Centralised medical gas pipeline systems deliver oxygen, nitrous oxide, medical air, and other gases from a central location directly to outlets near patients for safer, purer, and more reliable gas supply. The piped systems remove dangerous gas cylinders from bedsides and provide easier quality control since gases come from centralized pumps and manifolds. A well-designed system has separate manifold and plant rooms, uses copper piping tested for leaks, and provides oxygen from liquid tanks for large hospitals. Outlets include wall mounts and ceiling pendants correctly color-coded for each gas.
Central Medical Gas Distribution System
MedicalGasDistributionSystemisacentralsupplysystemtosupplyamedicalgas(O2,N2O,N2),medicalair,andmedicalvacuumtoeachwardofhospitalsafelyandconvenientlythroughacentralsupplypipingfrommedicalgassupplysources.
•Thesystemhasathoroughgoingcolorcoordinationaccordingtothekindofgas.
•Anaudio-visualmonitoringsystemcapableofcheckingthesituation
• Medical gas supply system in hospitals and
other healthcare facilities are utilized to supply
specialized gases and gas mixtures to various
parts of the facility .
Supply of Medical Gases:
• From:
• Cylinders (Manifold)
• PIPED gas system
• Medical gases commonly
used:
• Oxygen
• Nitrous oxide
• Air
• Nitrogen
• Carbon Dioxide
Central Medical Gas Distribution System
MedicalGasDistributionSystemisacentralsupplysystemtosupplyamedicalgas(O2,N2O,N2),medicalair,andmedicalvacuumtoeachwardofhospitalsafelyandconvenientlythroughacentralsupplypipingfrommedicalgassupplysources.
•Thesystemhasathoroughgoingcolorcoordinationaccordingtothekindofgas.
•Anaudio-visualmonitoringsystemcapableofcheckingthesituation
• Medical gas supply system in hospitals and
other healthcare facilities are utilized to supply
specialized gases and gas mixtures to various
parts of the facility .
Supply of Medical Gases:
• From:
• Cylinders (Manifold)
• PIPED gas system
• Medical gases commonly
used:
• Oxygen
• Nitrous oxide
• Air
• Nitrogen
• Carbon Dioxide
Oxygen concentrator-Applications and Maintenanceshashi sinha
Oxygen Concentrator is a Medical Device used to produce Oxygen from Compressed Air . An oxygen concentrator takes in air and separates the oxygen and delivers it into a person via a nasal cannula. Air is 79% nitrogen and 21% oxygen and a concentrator that works by plugging into a source of electricity delivers air that is upto 95% oxygen. The Technology is known as Pressure Swing Adsorption technology or PSA Technology.
HYBRID OPERATING ROOM
FEATURES OF AN OPERATION THEATRE:
•Generally windowless
•Controlled temperature and humidity.
•Special air handlers filter
•The air and maintain a slightly elevated pressure.
•Rooms are supplied with wall suction, oxygen, and possibly other, anesthetic gases.
Oxygen concentrator-Applications and Maintenanceshashi sinha
Oxygen Concentrator is a Medical Device used to produce Oxygen from Compressed Air . An oxygen concentrator takes in air and separates the oxygen and delivers it into a person via a nasal cannula. Air is 79% nitrogen and 21% oxygen and a concentrator that works by plugging into a source of electricity delivers air that is upto 95% oxygen. The Technology is known as Pressure Swing Adsorption technology or PSA Technology.
HYBRID OPERATING ROOM
FEATURES OF AN OPERATION THEATRE:
•Generally windowless
•Controlled temperature and humidity.
•Special air handlers filter
•The air and maintain a slightly elevated pressure.
•Rooms are supplied with wall suction, oxygen, and possibly other, anesthetic gases.
The most common type of anaesthetic machine in use in the developed world is the continuous flow anaesthetic machine, which is designed to provide an accurate & continuous supply of medical gases(such as O2 & NO2)mixed with an accurate concentration of anaesthetic vapour(such as halothane,isoflurane)& deliver this to the patient at a safe pressure & flow.
Modern machine incorporate a ventilator,suction unit & patient monitoring devices.
The anaesthesia gas machine is a device which delivers a preciselyknown but variable gas mixture, including anesthetizing and lifesustaining gases.
• Original Boyle was made by the firm COXTERS.
• There are several differences between newer and older anesthesia
machines.
• Advanced ventilators are the biggest difference between newer and
older gas machines.
Types Of Anaesthesia Machine
• Intermittent Anaesthesia Machine
-Gas flows only during inspiration
• Ex:-
• Entonox apparatus ,
• Mackessons apparatus
• Continuous Anaesthesia Machine
-Gas flows both during inspiration
and expiration.
