How to Fine-tune the Management of Medical Gases?

Medical gases are widely used in hospitals, some are directly used for clinical treatment, some are used for powering medical equipments, some are used for medical research, and medical gases are indispensable for the operation of hospitals. In order to ensure the safe, effective and timely supply of medical gases, each medical institution should combine the characteristics of each equipment in the medical gas system of the unit, establish and improve the management system, and publish the implementation. The relevant systems for the operation and management of the medical gas system include special equipment management and safety files.

I. Specialized equipment management

(1) The use of units should be in accordance with the provisions of the pressure vessel put into use before or within 30 days after use, to the location of the department responsible for the use of special equipment registration for the "use of special equipment registration certificate".

(2) The use of the unit should be used every month at least 1 monthly inspection of the pressure vessel, and should record the inspection records. Monthly inspection content is mainly: pressure vessel body and its safety accessories, loading and unloading accessories, safety protection devices, ancillary instrumentation is intact, the sealing surface of any leakage and other abnormalities.

(3) The use of the unit should be used every year at least 1 annual inspection of the pressure vessel, annual inspection in accordance with the requirements of TSG 21 "Fixed Pressure Vessel Safety Technology Supervision Regulations". After the completion of the annual inspection work, the pressure vessel should be used to analyze the safety situation, and the annual inspection of hidden dangers found in a timely manner to eliminate.

(4) the use of units should be in the pressure vessel inspection period expires 1 month before the expiration of the validity of the special equipment inspection agency to submit an application for periodic inspection, and to do a good job of periodic inspection-related preparatory work.

(5) Safety valves, bursting discs, pressure gauges and other safety accessories of pressure vessels and pressure pipelines are required to be within the validity period of validation, and relevant documents are filed. After the occurrence of an emergency, it should be followed up and evaluated, and appropriate measures should be taken immediately to prevent recurrence; after the emergency is disposed of urgently, the relevant indexes should be tested again, and the indexes should be put into use again only after meeting the relevant regulations.

II. Security files

(1) An overview of the medical gas system (including gas supply method, usage, etc.).

(2) Qualifications of the gas supply company.

(3) Operating contractor qualifications.

(4) Records of training and examination of operating personnel.

(5) Operator's license for special operations.

(6) The relevant equipment "special equipment use registration certificate", inspection reports.

(7) Pressure gauges, safety valves, explosion-proof sheet of the certificate of conformity, inspection reports.

(8) Records of safety and quality inspections.

(9) Emergency drills and evaluation reports.

(10) Equipment repair, maintenance and hidden danger ledger.

III. Utilization management system and records

(i) Management system for the use of medical gases

(1) Job accountability:

Separate tasks and requirements within the areas of responsibility of managers and staff, etc., in accordance with staffing requirements.

(2) Handover system:

There should be clear handover contents, procedures and requirements.

(3) Equipment patrol and inspection system:

① Determine inspection personnel, time, route, inspection content and requirements;

②Implement the requirements of safety inspections per shift and strengthen inspections at night and on holidays;

③ Inspectors fill out inspection records in accordance with the requirements of the inspection process, and managers should check the records;

④ During inspection, hidden dangers and faults found should be dealt with immediately and recorded; if they cannot be dealt with, they should be reported to the person in charge of management immediately and records should be filed; the recommendation for storing records should not be less than 2 years.

(4) Regular maintenance system for equipment:

①Implement the person in charge of maintenance management of medical gas equipment;

② Develop annual, degree, and monthly maintenance plans in accordance with equipment maintenance requirements;

(iii) Provide for inspection intervals and maintenance requirements for medical gas equipment and systems;

④ Establish maintenance management files for medical gas equipment and systems;

⑤ Medical gas equipment and systems in the pressure vessel, pressure piping and accessories should be qualified before the expiration of the validity period, to the special equipment inspection and testing organizations to apply for inspection.

(5) Safety management system:

①Medical gas practitioners should undergo safety training and be qualified by examination before they are allowed to work;

② Non-medical gas personnel are strictly prohibited to operate the gas source equipment;

③ When carrying out work related to medical gases, the staff should wear correct protective equipment, choose appropriate tools and strictly implement the operation procedures;

④ Medical gas equipment and systems should be maintained and serviced by specialized personnel;

⑤ Medical gas rooms must be kept locked;

(vi) The room used for medical gases shall be well ventilated, the temperature shall be controlled at 10℃~38℃, and the concentration of oxygen in the room shall not exceed 23%.

