The document provides a comprehensive overview of medical gases, detailing their types, identification, equipment used, and safety protocols. It highlights the roles of pharmacists in managing these gases and outlines various applications like oxygen therapy, anesthesia, and medical air distribution systems. Additionally, it addresses safety measures for handling and storage, emphasizing the importance of maintaining proper procedures to prevent accidents.

2. Medical Gases
Made By:
- Mustafa Kasem 201902021
- Momen Ahmed 201900588
- Mahmoud Abdelmonem 201902003
- Mark Naseem 201902600
- Zainab Mahmoud 202003984
- Ranem Maged 201901158
- Ahmed Mustafa 201902501

3. Table of contents
• What are medical gases ?
• Medical gases Identification
• Equipment used
• Uses of medical gases
• Safety and handling
• Distribution system
• Storage

4. Role of pharmacists ?!!
As a medicinal product Cylinder stock
Pipeline system
Supervision, and ordering Expiry checking and storage

5. What are medical gases ?

6. What are medical gases ?
• Any gas that is used for treatment, anesthesia or
operating a medical device

7. What are medical gases ?
• There are 7 kinds of gases that are commonly used
Oxygen Nitrogen Nitrous oxide
Argon Helium CO2
Compressed
air

8. Medical gases Identification

9. Medical gases Identification

10. Medical gases Identification

11. Medical gases Identification

12. Medical gases Identification

13. Medical gases Identification

14. Equipment used

15. Equipment used
1- Medical gas regulator “Oxygen regulator”
• intended for the administration of high level oxygen to
patients to improve their conditions
• Should be opened slowly “to avoid burning out of oxygen
cylinder”

16. Equipment used

17. Equipment used
2- Medical gas pipeline system “MGPS”
• Key element for every hospital
• provides vital medical gases for patient ventilation and
various clinical applications

18. Equipment used
3- Cylinder manifolds
• A cylinder manifold is a group of gas cylinders, commonly
used to supply gases via a pipeline
• Cylinders are grouped into a primary and a secondary
bundle
• When the gas of primary manifold is totally consumed,
secondary manifold takes the upper hand to provide gas
allowing the primary manifolds cylinders to be exchanged

19. Equipment used
4- Oxygen therapy equipment
a) Nasal cannulae
• Deliver 24-30% oxygen
• Flow rate 1-4L/min (4L will dry the nose, 2L is more
comfortable)
• Used in non-acute situations or if only mildly hypoxic

20. Equipment used
4- Oxygen therapy equipment
b) Non-rebreather mask
• Delivers 85-90% oxygen
• Flow rate 15L/min
• Has a bag on mask with valves to stop almost all rebreathing of
expired air
• Used for acutely unwell patients
- Note that saturations should be maintained at 94-98%, not 100%.
- Do not keep patients on 15L/min for longer than necessary as
over-oxygenating for prolonged periods can be harmful

21. Equipment used
4- Oxygen therapy equipment
c) Non-invasive ventilation (CPAP/BiPAP)
• CPAP (continuous positive airways pressure)
- High pressure air/oxygen with a tight-fitting mask
- Positive pressure all the time to help keep airways open (split
them)
- Used in acute pulmonary oedema and sleep apnoea

22. Equipment used
4- Oxygen therapy equipment
c) Non-invasive ventilation (CPAP/BiPAP)
• BiPAP (bilevel positive airways pressure)
- High positive pressure on inspiration and lower positive
pressure on expiration
- Used in acute pulmonary oedema and sleep apnoea

23. Equipment used
4- Oxygen therapy equipment
d) Simple Mask
• Fits over the mouth and nose of the patient and contains
exhalation ports
• Flow rate: 6-10 L/min
• flow rate should never be set below 6 L/min because this can
result in the patient rebreathing their exhaled carbon dioxide

24. Equipment used
4- Oxygen therapy equipment
d) Simple Mask
• Advantages: provide moderate oxygen concentrations
• Disadvantages: must be removed when eating, and they may
feel confining for some patients who feel claustrophobic with
the mask on

25. Equipment used
4- Oxygen therapy equipment
e) Venturi Mask
• For patients who require a specific amount of
supplemental oxygen to avoid complications, such as
those with chronic obstructive pulmonary disease (COPD)
• Flow rate: The flow rate depends on the adaptor and
does not correspond to the flow meter

26. Equipment used
4- Oxygen therapy equipment
e) Venturi Mask
• Advantage: A specific amount of oxygen is delivered to
patients whose breathing status may be affected by high
levels of oxygen
• Disadvantages:
- Risk of suffocation if the gas flow is interrupted
- The bag should never totally deflate
- The patient should never be left alone unless the one-way
valves on the exhalation ports are removed

27. Uses of medical gases

28. Uses of medical gases
• It is important to divide what are medical gases, such as
oxygen and nitrous oxide, supplied to patients in gaseous
form, and gases used as medical devices, for medical care
units, as facilitators or adjuncts.
• The difference is that only medicinal gases considered as
drugs exert their action by pharmacological, immunological or
metabolic means.

