EBME Forums Forums Management Medical Equipment Management Medical gas pipelines

Hello Guys and Gals,

I need advice on how often medical gas hoses should be replaced? Also, how often should the oxygen pipeline wall outlets be serviced?

John, when I did the course at Falfield a few years ago, they were talking about replacing any hose (wall to equipment) found to be over five years old. No doubt you are already aware of the colour-coded disc system used by the main players (that is, to identify the year of manufacture).

All the "advice" was a bit vague, though, as usual. Perhaps the current students get a bit more "Chapter and Verse" (but somehow I doubt it).

Meanwhile, it may come as a surprise to some on the forum that the course notes (and I'm looking at them now) also make mention that "manufacturer's recommendations suggest a quarterly inspection"!

Regarding wall outlets, I guess the place to look would be HTM 2022.

Hi John

We have all our O2 and Air cylinder regulators fully refurbished every four years so we have decided on replacement of all gas hoses after four years. We also inspect all these items anually and service/repair/replace if required.

ALso check out Medical Device Alert Notice MDA/2003/007...

http://www.mhra.gov.uk/Publications/Safetywarnings/MedicalDeviceAlerts/CON008679

...download available at bottom of page.

I will attempt to provide some relevant advice for you John.

Hoses should of course be replaced in line with the manufacturers instructions. The manufacturer is (hopefully) in control of the material specification, which in turn determines the viable life fo the hose. Medical gas hoses used in the UK are made from plasticised PVC. The plasticiser slowly migrates from the hose and makes the hose stiff; as stiff as a uPVC window frame if you leave it long enough. This phenomenon leads to hose to gradually loose its mechanical strength and resistance to abrasion. Up to 40% of the mass of the hose may be the plasticiser. Eventually hoses will fail if not replaced. It is likely this will be a good while longer than 5 years but there has to be a safety margin. I have heard anywhere from 3 to 5 years from different manufacturers. The other area you should consider are medical supply units (booms, pendants, gantry's, bweams etc.) typically in ICU/HDU and theatres. If these are adjustable they will have hoses inside feeding the gas outlets. Inspection here can be very difficult. Quarterly inspection would be quite onerous for some systems. The hoses are to some degree protected within the medical supply unit enclosure, but the rotation of say, a pendant, through as much as 340 degrees on its axis, can apply some significant rubbing and torsional stress to the hoses therein.

I recall an indcident at a hospital in the East Midlands where a hose had not been properly crimped to its fitting. This was inside a pendant in the A&E. It popped of the fitting on a Saturday night and the whole place was evacuated. Thankfully it was an air hose rather than oxygen, but the fire brigade were less than impressed.

Typically wall outlets will be 'serviced' quarterly but this typically involves only pluging in an FRDP (flow rate pressure drop test device' to prove the resistance to flow is below a defined limit i.e there is no blockage. The more likely failure will be a minor and not easily detectable leak. 1 l/min equates to over half a million litres over a year. There is a significant cost attached, especially for nitrous oxide or O2/N2O, but also a much greater risk of fire with oxygen in particular, as the local atmosphere becomes oxygen enriched.

There are better methods of PPM that can be adopted. For example targeting the high usage areas quarterly and low usage areas annually. This gives a significant drop in the total burden, since general wards are nearly always low usage but make up the majority of inpatient accomodation. If the contracted MGPS maintenance company were to take a portion, lets say half for arguments sake, of that time saving and apply it to finding and fixing leaks only, you would have a net reduction in both service budget and oxygen consumption.

BTW HTM2022 was replaced by HTM02-01 from Autumn 2006. Pretty much all the HTM's have been revised and republished in the last 3 years with a new numbering system. Quite fitting for the MGPS documents to be called 02 I think, even if it is a zero!

John,

We carry out the MGPS maintenance here, we have 3 HMT02 CP just been reregistered. Now has to be done 3rly.

There are numerous suppliers of MGPS out there I’m looking at the manual for a well known one, it reads:-

Monthly
Carry out visual inspection of 2nd fix, including operation.
If any reluctance to operation exists remove 2nd fix and repair/replace as needed.
Carry out operational test after any repairs / replacement in line with HTM.

Yearly
Remove fascia panels any clean behind them.
Remove 2nd fix and replace 1st fix o’rings.
Remove 2nd fix and replace 2nd fix check valve assembly.
Carry out operational test after any repairs / replacement in line with HTM.

We have a risk based schedule.
High risk areas get pm 1/4rly.
Low risk annually.
Risk level decided by the Risk Committee and GM'S.

regarding hoses we made a decision years ago that they would be done 3yrly. Based again on risk here, taking into account OEM, MHRA and deterioration factors.

Hi KM

3 yearly hose replacement - is that just O2 or air, entonox and suction pipeline hoses?

Mick

All.
We dont use a lot of Entonox probably 3 set ups in total.
Buit there are loads of the others including flexi pendants in cath labs.