASE BLOCK
PRIMARY VALVE: open when male probe
connected & close when detached
SECONDARY VALVE: shut off flow when
primary valve is removed
GAS SPECIFIC CONNECTION POINT /
SOCKET ASSEMBLY
 TERMINAL UNITS

GAS SPECIFIC CONNECTION POINT /

SOCKET ASSEMBLY
Connecter may be DISS/ Quick Connector
Equipped with a backflow check valve
Quick Connector easy to use; but leak more
 TERMINAL UNITS-types

Wall outlets
Ceiling mounted hoses
Ceiling mounted pendants
Ceiling mounted columns
 HOSES

connect anaesthesia machine to terminal units

each have a permanaent non interchangable
connector
Inlet & outlet connectors
Braid adds to strength
 TESTING OF MEDICAL GAS
DISTRIBUTION SYSTEM -INITIAL

blow down
Initial pressure testing
Standing pressure test
Piping purge test
Test for cross connections
 TESTING OF MEDICAL GAS
DISTRIBUTION SYSTEM-SYSTEM
VERIFICATION
Cross connection test
Test of values
Outlet flow test
Alarm testing
Piping purge test
Piping purity test
Final Tie-in test
Operational pressure test
Medical gas concentration/air purity test
Source equipment verification
 Problems

Inadequate pressure
Leaks
Excessive pressures
Alarm problems
Cross connection of gases
Contamination of gases
Fires
Depletion
Theft
THANK YOU
 .