(vii) Emergency measures in case of equipment failure and medical gas leakage;

(8) Conduct a comprehensive safety assessment of the medical gas station every year and write an annual assessment report. The results of the assessment are reviewed, and corresponding rectification programs are taken and implemented.

(6) Fire and electricity safety management system:

① Clarify the responsible departments and persons for the management of fire and flames, the scope, procedures and requirements for the approval of fire and flames, as well as the qualification requirements for welders;

② in the case of gas, medical gas room prohibit fire, electricity need to take explosion-proof measures; if there is an urgent need for welding and other open-flame operations, should be shut off the gas source, exhaust local pipeline gas;

(iii) Electrical line laying, electrical equipment installation and maintenance personnel shall have licensing requirements and shall not privately set up temporary electrical lines and equipment;

④Check and maintain all kinds of electric and gas equipment every week, and prohibit operation with malfunction;

⑤ For the requirements of the use of new electricity and gas equipment, they shall go through the approval procedures and shall be used only after they have passed the inspection and acceptance.

(7) Duty system:

① Establish staff duty schedules on a monthly basis to ensure that gas stations are manned 24 hours a day;

② The information, tools and accessories that should be available in the duty room need to be replenished in a timely manner if they are damaged or missing;

③Non-staff should not enter the equipment room, outside visitors can only enter with the consent of the competent leader, and make a record;

④Operation duty personnel should strictly implement the safety operation procedures, regularly check the equipment operation condition according to the inspection process, immediately deal with any abnormalities found, and make records;

⑤Operation duty personnel should stick to their posts, keep communications open, and are strictly prohibited from going to work after drinking;

(vi) Shift handover is carried out in accordance with the shift handover system.

(8) Gas cylinder management system:

① Management of gas purchases;

② Management of cylinder transportation, handling, storage and use, as well as management of gas supply to clinical cylinders to ensure a continuous supply of medical gases to clinical departments;

(iii) End-of-life management of gas cylinders;

④ Emergency measures to be taken in case of gas cylinder leakage;

⑤ Inspection of the safe use of gas cylinders.

(9) Emergency plan exercise system:

(1) Organization, personnel, projects and periodicity of emergency plan drills;

② Procedures for handling various emergencies;

③ Emergency personnel should be familiar with the emergency plan and emergency treatment;

④ Emergency drills should be carried out without affecting the normal medical work, and the medical gas system management department should report to the supervisor of the hospital, obtain approval and communicate with the clinical departments in advance to reach a consensus before carrying out;

⑤ Prior to the emergency drill, a notice of the drill should be issued and control measures for the emergency drill should be implemented to avoid causing clinical damage;

(vi) At the end of the exercise, it should be summarized and documented.

(10) Fire management system:

① Open flame is strictly prohibited in the room for medical gases; smoking is prohibited, and flammable, explosive and greasy items shall not be stored;

② medical gas station fire apparatus should be set up in line with the provisions of the fire department; regular fire apparatus placed, intact and the number of inventory and make relevant records;

(iii) Medical gas piping shall not be shared with cables and other piping and shall not be diverted for other purposes;

④ Fire operation is prohibited in the area of the medical gas station. Before fire operation is required in special circumstances, a fire program should be formulated and confirmed by the fire department before it is carried out;

⑤ Medical gas personnel shall learn fire fighting knowledge and the use of fire fighting apparatus, conduct regular fire fighting drills, and familiarize themselves with fire alarm telephone numbers and alarm methods.

(11) Safety education and training system:

① Utilize videos, boards, and lectures to educate on the principles, operation, and safety of medical gas systems;

② Organize monthly medical gas system studies, analyze medical gas system failures, and teach relevant regulations and safety knowledge;

③ Conduct pre-job safety training and assessment for new employees and keep records;

④ Train all management and operation personnel before new equipment and technology are put into operation, and keep records.

(ii) Records of operation and management of medical gases

(1) Registration record of entry and exit of outsiders to the medical gas station.

(2) Handover records.

(3) Employee training records.

(4) Medical gas equipment operating records.

(5) Medical gas equipment maintenance records.

(6) Medical gas equipment maintenance records.

(7) Medical gas manifold inspection records.

(8) Records of medical gas warehousing, receiving and distribution.

(9) Medical gas system inspection records.

(10) Daily inspection records for medical gas hazmat.

(11) Terminal inspection and maintenance records.

(12) Oxygen-specific tool cleaning and degreasing records.