The document provides comprehensive information on the components, installation, handling, and types of oxygen storage devices, including details about various oxygen cylinders, their specifications, and safety measures. It outlines the pros and cons of using oxygen cylinders in medical settings and includes precautions for handling and troubleshooting common issues. Additionally, it emphasizes oxygen inventory management and calculations for determining the required capacity based on patient needs and gas supply availability.

1. Reaching Impact, Saturation, and
Epidemic Control (RISE):
Oxygen Cylinders
Date

2. Session 2: Components, Installation,
And Handling Of Oxygen Cylinder
REACHING IMPACT, SATURATION, AND EPIDEMIC CONTROL (RISE)

3. Types of Oxygen Storage
Devices

4. Different Sources Of Medical Oxygen
Clinical
application
and/or use
case
Can be used for all
oxygen needs, including-
high-pressure supply;
facilities where power
supply is intermittent or
unreliable; ambulatory
service or patient
transport; backup for
other systems.
Used to deliver oxygen at
the bedside or within close
proximity to patient areas.
A single concentrator can
service several beds
Can be used for all
oxygen needs,
including high-
pressure supply.
Can be used for all oxygen
needs, including- high-
pressure supply and in
facilities where power supply
is intermittent or unreliable.
Appropriate
level of health
system
Primary, secondary,
possibly tertiary (any
medical unit requiring
oxygen).
Primary, secondary,
possibly tertiary (any
medical unit requiring
oxygen).
Secondary and
tertiary.
Secondary and tertiary.
Cylinders Concentrators Oxygen plant
(PSA)
Liquid oxygen

5. Types of Oxygen Cylinders

6. B-Type Small Medical Oxygen Cylinder (1.5 CU.M.)
• B-type high pressure seamless cylinder for medical
oxygen gas, cylinder is ISI marked conforming to
IS:7285 part 2, certified by the Bureau of Indian
Standards (BIS) and approved by the chief
controller of explosive (CCOE) Government of
India.
• Cylinder made from manganese steel.
• 10.2 litre. Water capacity (40 cu.ft.).
• Valve made of brass and chrome plated.
• Working pressure 150 kg. F/cm at 15 deg. C.
• Hydraulic test pressure 250 kg. F/cm .
• Colour code of the cylinder should be as per IS:
3933-1966 with updating till date.
• Filled with medical oxygen gas of medical grade.
• Matching key cum spanner to release oxygen for
each cylinder separately.
• Minimum two years guarantee for cylinder.
Oxygen Cylinder Type B & D
D-Type Jumbo Medical Oxygen cylinder (7
CU.F.M.)
• Cylinder made from manganese steel.
• 46.7 Litre. water capacity (220 CU.FT.).
• Valve made of brass and chrome plated.
• Working pressure 150 Kg. f/cm at 15 deg. C.
• Hydraulic test pressure 250 Kg. f/cm .
• Filled with medical oxygen gas of medical
grade.
• Matching key cum spanner to release oxygen
for each cylinder separately.
• Minimum two years guarantee for cylinder.
B D

7. Oxygen Cylinder Types
Cylinders type
(Gaseous Medical
Oxygen)
Dura Cylinder
(Liquid Medical Oxygen)

8. Gaseous Oxygen
Cylinders
• Oxygen gas can be compressed and stored in
cylinders.
• These cylinders are filled at a gas manufacturing plant,
either via a cryogenic distillation/ASUs in liquid oxygen
form or a process known as pressure swing adsorption
(PSA) in gaseous oxygen form or by an LMO-based re-
filler and transported to health facilities to be
connected to manifold systems (groups of cylinders
linked in parallel) that are piped to areas of the health
facility; or cylinders can be used directly within patient
areas.
• Cylinders do not require electricity, but they do
require several accessories and fittings to deliver
oxygen, such as pressure gauges, regulators,
flowmeters, and, in some cases, humidifiers.
• Cylinders also require periodic maintenance,
commonly provided by gas suppliers at the point of
refilling.

9. Cryogenic Liquid
Cylinders
(Dura Cylinder)
• Cryogenic liquid cylinders are insulated,
vacuum-jacketed pressure vessel
• They are equipped with pressure relief
valves and rupture disks to protect the
cylinders from pressure buildup.
• Liquid containers operate at pressures in the
range of 100 psig to 350 psig (24 atm) and
have capacities between 80 and 450 liters of
liquid
• Oxygen may be withdrawn as a gas by
passing liquid through an internal vaporizer
or as a liquid under its own vapor pressure

10. Cylinder Naming &
Sizing
• Oxygen cylinders are of different sizes.
• Cylinder sizes for medical gases are named alphabetically,
unlike industrial cylinders which are numbered.
• In India most commonly used cylinders are D type (Jumbo)
and B type (Portable) cylinders which contains gaseous
oxygen. Dura cylinders with liquid oxygen are also used in
the region.
• Cylinders are fitted with customized valves (either pin index
or bullnose type) that are opened with valve keys, and with
valve guards for safety.
• The Pin Index Safety System (PISS) is designed to ensure the
correct gas is connected to the regulator or other
equipment.
• The arrangement of the pins is unique for each gas, and the
positions of the holes on the cylinder valve must correspond
with the pins to prevent the use of the wrong gas.
• Some cylinders have built-in, integral pressure regulators,
which do not require a separate pressure regulator to be
fitted to the cylinder valve before use.

