Center for Improvement in Healthcare Quality Newsletter
June 2022

CIHQ-ARS Blog

Emergency Oxygen Connection Readiness

By: Don Roush
The pandemic we have been working through over the past year has tasked most of our staff, as well as our mechanical systems. For example, oxygen demand has increased tremendously to keep pace with the increased usage. The units that supply the oxygen have in many cases been driven to their operating limits. It is interesting that most people are not aware of what oxygen supply units do and take them for granted. How well would the hospital respond to this demand if the bulk oxygen system were to be interrupted? That is where emergency oxygen supply connections (EOSC) come into play. The EOSC system is a vital part of maintaining the oxygen supply to the hospital in the event the bulk system is interrupted.
The EOSC’s are located outside of the hospital remotely from the bulk oxygen system and piped directly to the main oxygen pipeline through a one-way valve. However, if you need to use the EOSC you simply cannot pick up the phone and call a company that supplies oxygen and have them bring in one of their trucks to hook up to your EOSC. Why you ask? These trucks are filled with liquid oxygen and are not compatible for direct connection to a piped system without a disastrous outcome. Simply put, a bulk oxygen system involves changing stored liquid oxygen into usable gaseous oxygen. So, how do you prepare for emergency gaseous oxygen to be available for use in your hospital?
Essentially, if you want to use your EOSC you need to plan. By doing so you can effectively get emergency oxygen into the hospital using your EOSC connection. There are several options for your hospital. One option to consider is the use of portable oxygen units mounted on a trailer. These units are designed to convert liquid oxygen into usable gaseous oxygen that can be piped directly into your EOSC connection. This sounds like a great option until you discover that:
  • There are not many of them available
  • Depending on where you are located, they may need to be shared over a large geographical area or between several states
  • They will need to be filled once they arrive at your hospital, since most of them are not rated to transport liquid oxygen on the highways
  • Once the unit is filled, it will need to be tested to ensure that it is safe for patient use
Another type of portable unit that can be used with EOSC’s is what is referred to as a “dewars”. Dewar’s are cryogenic liquid containers and most of them have a vaporizer installed inside the tank to convert the liquid into a gas. These units generally can be delivered quickly, however, the size of the internal vaporizer restricts the flow of gas. If your hospital uses a large amount of oxygen, the unit may not be able to feed oxygen to the hospital fast enough to keep up with demand due to the limited size of the internal vaporizer that restricts the flow of gas. If you are lucky and have an emergency manifold that consists of a vaporizer and regulators built to connect directly to the liquid side of the dewar and then connect to the EOSC, it may be possible that you can provide adequate oxygen supply to the hospital.
Another way to supply oxygen to the hospital using the EOSC connection is with high-pressure cylinders. Even though these cylinders are readily available there is a limit on the amount of oxygen they can supply. Also, you need to ensure that you have the proper hose connections and regulators to properly connect the cylinder manifolds to the EOSC connection.
Large 18-wheeler units called “tube trucks” can also be used. As with the high-pressure cylinders you will need to verify that you have the proper hose connections and regulators and that the tube truck suppliers’ requirements for use are met. In addition, the medical gas supplier may require the same clearances and concrete pad as if it were the bulk tank itself.
To assess if an emergency oxygen source may be needed, organizations should conduct an analysis of the amount of oxygen used daily. Once this is calculated, contact a portable oxygen supplier, and determine what units would be available to meet your hospitals daily demands. Be sure when you perform this evaluation you use data during a specific period when oxygen usage is greatest. Also, having a contractual agreement is a good idea but be sure to investigate all potential medical air suppliers that could meet your demands.
Remember, no matter what supplier you use in an emergency, you must be able to get oxygen from the device into the EOSC. By preparing for such an emergency you can ensure that the oxygen supplier has the correct regulators, hoses, valves, and piping. You will also need to ensure that the location of your EOSC will support the regulatory requirements of the supplier’s vehicle used to supply oxygen to your hospital. Your bulk oxygen supplier is one of the best places to start this process. They will let you know if they support your EOSC connection, and if not, in most cases can direct you to someone who can.
When you think about it, the average person can only hold their breath for about 30-90 seconds, and this is one statistic you do not want to test in the event your oxygen supply is interrupted. You will want to plan if you intend on getting needed oxygen to the hospital in the event your bulk oxygen system in interrupted in an emergency.
View Other CIHQ-ARS Blog's at CIHQ-BLOG.org