29. Uses of medical gases
1) Nitrogen (medical liquid nitrogen):
• Nitrogen is a colorless, odorless, non-toxic, non-flammable gas. It’s
a medical gas used for the cryosurgical removal of some cancers
and skin lesions.
• It is in liquid form and at very low temperatures, so it is also used
to store and freeze tissues, cells and blood at cryogenic
temperatures to prevent oxidation of samples.
• For example, the pharmaceutical industry uses this medicinal gas in
the manufacture of medicines.
• Gaseous nitrogen, the largest component of our atmosphere, is
used in medicine mainly to propel surgical tools.

30. Uses of medical gases
2) Medicinal Oxygen:
• Oxygen is the most basic gas for life, and it is used medically to
supplement oxygen to oxygen-deficient patients. Direct inhalation of
high purity oxygen is harmful to the human body.
• Odorless, colourless and tasteless, it is used for resuscitation and
inhalation therapy.
• It is also used in anaesthesia before any intervention, in the
treatment of burns or in hyperbaric therapy to treat numerous
diseases.
• Long-term use of oxygen concentration generally does not exceed
30-40%.
• Ordinary patients breathe oxygen through oxygen flowmeter;
critically ill patients breathe oxygen through the ventilator.

31. Uses of medical gases
3) Carbon dioxide:
• Medically, carbon dioxide is used to inflate the
abdominal cavity and colon for laparoscopy and
colonoscopy. In addition, it is also used for
laboratory culture of bacteria (anaerobic bacteria).
• Carbon dioxide can be made into dry is used for
cryotherapy to treat cataracts and vascular diseases.

32. Uses of medical gases
4) Nitrous oxide:
• It is known as “laughing gas”.
• Inhalation of a small amount of nitrous oxide has an
anesthetic and analgesic effect, but a large amount
of inhalation can suffocate people. Medically, a
mixture of nitrous oxide and oxygen is used as an
anesthetic agent

33. Uses of medical gases
5) Medicinal air:
• Mainly used in ICU and NICU areas because it
allows for the mobilisation of compressed air
driven respirations, or as a diluent for
administered O2, since O2 in concentrations of
100% is toxic to the body.
• Compressed air is used to deliver power to oral
surgical instruments, orthopedic instruments,
and ventilators.

34. Uses of medical gases
6) Helium, Argon
• They are colorless, odorless, non-toxic inert gas.
Medically used for argon gas knife, gas knife, and
other surgical instruments. its application is
focused on the diagnosis of diseases through
magnetic resonance imaging, since MRI
equipment needs liquid helium to maintain a low
temperature that allows the superconductivity of
the magnets

35. Safety and handling

36. Safety and handling
• Medical gas cylinders are very heavy and contain contents
that are under a large amount of pressure. This means that
improper handling is likely to cause a serious accident.
• Additionally, different gases can also present unique risks.
Medical oxygen, for example, is extremely flammable and
must be kept away from combustible materials and heat
sources. Other medical gases may cause asphyxiation,
embolism, poisoning..

37. Safety and handling
Keep in a safe
position
(either in a stand or
clamped vertically)
Keep free of
sources of ignition
Never knock
violently or allow
to fall

38. Safety and handling
Keep free of oil
and grease
Do not use force
when opening or
closing valves
Check cylinder for
unique barcode

39. Safety and handling
Read labels before
use
Keep full and
empty cylinders
separate
Wear safety
clothing to prevent
personal injury
Store in well
ventilated
areas

40. Safety and handling
• Just prior to connecting the equipment, momentary
opening of the cylinder valve blows away any dust or
particles. This is known as “snuffing” or “Cracking.

41. Safety and handling
• Always be aware of your cylinder; listen for sounds of
leaking gas and inspect regularly for signs of damage
• Check for leaks: By a hissing noise OR by using a little soapy
water which will produce bubbles if there is a leak
• Report a leak as soon as possible

42. Safety and handling
• During use: The pressure should be checked regularly to
ensure that there is sufficient gas remaining.
• After use: The valve should be closed immediately

43. Distribution system

44. Distribution system
• Medical Gas Pipeline System (MGPS) is installed to provide a
safe, convenient and cost-effective system for provision of
medical gases to the clinical and nursing staff at the point-of-use
for patients. It reduces the problems associated with the use of
gas cylinders such as safety, storage and
• The pipeline distribution system is an integral part of all medical
Gas Management Systems. It serves to bring all required medical
gases and vacuum to areas where they are needed. Without a
properly designed, installed, and maintained distribution system,
the security of the whole hospital can be at risk.

