Extra demands will be placed on medical gas systems at facilities as a result of the expected surge.
“The surge will result in heavy ventilator use within the existing ICU rooms and modified ICU spaces,” said Larry Wilson, vice president with WSP in Chicago.
With ventilators requiring up to five times the typical medical air and oxygen versus a standard ICU room, modifications to these systems are especially critical.
“Without design calculations available that match the installed piping layout, it will be difficult to predict system behavior if each ICU room has a ventilator in operation, especially if they’re each operating with 100 percent oxygen use,” Wilson said. “Also, in a fully occupied ICU suite over an extended period, the rate of consumption of oxygen product will increase substantially.”
In many cases, the existing oxygen and MS-AIR systems servicing these rooms will be inadequate to support the use of ventilators regardless of which mode of clinical operation is used. “These rooms would be useful, however, for patients who need oxygen but don’t need a ventilator to breathe for them,” he said.
Wilson added that pre-operation and recovery rooms with ventilators could also support patients who need oxygen, but do not need a ventilator.
However, it is important to note that the medical oxygen and MS-AIR system pipework are often designed with enough diversity to handle increased flow. The increase demand caused by multiple ventilators can be helped by working with the oxygen supplier to raise the operational pressure of the system. It is important that the medical gas designer is brought onboard to fully analyze the system capabilities.
Another strategy is to provide temporary supplemental oxygen and MS-AIR sources in strategic locations.
“These new sources would be stored as a high-pressure gas in cylinders connected to a manifold, which could be tied into existing piping so that there would be almost no pressure drop in the piping because of the proximity of the source to the outlets, thereby preserving flow and pressure,” Wilson said.
Facility managers should be in constant communication with their gas supplier in order to ensure that product can be delivered in a timely manner and that access to bulk plants and loading docks has not been compromised by any temporary structures or other obstacles.
Furthermore, some gas suppliers will not allow their employees to enter the hospital so the facility will need to make its own staff available to handle incoming full or outgoing empty cylinders or containers, including making and breaking connections at manifolds in interior rooms.