Medical Gases

• A medical gas is defined as one that is manufactured, packaged, and intended for   administration  to a patient in anesthesia, therapy, or diagnosis.
• Medical Gases and their associated equipment are widely used for treating patients in hospitals, at home, and by the emergency services- they are lifesaving!
• All medical gases and some of the associated equipment used are highly regulated by European Directives and UK legislation Medical gas is critical to the function of hospitals and many other healthcare facilities.
• Knowing the most common types of gases and why we use them is essential All medical gases are a drug, even suction

• Oxygen (02) uptake is from the air (atmospheric) and is essential for respiration therefore essential to life!
• Oxygen percentage in the atmosphere is  21%- but sometimes we need more!
• Supplemental oxygen may therefore be required for many reasons
• Piped oxygen is delivered in liquid form to a hospital at -186 degrees C and is warmed up to provide the hospital with a gas

• Nasal Cannula: low flow- up to 5 litres minute (5 L/MIN) = 44% oxygen
• Simple face mask: low to high high flow- up top 10 litres per minute (15 L/MIN) = 70% oxygen
• Venturi masks: High flow- up to 15 litres per minute (15L/MIN)= 60% oxygen 
• Non-rebreather mask: High flow- up to 15 litres per Minute (15L/MIN) = up to 80% oxygen
• Intubation: Varying- Up to 100% oxygen

Oxygen supports combustion!

• Avoid contact with naked flames, static electricity, certain oils or greases and hands to which hand cream (which may contain paraffin oil) or alcohol gel has been newly applied.
• Patients must not smoke. No-smoking signs must be visible. Lubricants such as petroleum jelly should not be used in patients receiving oxygen therapy.
• Keep oxygen cylinders away from highly flammable liquids and other combustible materials and any sources of heat or ignition

• uMedical Air refers to a clean supply of compressed air used in hospitals and healthcare facilities to distribute medical gas. It is free of contamination and particles, has no oil or odors, and is dry to prevent water buildup
• Drive ventilators and incubators
• As a carrier gas for anaesthetic agents
• Power source for driving some medical equipment- especially in operating theatres

Nitrogen

• Nitrogen, used to provide pneumatic pressure in medical equipment
• to prevent combustion and other chemical reactions
• as a component of many gas mixtures.
• Used in cryotherapy

Carbon dioxide

• Carbon dioxide, used to inflate areas of the body for "keyhole" surgery (small incisions made to accommodate surgical instruments )
• mixed with air or oxygen to stimulate breathing
• Used in cryotherapy

• Used for pain relief- for example during childbirth and by the ambulance service and in accident and emergency
• used as an anesthetic agent in surgery
• mixed with oxygen to help patients relax during dental procedures
• in cryosurgery (the use of extreme cold to destroy tissue)

• The use of negative pressure (Vacuum effect) to create a ‘suction’ to remove something.
• The use of suction to remove debris or bodily fluids from an airway, body cavity, orifice or surgical site.
• The purpose of oral suctioning is to maintain a patent airway and improve oxygenation by removing mucous secretions and foreign material (vomit or gastric secretions) from the mouth and throat (oropharynx)
• In surgery is used to clear bodily fluid form the surgical area.
• Can be life saving!

• Suction can be wall mounted and provided centrally from the gases network or portable
• Suction controllers are used to regulate the level of suction produced
• Caution must be exercised and should only be performed when trained to do so!

Tubing connects to the controller and then a suction catheter is placed at the end:

• Yankauers (rigid- used to clear liquid from the upper airway)
• Fine bore suction catheters- flexible- used to clear secretions from tracheostomy tubes and can be passed down advanced airway adjuncts).

• medical gas systems are monitored 24hrs a day 365 days a year
• If the gas is not in use then turn it off- we do not want beds or patient clothes etc being enriched with medical gases particularly oxygen as this is extremely dangerous, if 15 litres of oxygen is being wasted all day every day then that equates to 20 tonnes of liquid
• Pay attention to the medical gasses monitor- if it is alarming then escalate!
• Be carful and ensure you follow the guidelines in the area you are working in