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  • medical gas cylinders

  • oxygen supply systems

There are many things that are a part of our lives, both personal and professional, that we take for granted. When we turn on the faucet, we expect water to come out; when we turn on the TV, we expect there is electricity flowing through the wires in the room so the TV comes on; and when we turn on an oxygen flowmeter, we expect oxygen to be there as well. But how does the medical facility in which you train or practice ensure that there is oxygen available when you turn on the flowmeter? Many of us might understand how we get the water to the tap or the electricity to the outlet better than we understand where the oxygen we use in great quantities every day comes from.

As a clinician, you will use much more oxygen in a day than you use water—did you ever think of that? So, it is a good idea to talk about where the medical gases we use get to the outlet for us and what would happen and what you would do if that supply was interrupted. Don’t assume that somebody else will know what to do. It’s your responsibility.

When we discuss medical gases, the big one is, of course, oxygen. We have the ability on our anesthesia machines to use oxygen from two different sources—cylinders and the hospital pipeline (wall) source. But you should remember that unless you always use cylinders of nitrous oxide and medical air, these two gases for your anesthesia machine come from the hospital supply as well.

In this chapter, we will discuss the systems that facilities use to supply oxygen, nitrous, and air via pipelines as well as some potential problems that can happen. We will also talk about how medical suction is generated and distributed throughout a building.


Oxygen supplied through a medical pipeline system can have two sources: it can originate from a collection of large cylinders, or it can come from a liquid oxygen storage system. Smaller facilities, such as an outpatient surgery center that is not a part of a larger health care campus, will likely have a group of large oxygen cylinders as the source of pipeline oxygen. Hospitals, which will use thousands of liters of oxygen a day, use bulk liquid oxygen to supply their needs. We will discuss both kinds of sources.


In this setup, a group of “H” cylinders of oxygen will be attached to each other through a common manifold. The number of cylinders involved depends on the oxygen consumption of the facility—there can be as few as two or as many as the facility needs. There is a one-way valve between each tank and the common manifold, so ...

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