When it comes to the most critical situations, in which, patients’ battle for their precious lives, the first thing comes to our mind is oxygen. An intact oxygen supply or so-called ventilation saves millions of lives around the world every year. Since it was invented long ago, it was not something much talked about. While most of us do not know much about those small green color cylinders which stand next to the hospital beds supplying this oxygen, it is wise to know some important information about them. You never know – it might save you or others someday!
Medical oxygen cylinders have many varieties. Each of these cylinder varieties has different pressure. Generally, the oxygen cylinders come with a pressure of 13,700kPa, but it can fall between the ranges of 12,000 – 17,000kPa. However, the pressure of the cylinder decreases as the oxygen content of the cylinder decreases.
Moreover, oxygen cylinder can vary with its content and its sizes.
According to the content of the oxygen, it can be classified as follows. They are:
Compressed oxygen cylinders
Compressed oxygen cylinders are usually very cheap and affordable to most of the people. The oxygen content is stored in these cylinders in the form of compressed oxygen gas, and due to this, the cylinders are very heavy. However, most people tend to use portable version by taking smaller units of compressed oxygen thinking that they are handy, but these small units also weigh only a little less heavy. According to the way they are stored, it is not wrong to say that these oxygen cylinders have a long lasting shelf life. However, the main rule in storing these oxygen cylinders are by storing them in an upright position, in order to avoid any malfunctions of the compressed oxygen cylinder. These oxygen cylinders are usually covered by insurance. And, these cylinders are more commonly used in house settings.
Liquid oxygen cylinders
The next on the list is Liquid oxygen cylinders and they are very expensive. The oxygen content of the liquid oxygen cylinders is cooled down to -1830C in order to store them. It is usually one of the preferred methods to store a high volume of oxygen. By storing in the liquid form these cylinders are able to keep more oxygen within the cylinder. In addition, these cylinders are also not too heavy and the smaller units of liquid oxygen cylinders are used for portability purposes. Even though they are better as portable cylinders, these oxygen cylinders are mostly used in hospital settings. But, the smaller units of liquid oxygen cylinders can be used in home settings too and they are the best source of oxygen for people who wants to reduce their electricity bill, due to the fact that these oxygen cylinders do not use electricity. The only minus point in these cylinders is that liquid oxygen cannot be stored for a longer period unlike compressed oxygen because liquid oxygen evaporates quickly and does not stay stable as compressed oxygen. The liquid oxygen cylinders also cannot be transported in planes, due to the pressure difference inside the plane compartment. And the insurance companies do not provide their coverage for this type of cylinder due to its expensive bill.
Oxygen tank sizes
The oxygen cylinders can also be divided according to its size. There are two types of methods used in this classification. The older method uses alphabets A-E to naming the oxygen tanks. ‘A’ is the smallest oxygen cylinders, while ‘E’ is the largest. But, ‘E’ is the most common size of oxygen cylinder used. However, this type of naming is not in practice today, rather they use the letter ‘M’ with the number added (For example M2). The number denotes the cubic feet of oxygen in the cylinders. Nevertheless, these oxygen cylinder suppliers indicate the equivalent of old method (A-E) in the new method (Mx, where is a number) so that there won’t be any confusion.
Parts of oxygen cylinder
The oxygen cylinders also come with several parts and these specific parts help the oxygen cylinder to function at its best. From the supply to its target, these parts participate in carrying out an intact oxygen supply. The main parts of an oxygen cylinder are;
The regulator part of the oxygen cylinder is an important element in safeguarding the patients who receive the oxygen. It is because; this regulator controls and decreases the pressure of the oxygen to a safer level to be used by the patient.
Cylinder gauge & Cylinder valves
The cylinder gauge has colored indicators, which indicates the amount of oxygen left in the cylinder. Even though the cylinder is full, if the indicator shows the red color, it indicates that the cylinder is not available to be used. The red color in the cylinder gauge usually indicates that the cylinder is empty. In some of the cylinders, the valve needs to be opened, before taking the reading on the cylinder gauge. In those circumstances, the valve should be closed after taking the reading.
The flow of oxygen can be controlled through the flow meter. The amount of the concentration required for the patient and also the rate, in which it is requires, can be controlled through the flow meter. Furthermore, the medical assistant need to make sure that the prescribed dose in L/min is well maintained.
The cylinder key is used to turn on and turn off the cylinder usage. This is almost like a gate which opens and closes the flow.
The delivery device supplies oxygen to the user. The delivery device comes in various forms as if nasal cannula, simple face mask, partial rebreather and so on. The choice of the delivery device varies according to the patient and the disease to which he/she is treated.
What to check before using it?