• Ex:-
• Boyle Machine
• Forregar
• Dragger
Managing the unexpected in
a healthcare organisation is a
challenging and arduous task.
Experience of other
industries like aviation, nuclear
power etc. have proved that
it is possible to achieve this.
Hospital administrator should
ensure that clear, early,
complete and simple financial
communication is provided
both at the admission and
at the discharge occasion to
create patient-friendly financial
services for customer delight.
This effort shall enhance
both the brand value and
bottom line of the healthcare
organisation
Manpower is a
Health care organisation’s greatest asset and the development
of this asset is critical for
continued financial health of
the organisation
Health care organisation should provide top priority to the health hazards resulting from use of malfunctioning equipment in the present era of medical
device driven healthcare.
Clinical Audit is a method of confirming the quality of clinical services and identify the need for improvement. A skill hospital administrator should learn and practice.
Medication error is a most common problem in a health care organisation.Its prevention can improve patient satisfaction,organisation brand value and bottom line.
The implementation of Risk management in a health care organisation ensure safe health care,increased patient satisfaction , improved bottom line and brand value.
Suicide in a hospital is known risk factor and recognized as sentinel event by JCI &NABH. Health care provider should know what to do in a post suicdide scenario.
In the present era of Pvt Health care industry in India with rising penetration of health care insurance,the need of Revenue Cycle Management is of paramount importance for organisation bottom line
The global radiation oncology market size reached US$ 8.1 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 14.5 Billion by 2032, exhibiting a growth rate (CAGR) of 6.5% during 2024-2032.
More Info:- https://www.imarcgroup.com/radiation-oncology-market
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
TOP AND BEST GLUTE BUILDER A 606 | Fitking FitnessFitking Fitness
"Feature:
• Intelligent Ergonomically Design Glute Builder Is A Must Have For Those Looking To Target Their Gluteal Muscles And Hamstrings With Precision.
• The Ability To Adjust The Starting Position, This Machine Allows For A More Targeted Workout That Is Tailored To Your Specific Needs.
• Spacious And Supportive Cushioned Seat Provide Added Comfort And Stability During Your Workout."
Get more information visit on:- www.fitking.in
Our mail I.D:-care@fitking.in, fitking.in@gmail.com
Call us at :- 9958880790, 9870336406, 8800695917
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
Our mission is to provide a safe and supportive environment where our clients can receive the highest quality of care. We are dedicated to assisting our clients in reaching their objectives and improving their overall well-being. We prioritize our clients' needs and individualize treatment plans to ensure they receive tailored care. Our approach is rooted in evidence-based practices proven effective in treating addiction and mental health disorders.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
2. Centralised medical gas pipeline system is a vital and
integral part of a modern hospital, with emphasis on safety,
reliability and purity of the gases.
The central piped medical gas system is one of the newer
types of hospital plumbing systems to be introduced into
the delivery of direct patient care.
Medical Gas piping is needed for oxygen, nitrous oxide,
medical air, nitrogen, carbon dioxide, vacuum and
anesthesia waste exhaust.
Dr A.K.Khandelwal
3. Piping medical gas from a central location directly to outlets at
the points of patient use provides high level of safety unheard of
in the past.
The direct piping method removes obsolete, bulky and dangerous
pressurized cylinders from the patient's bedside.
Also, these piped systems provide easier quality control and
pressure regulation because all gases are delivered from
centralized pumps, compressors or cylinder manifold systems.
The piping is designed and installed under strict national
regulations
Dr A.K.Khandelwal
4. ADVANTAGES OF CENTRALISED MEDICAL
GAS DELIVERY SYSTEM
FOR PATIENTS:
No distressing sign of oxygen cylinder at bed
side.
Elimination of noise produced by their
movement.
Protection of sterile areas from contamination
caused by use and movement of cylinder.
Uninturrupted and clean gas supply at desired
locations
Dr A.K.Khandelwal
5. FOR HOSPITAL STAFFS:
Instant availability of gas.
Clean, safe and reliable delivery of gases.
Continuous flow of gases when and where required.
Minimal accident hazards due to mishandling of
cylinders.
Dr A.K.Khandelwal
6. FOR HOSPITAL ADMINISTRAOR:
Easy purchase of gases in bulk quantities at
favorable term.
Economy on purchase of cylinders.
Fewer breakages
Minimum damages to building due to handling of
cylinder.
Rationalization in ordering, storing and
transporting.
