Centralized Gas and vacuum supply service is a modern system of piped supply of medical gases (Oxygen, Nitrous oxide); Compressed Air and Clinical Vacuum Delivery from a central storage area called the Manifold Room, to all delivery points/patient areas in various wards, OT, labor room, etc. in the hospital.
The service is very crucial for the efficient treatment and survival of many patients in a hospital so much, so that even a couple of minutes break can lead to serious consequences including loss of lives.
The central supply station is among the most hazard prone areas in a hospital. Because of the storage of gases, any safety violations can cause explosions which can be disastrous.
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Further, unless the distribution pipelines and the terminal unit are periodically inspected and their patency is maintained, there is always a chance of leakage and erratic supply at the user end endangering thereby, the life and safety of patients. Yet, it is a department often ignored.
For safety of gas and vacuum supply service, the hospital management must pay attention to the following important aspects:
1. The department should have a documented SOP for all activities including the procedure for safe operations, the safety precautions to be taken, periodic inspection of the distribution system and the actions to be taken in case a leakage is suspected/ detected in the distribution system.
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2. Adequate staff: The staff should be well trained and adequate to provide round the clock cover and emergency maintenance service.
3. Quality of Equipment: The Source Equipment, the Distribution System and the Terminal Units must be as per the prescribed standards.
4. Color Coding: The color of gas cylinders and distribution pipelines should be strictly as per the prescribed Color Coding (IS 2379-1963-Indian Standards Specifications and Codes) and all staff posted in the manifold room should be fully acquainted with it.
5. Separate enclosures for the compressor for compressed air, the gas supply and the vacuum pumps for vacuum supply.
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6. There should be a documented procedure to ensure the supply of gases and vacuum at the desired Pressures (4.22 Kg/sq cm for oxygen). The pressure range should be displayed on the wall next to the particular equipment.
7. The cylinder banks should have adequate number of cylinders to ensure uninterrupted supply for at least 48 hours.
8. The gas cylinders must be in compliance with the Gas Cylinder Rules 1981. The important aspects to be ensured are:
i. The cylinders are manufactured as per the rules
ii. The cylinders have the color coding as per the rules
iii. The cylinders are filled as per the rules governing the gaseous pressure
iv. The cylinders are filled by an authorized agency and as per the rules
v. The cylinders are refilled correctly as per the color coding
vi. The cylinders are stacked and stored as per the rules prescribed
vii. They are kept in an area safe from the obvious hazards of explosion
viii.Repainting of cylinders should be done only by the suppliers and never by own staff.
9. Empty and full gas cylinders must be stored, separately. Full cylinders in use should be in a standing position chained to the wall so as to preclude any possibility of their falling down.
10. Adequate lighting and ventilation is to be ensured in all areas of manifold room.
11. Meticulous cleaning: No oil spills or grease on the floor or the equipment in the area.
12. The distribution pipelines should have stop valves at suitable intervals to disconnect the flow in case of any leakage or during repair work.
13. There should be a system of visual (green-normal, red-abnormal) and auditory alarms to indicate any fluctuations in the pressure beyond the acceptable range.
14. No Fire Hazards: There should be no fire hazards allowed in the vicinity of the manifold room and the warning sign should be displayed prominently outside the facility.
15. Being an area prone to fire hazards/explosions, the manifold room must have a well equipped and reliable system of fire prevention and safety.
16. Planned preventive maintenance, recalibration and observance of precautions including regular periodic check of the distribution pipelines for any leakages.
17. No unauthorized entry, no other activity and no other stores/equipment should be allowed inside the manifold room.