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Define critical temperature
Temp above which a gas cannot become liquefied by the application of pressure (ex. H2O =374C)
Define critical pressure

  • The force required to liquefy a gas at its critical temp (ex. H2O = 218 ATM)

  • Gases are seperated from air by application of the critical temp and pressure

Fractional distillatin for O2
  • Air is compressed at 200 atm
  • increase in pressure causes an increase in heat
  • The heat is removed and the gas becomes liquefied
  • Liquid is slowly warmed
O2 characteristics
  • Boiling point -297F
  • Stored as gas in green tanks
  • Stored as liquid in white tanks
  • All inhalation mixtures must contain > 20% O2
Compressed Air Characteristics

  • A/C

  • Produced by collecting, filtering air and compresses air by means of a compressor

  • Used to deliver meds to patients unable to use pure oxygen

  • A/C blended with 100% O2 to achieve FIO2 between 21% and 100%

Carbogen uses
  • Loss or impaired vision due to thrombus in retina
  • CO2 good vasodialator
Carbogen Hazards
  • Causes increase in RR
  • Increases depth of respiration
  • Potent dilater of cerebral blood vessels (check blood pressure frequently)
  • Check BP, HR, RR before during and after tx
Carbogen Delivery
  • Tank color gray and green
  • Mixture is 95% O2 and 5% CO2
  • Use simple mask or non-rebreather
Helium Characteristics
  • He2
  • Non explosive
  • Inert
He2 and O2 Delivery
  • Heliox
  • Tank is brown and green
  • delivered via mask
  • 80% He2/20% O2 or 60% He2/40% O2
Heliox uses
  • Low density so it decreases WOB
  • Used for patients with status ashmaticus
  • Large airway obstruction
Heliox hazards
  • Hypoxia
  • Less effective cough
Nitrous oxide characteristics
  • N2O
  • Analgesic
  • Stored in blue tanks
Nitric Oxide Uses
  • Adult Resp Distress Syndrome (ARDS)
  • Pulmonary hypertension
  • COPD
Nitric Oxide hazards
Rebound hypoxia due to vasal constriction
Cylinder Safety

  • Never use oil on tank or regulator

  • Cylinders under pressure handle with caution

  • Store in well ventilated area

  • Avoid high temps

  • Protect valve with cover

  • Always secure tank during storage or transport

Hydrostatic testing

  • Done to test tank integrity

  • Filled with O2 at 3000 psi while submerged

  • cylinder wall displacement is measured

  • Normal psi 2200

Department of Transportation
  • DOT
  • Shipping
  • Fillling
  • Marketing
  • Labeling
Bureau of Medical Devices (FDA)
  • Sub agency of FDA
  • Standards for minimal acceptable levels of quality and purity
  • Classification of medical gasses
Compressed Gas Association
  • CGA
  • handling and storage of cylinders
  • Pipings and fittings
  • cylinder markings
Dept of Health and Human Services
  • duplication of services
  • purity
  • potency
  • quality
National Fire Protection Association 
  • NFPA
  • Safety
  • Storage
  • Cylinder identification
  • Environment surrounding storaGE SITE
  • Techniques and adminstration of medical gas
American Standard Safety system
  • ASSS
  • Regulates outlet connectins on cylinders
  • Regulates inlet connections on cylinders
  • cylinders sizes F-K pressures > 200 psi
  • Prevents accidental interchange of cylinders and regulators
  • for threaded high pressure connection
Pin Index Safety System
  • Prevents accidental attachment of valve for one type of gas to another
  • Based on a pin in a hole 1-6 scale
  • Pressure regulator with protruding pins match to holes on cylinder
Gas with pin index
  • O2 2,5
  • CO2/O2  2,6
  • Air  1,5     
Diameter Index System
  • DISS
  • Standard to insure non-interchangeable connections for removable threaded connectors
  • Used <200 psi
  • found on blenders, quick connect, flow meters
Rules for safe handling of cylinders
  • Store according to gas contents
  • Non-flammables with non-flammables only
  •  Before using crack cylinder to blow out dust or debris
  • Routinely inspect for general appearance, tags, valve operation and test date
Safe handling Part 2
  • ID contents by label or color before use
  • Cylinder valves should be losed and bled when not in use
  • Never force connections that don't fit
  • Open valve slowly
  • Before disconnecting close cylinder valve and release all pressure from device
Cylinder conversion Factor
  • E = .28
    G =  2.39
    H/K =  3.14
Tank Colors
  • O2   =  Green
  • NO (Nitric Oxide) = Teal/Black
  • Carogen  =  Gray/Green
  • He  =  Brown
  • HeO2 (Heliox) =  Brown/Green
  • N2O (Nitrous Oxide) = Blue
Cylinder Markings
  • Initial hydrostatic pressure date with update every five or ten years (ten plus star)
  • 3AA = Meets DOT regulations
  • 2015= working pressure tank was designed for routinely filled to 2200 psi
  • CR-MO = chromemolybdenum
  • 6m93  = date of original test
Single Stage Regulators
  • Gas enters the regulator from source at high pressure
  • Pressure is metered down to 50 psi
  • Appropriate flow is expelled through needle valve
  • More precise than multi stage
Multistage Regulators
  • Gas enters from source at high pressure
  • Pressure is metered down to 200 psi
  • Pressure is metered down to 50 psi
  • Appropriate flow of gas is expelled from flowmeter
  • Advantage- steadier flow of gas
  • Disadvantage- more expensive
Characteristics of Thorpe tube
  • Gas flow widens at top
  • As flow increases the ball moves to the top allowing more gas to pass
  • Needle valve permits adj of gas flow
  • Flow is measured in L/M
Thorpe tube must always be in a ______ position.
Vertical
Describe pressure compensated Thorpe tube
  • Flowmeter has needle valve distal to flow tube
  • Back pressure will not affect meters accuracy
Describe non pressure compensated Thorpe tube
  • Flowmeter has needle valve proximal to the flow tube
  • Utilized in quick connect flowmeters
Bourdan flowmeter
  • Measures pressure
  • is uncompensated
  • Not position dependant
  • Accuracy not affected by position (laying down or upright)
Bourdan flowmeter disadvantages
E Cylinder Cubic Ft O2
22
G Cylinder Cubic Ft O2
186
H/k Cylinder Cubic Ft O2
244
Reducing Valves Characteristics
  • Reducing valve and flow meter
  • Reduces cylinder pressure to 50 psi
  • designed to indicater flow and pressure
Bourdon Flow Meter Characteristics
  • Measures pressure
  • Uncompensated
  • Not position dependent
  • Accuracy not affected by position
Bourdon Flow Meter disadvantages
  • Back pressure will cause reading higher than what is being delivered
  • Less accurate when tank pressures < 200 psi
One cubic ft of liquid O2 = _____ cubic ft of O2 gas
860
Working pressure of bulk O2 in building
50 psi
Guidelines for safe adm of O2
  • Use FIO2 < 32% pts with emphysema
  • Use FIO2 < 40% prem and newborns
  • Do not exceed 50% O2 without Drs order
Paramagnetic O2 analyzer
  • O2 has strong paramagnetic atomic config
  • Can be attracted to magnetic field
  • Causes O2 to behave like temporary magnet
  • Greater the density of O2 the more the magnetic field is altered
Thermoconductive O2 analyzer
  • O2 conducts heat faster thsn any gas
  • The rate of heat conducted from a surface, is directly proportinal to concentration of O2 in mixture
  • Temp change is recorded when O2 exposed tp heated wire
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