The oxygen cylinders need to be checked for several features before using it. The most important feature is the hydrostatically checked label. The oxygen cylinders should be hydrostatically checked every 5 years. The label is usually placed on the shoulder of the cylinder as month and year. In addition, the batch label should be clear with the date of expiry. If the batch label is not clear or missing, you need to assume that the expiry date has been exceeded. No one should be given oxygen with a cylinder that was not hydrostatically checked within 5 years and if it is expired or does not contain any data about it.
Indication for medical oxygen cylinder
Moreover, oxygen cylinders are usually used during anesthesia and also during recovery process after a surgical procedure. It is also used in situations where oxygen depletion should be prevented as if in trauma, heart diseases, blood loss, carbon monoxide poisoning, high fever, lung diseases, during resuscitation procedure, and for severe headaches as if cluster type. Like it was mentioned above, an oxygen cylinder comes in handy in the most critical times and therefore, is considered as a life saving equipment.
What should be taken care before using oxygen cylinder?
Before using oxygen cylinders, you need to make sure that you know the procedure and if the person who needs the procedure is a child, the parent or guardian should be well informed about the usage of the oxygen cylinder. If the child is premature and the oxygen should be administered, you need to make sure that the oxygen is given at a prescribed rate. In addition, if the person receiving oxygen is a patient who suffers from any lung disease of chronic nature as if asthma, bronchitis and so on, the amount of oxygen delivered to the person should be maintained for its flow rate, as improper oxygen concentration can cause severe complications in this group of people.
Moreover, if the patient has taken paraquat or any other drugs, you need to inform your doctor before using oxygen cylinder, as this drug can increase the lung toxicity. The usage of prescribed medications as if Bleomycin, Amiodarone, Nitrofurantoin, and other antibiotics along with over the counter medications should be notified to the doctor as well. This is an important practice you do to prevent many unnecessary reactions and especially, lung toxicity.
Furthermore, the usage of oxygen cylinder during pregnancy does not harm the mother or baby. Therefore, pregnancy, child birth or lactation is not on the list of contraindications. But the only thing we need to be sure about is that the person who uses oxygen cylinder can drive or operate the equipment without any problem.
Side effects of oxygen cylinder usage
The usage of oxygen cylinder also comes with some of the side effects and these effects are chest soreness and difficulty in breathing (dyspnoea). They are common side effects which can be seen after continuous use of medical oxygen cylinders for about 6-12 hours. And this can be aggravated if the patient has smoking habits and also due cold climate. The other side effects which can occur after 2-3 hours of usage of medical oxygen cylinders are dizziness, seizures, and episodes of fainting. These side effects can be stopped by keeping the person in a hyperbaric chamber. However, the most severe complication occurs with babies who are exposed to oxygen concentrations more than 40%. This results in blindness (due to eye damage) or retrolental fibroplasia. It is one of the worst side-effect which can occur due to the use of medical oxygen cylinders. To avoid this the oxygen supply should be well monitored if the receiver is a child.
Warnings and precautions with the usage of medical oxygen cylinders
People tend to be anxious when they hear the word, “warnings”. However, this is not to fear you, but to make you acknowledged and to keep you alert on risky things that could come with the life saving equipments. It is the user’s responsibility to follow the warnings accordingly. The first warning need to be checked is that whether the cylinder is placed on a flat surface and the cylinder would not fall. Because it is not good for the oxygen cylinder to damage as well as it can cause injury to people around. And also avoid keeping the cylinder on your bed, as this also can be a dangerous. Do not forget that oxygen is highly flammable. So no smoking or no fire near an oxygen cylinder!
In addition, always the user should make sure that he/she checks the cylinder gauge and ensure that the cylinder has enough amount of gas for the usage. This is because it is not advisable to use a lesser volume of gas than that the doctor has prescribed. Also, check that the tubings used are correctly connected and there is no any kind of leak. If there is a possible leak, you can hear the hush or hissing sound. Then, you need to close the valve gently and check whether you hear the hissing sound. This helps to identify the leakage location. However, if you still hear the hissing sound and cannot spot the location, you need to call your healthcare provider.
Moreover, the flow rate should be properly checked, as different concentrations of oxygen are delivered through the control of flow meter. You need to make sure that the flow rate prescribed by your doctor is used and not any other flow rates. The change of flow rate other than the prescribed dose can lead to the development of complications or severe side effects.
It is also wise to know that these cylinders should be stored in a clean place, free from any oil or greasy substance. Further, these cylinders should be kept at room temperature and should be kept out from extreme cold or hot.
Now that you know all about this important cylinders that carry oxygen, have a look at one when you ever get a chance to be sure you well recognize each and every detail you read here!