Dr A.K.Khandelwal
7. Oxygen System:
Oxygen System Shall consists of the followings:-
Liquid Oxygen System (optional)-
Oxygen Manifold System with Automatic Control Panel
Oxygen Emergency supply system
Dr A.K.Khandelwal
8. Oxygen Manifold
It is the central supply room consists of cylinder manifold
and a control panel.
The manifold may be as small as two banks of 2 cylinders
each or as large as two banks of 20 cylinders each.
The control panel consists of primary and secondary
pressure regulators to ensure delivery of gas to the pipe
line at required pressure.(61PSI)
Dr A.K.Khandelwal
10. Normally a change over two to three times a week is
acceptable.
More frequent change indicate requirement for a bigger many
fold.
It is preferable that this room is located on the ground floor
and should have easy access to delivery vehicles. It should be
well ventilated and lit. For ease of handling of cylinders the
floor level should be at a height of one meter from the ground
level.
Dr A.K.Khandelwal
11. Oil or oil mist and other hazardous material should not
contaminate the surrounding atmosphere. No grease, oil
or naked flame should be used in the near vicinity and the
area should be a ‘No Smoking’ zone.
It should never be used to house compressed air and
vaccum unit
Dr A.K.Khandelwal
12. Fully Automatic Oxygen Control Panel
The Oxygen Control Panel shall be of microprocessor based
Digital Display Type..
Panel shall be Fully Automatic and shall switch over
from “Bank in Use” to ‘Reserve Bank’ without
fluctuation in delivery line pressure and without the
need of external electrical power.
The control panel incorporates six coloured LED’s,
Green for Bank in use,
Amber for Bank ready and
Red for Bank empty.
Dr A.K.Khandelwal
13. Alarm System
Two kinds of alarm are usually incorporated in system in
the centralized medical gas system.
One monitor the pressure it becomes red when pressure is
low.
The other alarm is remote signal lamp. It is preferably both
visual and audible.
Dr A.K.Khandelwal
14. Distribution piping
Copper pipes should be solid drawn, seamless, deoxidized, non
arsenical, half hard, tempered and degreased copper pipe
conforming to standards BS EN 1057.
When whole system is in place, pipe lines should be subjected to
a test pressure of 150 psi or one and a half times the working
pressure for 24 hours by means of oil free air or nitrogen to check
if it can withstand the required pressure as well as any
leakage..This test is called pressure lock test.
The isolation Valves will be made of Chromium plated brass and
Non Lubricated Ball type. All Valves shall be pneumatically
tested for twice the working pressure and Factory Degreased for
medical gas service Dr A.K.Khandelwal
15. Piping shall be protected against physical damage, corrosion
etc
Piping shall not be installed in kitchens or electrical
switchgear rooms. Avoid areas/corridors where movement of
equipment may cause physical damage. If unavoidable
protective shields to be used.
Correct size piping is one of the most important aspects to be
considered in designing system for central for medical gas
delivery system
Dr A.K.Khandelwal
17. Separate rooms are recommended for housing the Gas Control
Panels and other equipment. The room where Gas Control Panels
are kept is known as Manifold Room.
It is preferable that this room is located on the ground floor and
should have easy access to delivery vehicles. It should be well
ventilated and lit. For ease of handling of cylinders the floor level
should be at a height of one meter from the ground level.
A separate room called Plant Room should be used compressors
and vacuum pumps. This room should be in close proximity of the
Manifold Room.
Oil or oil mist and other hazardous material should not
contaminate the surrounding atmosphere. No grease, oil or naked
flame should be used in the near vicinity and the area should be a
‘No Smoking’ zone.
Dr A.K.Khandelwal
18. For ensuring uninterrupted supply two separate banks are used.
Gas from one bank is utilised at any point of time. The other bank
is kept as stand by or reserve.
A control panel installed between the two banks ensures that both
banks are not depleted simultaneously and the control of the
manifold automatically shift the flow of gas from the primary side
to secondary side when the primary bank pressure falls below the
set level. The control panel used should be built in accordance to
the international standards.
Dr A.K.Khandelwal
19. There should be a regulator for each cylinder bank to initially
reduce the cylinder pressure to the two line regulators that
control the final pressure. Both line pressure regulators should be
in service at all times.
The change over from the depleted bank to secondary bank
should be immediate with out fluctuation of line pressure.
Isolation of banks for ensuring on-line servicing is necessary.
The manifold should have intermediate and line pressure relief
valve.
Dr A.K.Khandelwal
20. Before the system is finally handed over the following tests
should be carried out:
1. Pressure drop test to ensure that there is no leakage in the
system.
