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Medical Air Systems for Healthcare Facilities
Medical air systems are a vital element of all hospitals and most other healthcare facilities. The engineer must consider cost, capacity, physical size and weight, space limitations, and the availability of mechanical and electrical connections when selecting a system for a particular project. It is important to coordinate the selection of equipment with the owner, as well as other engineering and architectural disciplines.
The first priority is life safety. Medical air is used for respiratory therapy and calibration of medical devices for respiratory use. Ensuring clean, oil-free air is mandatory. The medical air system should not be used to supply air for any other purpose (eg hospital laboratory use) due to the potential for contamination of the distribution system. If a patient breathes in medical air contaminated with oil from a broken compressor or nitrogen from solder purging, the consequences can be irreversible. In addition, utility or pipeline shutdowns must be coordinated with hospital staff to prevent accidental interruption of service while patients are connected to the system. Engineers should be aware of the requirements before designing any medical gas system.
Medical compressed air systems must be designed to prevent contaminants or liquids from entering the pipeline. Medical air systems must:
• be supplied from cylinders, bulk tanks or medical air compressor sources; or reconstituted from oxygen USP and oil-free dry nitrogen
• meet the requirements of medical air
• do not contain visible liquid hydrocarbons
• contain less than 25 ppm of gaseous hydrocarbons
• contain 5 mg/m3 or less of permanent particles 1 micron in size or larger at normal atmospheric pressure.
In a typical fully functional healthcare facility, medical air is supplied by a high-pressure cylinder manifold or medical air compressor system. Manifold distribution systems are typically used in facilities that have a very low demand for medical air. Medical air compressors are usually for larger facilities.
Existing facilities may choose to upgrade their equipment and associated piping or add medical air facilities as the facility expands. When choosing equipment for a new facility, the possibility of future expansion should be considered. To allow for future growth, it is good practice to be conservative in sizing the system.
Duplex medical air compressor source systems
An engineer usually has more options available when designing a new facility than for a renovation or replacement project. Electrical and mechanical installations can be calculated more easily, and chilled water, ventilation and electrical installations can be dimensioned and adequately located. An ideal schematic design includes a well-ventilated, easily accessible mechanical room for medical gas equipment.
When selecting a medical air compressor for upgrading, the engineer may have problems due to inefficiencies in mechanical use (eg, poor quality of chilled water, poorly ventilated mechanical space). The local utility may not support the pump layout or poor access to the equipment may require parts of the equipment to fail at a significant cost increase. It is imperative to conduct thorough research of the surrounding mechanical space and utilities before determining the best type of compressor for the project.
It is good to choose more than one type of compressor at the stage of designing the scheme. You should develop a master plan that shows existing demand and estimated spare capacity. The owner may want to get a cost estimate before making a final decision.
Types of compressors
All medical air compressors must be able to deliver oil-free compressed air. This article deals specifically with medical air systems for level one hospitals.
There are three acceptable types:
• Oil-free compressors: These reciprocating compressors do not have an oil film on the surfaces that are exposed to the compressed air. They have oils in the machine and require separation of the part containing the oil from the compression chamber with at least two seals. The connecting shaft and seals must be visible without disassembling the compressor.
• Oil-free compressors: These reciprocating or rotary compressors have no oil in the machine. Lubrication is limited to the seal bearings.
• Liquid ring pump: These rotary air compressor pumps have a water seal. It is recommended to use a heat exchanger to save sealing water.
Medical air compressor plants should be sized to meet the peak calculated demand when the largest compressor is out of service. In an efficient design of a larger system (ie three pumps or more), each compressor is sized to handle an equal percentage of peak demand and create redundancy. There should never be less than two compressors.
Several pieces of mechanical equipment accompany a medical air compressor system:
• Intake: Compressor air inlet must be located outside, above roof level, and at least 10 feet from any door, window, other intake or other opening. Intakes must be reduced, protected and equipped with suction filter silencers. These filters remove large amounts of particulate matter (microscopic particles of solid or liquid matter floating in the air) and contaminants at the compressor inlet.
• Air receiver: The role of the air receiver is to store air and balance pressure variations. It must have a full size bypass as well as a manual and automatic drain to remove accumulated condensate. Must meet the American Society of Mechanical Engineers (https://asme.org) Boiler and Pressure Vessel Construction Standards (https://asme.org), Section 8. The receiver is sized based on system requirements, compressor size, and compressor run time.
• Compressed air dryer: The dryer is used to remove water vapor from the air stream. At a minimum, it must be a dual valve system to allow one unit to be serviced. The dryers should be of the double drying tower type, dimensioned for 100% of the calculated load in design conditions. They should be rated for 32°F (0°C).
• Duplex final filters: Should be rated for 100% system capacity, with a minimum of 98% efficiency at 1 micron or greater. The filter must be equipped with a visual indicator that shows the remaining life of the filter element.
• Medical air regulators: Regulators control the pressure of the air system. They should be sized for 100% of the peak calculated system demand under design conditions. Pressure regulators should be set to provide the furthest outlet with 50 psig medical air.
• Alarm sensors: The medical air compressor must have alarm sensors located nearby where they can be continuously monitored by hospital staff. Common alarms are for high pressure, low pressure and other problems (eg lead/lag pump operation, high temperature, high dew point, carbon monoxide). Additional alarm signals can be added depending on the type of compressor and the owner’s preferences.
• Anti-vibration mounts: They should be provided for compressors, receivers and dryers, according to the manufacturer’s requirements.
Medical air tubing is sized according to the calculated flow rate in cubic feet per minute (cfm). The compressed air pipeline is made of brazed L-type copper prepared for oxygen supply. The pipeline must be sloped towards the central plant, have drains at lower points and must be valved and identified.
The flow rate for medical air outlets is generally 1 cfm. The flow rate in the pipeline is calculated by counting the associated medical air outlets and applying a usage factor. The flow from the total number of outlets is called the total connection load. Since not all outputs are typically used at the same time, a concurrency factor should be applied to reduce system throughput. The rate is then applied to the piping and compressor size. The American Society of Plumbing Engineers (https://aspe.org/) has developed a table that quantifies the consumption of medical air in different areas of the hospital.
When the total connection load is calculated and the utilization factor is applied, the main piping and compressor equipment can be efficiently sized and selected.
In short, engineers must be careful when sizing and specifying medical air equipment to meet the needs of the healthcare facility and its patients. Before starting a project, be sure to review the medical gas system requirements of the latest codes. Both the information at hand and the technology are evolving daily, and it is the engineer’s responsibility to stay informed.
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