45. Distribution system

46. Distribution system
Various gases / services covered of medical gas distribution
system
• Oxygen
• Nitrous oxide
• Anesthesia gas
• Medical air
• Nitrogen
• Surgical Air
• Carbon dioxide
• Mixed gas

47. Distribution system
Various gases / services covered of medical gas distribution
system

48. Distribution system
Various gases / services covered of medical gas distribution
system

49. Distribution system
Compressed Air Plants
• Compressed Air Plants are used to provide Compressed
Medical grade Air under in bulk quantity at constant
pressure through a piped system for use inside a hospital.

50. Distribution system
Vacuum Plants
• Vacuum plants provide bulk vacuum through a piped
system for providing vacuum at patient locations and in
operation theatres for running medical equipment.

51. Distribution system
AGSS/ WAGD Plants
• AGSS / WAGD plant system also called gas scavenging
system is required for disposal of waste anesthetic gases
from inside the operation theatres to outside atmosphere.

52. Distribution system
Adapters
• Adaptors are devices used to quick-connect the medical
gas supply at gas or vacuum outlets to the patient using
compatible media.

53. Distribution system
Flow meters
• Flow meter is an instrument used to measure the flow rate
of the incoming medical gas supply at user end.

54. Distribution system
Zonal Valve Box
• Zonal valve boxes are required to cut-off the supply of gasses
inside hospital premises when required. PES supplies single
and multiple zone valves boxes which are NFPA 99 compliant.
These have competitive features such as:

55. Distribution system
Medical Gas Colour LCD Touch Screen Area Alarms

56. Distribution system
Medical Gas Colour LCD Touch Screen Area Alarms
• Identification of gas and alarm conditions via 5.7" Colour LCD
• Touch screen operation
• User defined password based activation
• Audio- visual indications
• Adjustable settings

57. Storage

58. Storage
• Medical gases are stored in specialized cylinders. Cylinders
should be stored, handled, and used in accordance with a
strict code of practice prepared by the British Standards
Institution (BS 1319) to minimize any risks associated with
their use
• In most hospitals rather than cylinders, a pipe system is
employed

59. Storage
• Medical gas cylinders need to be stored in cool dry conditions
to avoid rusting and damage to the paint
• Care is required to ensure that there is no confusion between
full and empty cylinders. This may be achieved by the use of
disposable shrink seals and marking empty cylinders clearly

60. Storage
Oxygen storage
• Medical oxygen can either be stored in cylinders or in vacuum
insulated evaporators (VIE). Oxygen cylinders have a black body and
white shoulders and contain gaseous oxygen at a pressure of 13,700
kPa at room temperature. Oxygen cylinders may be made of a
variety of materials, but typically molybdenum steel is used to allow
for higher filling pressures although it is heavy and less portable.
Aluminium cylinders are 25_40% lighter and suitable for use in MRI
scanners. Cylinders are hydraulic and endoscopically tested on a
regular basis (10 years for steel cylinders) with the date of the next
test indicated by a plastic ring around the neck of the cylinder

61. Storage
Nitrous oxide storage
• Nitrous oxide is stored in blue cylinders at a gauge pressure of
4400 kPa in both liquid and vapour forms. As the cylinder
empties, a constant pressure of 4400 kPa is maintained by
evaporation of liquid until it is all depleted.

62. Storage
Entonox storage
• Entonox is stored in cylinders with a blue body and blue/white
quarter shoulders, at 13,700 kPa in its gaseous form.
• Note careful storage of Entonoxis essential because of the risk
of separation of the nitrous oxide and oxygen below its
pseudocritical temperature. Pseudocritical temperature refers
to the temperature at which a mixture of gases will separate
out into its constituent parts. Entonox separates into nitrous
oxide and oxygen at 5.5C at 117 bar, 7C at 137 bar (cylinder
pressure) and 30C at 4 bar

63. Storage
Carbon dioxide
• Its liquid form at a pressure of 5000 kPa with a filling ratio of
0.76

64. Storage
Heliox
• Heliox is a mixture of 21% oxygen + 79% helium and produced
by fractional distillation of natural gas. Heliox is stored in
cylinders with a black body and white/brown quarter
shoulders at a pressure of 13,700 kPa in its gaseous form

65. References

66. References
• https://tediselmedical.com/en/the-use-of-medical-gases-in hospitals/
• https://www.chthealthcare.com/blog/5-common-med-gas
• https://www.amcaremed.com/knowledge/types-uses-medical-gases/
• https://www.sps.nhs.uk/articles/pharmacy-responsibilities-and-medical-gases-
oxygen-and-the-covid-19-pandemic/
• https://oxfordmedicaleducation.com/prescribing/oxygen-delivery/