11. Color Coding for Gases

12. All cylinders are marked by different colors based on the type of gas; it is
important to note that there are two parallel tank coloring systems in place (US
and ISO):
Color Coding For Gases

13. Cylinder Labelling

14. Cylinder Labelling
• Medical gas cylinders are required to be
labelled, as the primary means of identifying
the contents of the cylinder. The colors of the
cylinder is only a guide.
• Labels for gas cylinders can be reduced in size
and shape to the dimensions specified in ISO
7225 – Gas cylinders – Precautionary labels.
• The figure is an example of a typical label.

15. • Diamond hazard label: displaying the primary hazard
with additional hazard labels displaying any
subsidiary hazards. These labels will display the
dangerous goods classification number.
• UN number: preceded by the letters UN. The UN
number is a number assigned by the United Nations
Committee of Experts on the Transport of
Dangerous Goods. The UN number for compressed
oxygen is UN 1072.
• Proper shipping name.
• Product name (may be omitted if the proper
shipping name is identical).
• Signal word, hazard and precautionary statements.
• EC number (if applicable).
• Package size and pressure.
• Company name.
• Address of the gas company.
• Additional company information.
• Contact telephone number.

16. Pros and Cons of Oxygen
Cylinders

17. Oxygen Cylinder – Pros And Cons
Pros
• Installation does not
need permission from
any authority like
Petroleum and Explosives
Safety Organization
(PESO).
• Space accommodating as
construction is long and
linear.
• Easy setup, can also be
used bedside without
medical gas pipe system.
Cons
• Recommended as
primary source for small
size hospital up to 30
beds.
• Not recommended
(specially in current
pandemic) as primary
source to ICU's.
• Erratic supply chain.
• Chances of carrying
infection.

18. Precautions Handling
Oxygen Cylinders

19. General Handling
•Personal protective equipment should be worn when handling oxygen cylinder
•All compressed medical oxygen gas cylinder should be secured to racks, walls,
work benches or hand trolleys by a strong chain or strap
•Secure in an upright position
•Do not drop cylinders or allow sharp impacts on cylinders
•Cover the top of oxygen cylinder with the cap when not in use or when being
transported
•Set up the cylinder at a safe distance from the patient

20. General Handling
•Do not place cylinder on a patient’s bed
•Disconnect the cylinder from regulators or manifolds before moving the cylinder
by applying protective valve caps
•Cylinder should be moved only on a hand truck or other cart designed
•No more than one cylinder should be handled at a time
•All medical gas cylinders should be clearly labelled to identify the contents
•All defective gas cylinders or equipment should be reported immediately to the
supplier for correction or replacement

21. Storage
•Physically separate full and empty medical gas cylinders
•Ambulatory organizations can do using separate racks, physical barriers
or by colors coding the storage rack
•Label the cylinder clearly to avoid confusion and delay in selecting the
cylinders
•Store in well- ventilated, clean, dry conditions, not exposed to extreme
of heat or cold
•Do Not use oil or grease on the valve of cylinders or regulators/ gauges
•Never use a single use and/ or re-use an industrial gas cylinder for
refilling medical oxygen

22. When And How To Change A Cylinder
• Gas cylinders should only be transported with their protective metal cap in place,
using a cylinder trolley where available.
• Be sure that the cylinder contains the right gas.
• The tank valve must be closed and the pressure has to be released completely
before disconnecting the regulator.
• The valve must not be damaged and must be free of dirt, dust, and grease.
• When the regulator has an O-ring, check if it is correctly in place and not damaged.
• Do not use Teflon tape on the high pressure side.
• Use the right spanner key/ spanner to tighten/loosen the pressure regulator.
• Do not use too much force. Never use a longer lever or a hammer to tighten a
regulator. The regulator will tighten itself further under pressure.
• Open the cylinder valve slowly.
• Check for leaks around the regulator. Listen to hissing sounds. After closing the
cylinder valve, the pressure shown on the pressure gauge should remain stable.

23. Fire Safety
• Ensure appropriate fire extinguishers to be kept nearby and regularly
inspected
• Keep oxygen cylinder at least several meters from a heat source, open
flames, electrical devices or other possible source of ignition
• Put a “No Smoking” sign near oxygen sources in the hospital
• Check for electrical circuit breakers and devices are in safe working
condition and free from sparking to prevent a serious fire occurrence.