2. Valve tightness and correct valve zoning.
3. Satisfactory mechanical operation and non-interchangeability
of each terminal outlet y means of probes.
4. Anti-confusion test for checking cross connection.
5. Flow rate and pressure at each terminal outlet.
6. Change over mechanism of Gas Control panels.
7. Satisfactory performance of compressors, vacuum pumps and
WAGD.
8. Performance of alarm system
Dr A.K.Khandelwal
21. TERMINAL UNITS
The pipe line ends in the terminal units:
Wall Outlets- self sealingvalve at outlet point is fixed to
the wall and is encased in a small rectangular shaped boxed
labeled and colored for instant identification.
Its use is established as soon as a safety key plug connector
is inserted in to it. It should be atleast 20 cm away from
electrical fitments.
Dr A.K.Khandelwal
22. Ceiling Pendents :It reduces floor congestion.
Pendants for OT
It accommodate the following:
Up to 10 Gas Service outlets in any desired sequence.
Up to 10 Hospital Grade electrical Outlets (Indian type).
Any Combination of Ground Jacks, Computer Outlets,
communication Devices, Slides and IV Hooks.
Hose for scavenging system.
Dr A.K.Khandelwal
24. Pendant for ICU
It accommodates Provision for 5 gas outlets, 8 electrical
outlets, selves with drawer system and side rails,
Examination lamp and basket for suction catheters and
monitor cables.
Quadruple infusion management system
Dr A.K.Khandelwal
25. Gas Outlets
Outlets shall be manufactured with a 165 mm long Copper inlet
pipe stub which is silver brazed to the outlet body. The inlet pipe
stub should be capable of swiveling by 360 degrees. Body shall
be 33 mm diameter one-piece brass construction.
For positive pressure gas services, the outlet shall be equipped
with a primary and secondary check valve and the secondary
check valve shall be rated at minimum 200 psl in the event the
primary cjeck valve is removed for maintenance.
Outlet bodies shall be gas specific by indexing each gas service
to a gas specific dual pin indexing arrangement on the respective
identification modula.
Dr A.K.Khandelwal
26. Safety measures for medical gas delivery system
a.Safety valves provided to be set at 1.5 times the working pressure
b. Locknut provision on regulators for preventing inadvertent high-
pressure settings
c. Two stage regulators for avoiding fluctuation in flow
d. Line pressure alarms for continuous monitoring pipeline pressure
e. Gas specific color-coding in each pipeline
f. Gas specific color-coding on cylinders.
g. Specific color-coding on each outlet
h. Non-interchangeable adaptor for each outlet
Dr A.K.Khandelwal
27. VACCUM UNIT
It is used in treatment are,OT, Surgery ,laboratory
It consist of electrically driven vaccum pump to create a
pressure much lower than atmospheric pressure in reservoir
tank which could be 3 meters in height.This vaccum creates a
suction effect at out lets unit
The reservoir tank stabilizes vaccum pressure in the pipe line
between-305mm to 635mm. Of mercury at all out lets
Dr A.K.Khandelwal
28. Vacuum (suction) system
Vacuum system shall be stack mounted ---------------- cfm capacity. (as per
requirement of the hospital)
Dr A.K.Khandelwal
29. COMPRESSED AIR UNIT
It is used for inhalation therapy, to run ventilators,orthopedic and
dental drills, other Pneumatic tools.
It consists of an electrically driven air compressor.Water is
required for cooling the compressor.Air pressor at compressor is
about 100-118PSI and this reduced to58-61PSI for use at patients
end.
Dr A.K.Khandelwal
31. LIQUID OXYGEN SYSTEM
It is economical for superspecility hospital with beds above
200,where weekly oxygen consumtion more than10,000Lt.
The equipment is designed with sufficient safety to store
cryogenic liquid oxygen,transform it to gaseous form and
supply it at a pressor consistent with medical requirement.
The liquid oxygen tank should have capacity for 6 days.
Liquid oxygen is replaced by tanker carrier.
Dr A.K.Khandelwal
33. Oxygen cylinders available
Size
Cubic meter
Quantity
cc
Price of
Empty
Refill charge
Rs
0.75 750 4500 70
1.5 1500 5000 80
7 7000 7500 125
10 10000 8000 180
Dr A.K.Khandelwal
34. Pressure Monitoring of Filled up Cylinder-
It should be 120-130 kg/Sq cm in Summer.
It should be 120 kg/Sq cm in Winter.
Pressure in Pipe line should be 4kg/Sqcm/60 PSI
Dr A.K.Khandelwal