24. Precautions During Equipment Handling
• Handle cylinders carefully, move in
trolley
• Keep cylinders clamped or chained
to prevent from falling over
• Only store as many cylinders as
needed; return empties to
suppliers
• Open valves slowly and in correct
order
• Close valve when not in use
• Never insert an object into cap
openings
• Use an adjustable strap wrench to
remove over-tight or rusted caps
• Install valve- protection cap
• Store full and empty containers
separately
• Protect cylinder from physical
damage
• Never attempt to lift a cylinder by
its cap
• Use a first-in, first out inventory
system

25. Do’s Don’ts
 Ensure a regulator is fitted before use
 Ensure cylinder is firmly secured
 Ensure connections are tight and suitable
 Ensure cylinders are stored and used away from
sources of ignition (no smoking!)
 Store full and empty cylinders separately
 Ensure valve guards or caps are fitted when
cylinders are not in use
 Use mechanical assistance when handling
cylinders (e.g. trollies)
 Repaint a cylinder
 Change the markings on a cylinder
 Use oil or lubricants on cylinder valve
 Tamper with the gas cylinder test tag
 Tamper with or remove the barcode from a cylinder (if
applicable)
 Roll cylinders along the ground
 Attempt to fight a fire involving a gas cylinder
 Transport gas cylinders in the passenger compartment
of a vehicle
 Use a cylinder that shows evidence of damage or
corrosion
 Fill cylinders with any material
Cylinder Safety

26. REACHING IMPACT, SATURATION, AND EPIDEMIC CONTROL (RISE)
Duties Of Medical
Staff

27. REACHING IMPACT, SATURATION, AND EPIDEMIC CONTROL (RISE)

28. • Bodok seals – is a particular type of washer/seal that functions with the pin-
index system to ensures a gas-tight seal between the cylinder yoke and
regulator set.
• Normal rubber washers
• O-rings
• Keep all broken gauges or complete regulators in your workshop, as it is
often possible to make one functioning out of two damaged ones.
• Hoses – best quality, reinforced with fabric if possible. Rubber or plastic
tubes become brittle with age and develop cracks. Often it happens at the
ends of the hose where there is an adapter or fitting. This broken part can be
cut off and the part in good shape can be refitted.
Troubleshooting Of An Oxygen Cylinder

29. Oxygen Cylinder And Associated
Accessories (Common Problems And
Troubleshooting Guide)

31. In small groups, discuss how you would troubleshoot faulty cylinders and
flowmeters.
• No oxygen is flowing.
• Leakage from cylinder or flowmeter.
• Leakage cannot be located.
• Flowmeter ball not moving, yet oxygen is flowing
• Pressure gauge does not show pressure, yet oxygen is flowing.
• Outlet pressure slowly increasing, unable to close valve on pressure
regulator completely.
Please note what tools you would use for this PPM/ Troubleshooting
Practical Session – Troubleshooting
Oxygen Cylinders And Flowmeters

32. Medical Gas Rule, 2016

33. Medical Gas Rule, 2016
REACHING IMPACT, SATURATION, AND EPIDEMIC CONTROL (RISE)

34. Session: Oxygen Inventory Management
REACHING IMPACT, SATURATION, AND EPIDEMIC CONTROL (RISE)

35. Oxygen Calculation

36. • To understand the capacity of oxygen available in the facility
• To determine the total litre per minute requirement in given circumstances
• Helps understand complex conversion from Metric Ton to Kilo Litres, Kilo Litres
of liquid oxygen to gaseous state of oxygen.
Oxygen Calculation

37. 1 CuM (m3
)= 1,000 litres (Gaseous O2)
1 Metric Ton (MT) = 770 CuM (m3
) = 7,70,000 liters (Gaseous O2)
1 Metric Ton (MT) = 876 litres of Liquid Oxygen
1 KL Liquid O2 = 877.8 CuM
1 Litre Liquid O2 = 861 litres of gaseous O2
Conversion Table

39. Calculating Oxygen
Requirement

40. Oxygen Requirement (Bed Strength)

41. Daily Oxygen Consumption
(Based On Active Cases)
As per the state trend/average total 12% of total active cases need medical oxygen support out of which 8% on O2 beds and 4% on ICU
beds. District/Facility can use the actual percentage as per their patient data on oxygen support requirement.

42. Calculating Oxygen Sources

43. Gaps To Be Addressed For Oxygen Supply
Gaps in O2 supply = Total oxygen required (X+Y) – Total availability (A+B+C+D+E) in m3

44. Daily Oxygen Calculations: Based on output sources
Devices
Daily Oxygen Calculations: Based on
Output Sources
Non- Rebreather mask

45. Daily Oxygen Calculations: Based on
Oxygen Storage

46. Operation Medical Gas Pipeline System

47. Thank You!
This presentation was made possible with support from the United States Agency for
International Development funded RISE program, under the terms of the cooperative
agreement 7200AA19CA00003. The contents are the responsibility of the RISE program
and do not necessarily reflect the views of USAID or the United States Government.​