Rebuilding Amico & Beacon Medaes Outlets (Series B style, Diamond style quick connect)

When you have a hospital of any age it is likely that you probably have outlets manufactured by more than one company. When this happens you may get outlet repair parts mixed up especially in the case of Amico and Beacon (Series B) style outlets. If you’ve ever rebuilt the latch valve of one of these outlets and noticed that you fixed the leak but created a flow problem (low or no flow) the reason is because of the dust cap used by Amico and Beacon Medaes.

At first glance they appear to be identical, but upon further inspection you will notice subtle differences in each one. Amico has two different styles that come in their standard repair kit, a white cap and a gray cap. The gray cap can be put aside because we are talking specifically about Ohmeda/Medaes Diamond style quick connect outlets. The gray dust cap is specifically for Chemetron (Allied Healthcare) style vacuum inlets.

In the picture below you will note a couple of key differences. The front of the Beacon Medaes dust cap has three lines that meet in the middle to form a triangle. The Amico dust cap is flat with no texture. If you look at the back you will notice another key difference and this is what can cause flow issues. The Amico has a raised portion on the inside front of the dust cap, but the raised portion is solid. The Beacon Medaes dust cap also has a raised portion but it is hollow and has a hole in the middle, this allows the brass poppet to seat slight further within the barrel than on the Amico latch valve. That is why mixing the dust caps can cause no flow issues when Amico dust caps are used on Beacon Medaes outlets.

The moral of the story is be sure to keep your outlet parts segregated and use the appropriate manufacturer repair parts for each individual outlet or inlet.

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NFPA 99 2012 Medical Gas Outlet Testing Requirements – Existing Facilities

NOTE: All references are taken from NFPA 99 – 2012 edition

overviewPIC

There seems to be much confusion over the requirements set out by NFPA 99 for existing facilities vs. those for new construction / renovation work.  The 2012 edition of NFPA 99 has done a great deal to clear some of this up.

5.1.1.5 Subsection 5.1.2 through 5.1.12.3.14.5 and 5.1.14.4.2
shall apply to new health care facilities or facilities making
changes that alter the piping.

5.1.1.6 Paragraph 5.1.14.4.3 through 5.1.14.4.9 and 5.1.13
through 5.1.15 shall apply to existing health care facilities.

NFPA 99 doesn’t mention a specific schedule for medical gas outlet testing on existing outlets, it just says periodic.  The healthcare facility will need to make a policy that says how often the med gas outlets get checked (i.e. every three years etc) and adhere to that.

The section of NFPA 99 that specifies all outlets / inlets must be checked falls under the new construction / renovation portion.  (5.1.5* Station Outlets/Inlets.)  These requirements as they are written in 5.1.5 are not intended to be applied to existing healthcare facilities.

The medical gas outlet testing section for 5.1.14 is as follows:

5.1.14.2 Maintenance of Medical Gas, Vacuum, WAGD, and
Medical Support Gas Systems.
5.1.14.2.1* General.
Health care facilities with installed medical
gas, vacuum,WAGD, or medical support gas systems, or combinations
thereof, shall develop and document periodic maintenance
programs for these systems and their subcomponents as appropriate
to the equipment installed.

5.1.14.2.3.1 General. The elements in 5.1.14.2.2.2 through
5.1.15 shall be inspected or tested as part of the maintenance
program as follows:
(11)*Station outlets/inlets, as follows:
(a) Flow
(b) Labeling
(c) Latching/delatching
(d) Leaks

Remember that the * next to (11) refers to additional material which is located in the annex  of NFPA 99.  In this case A.5.1.14.2.3.1(11) simply states that the outlets should be inspected for a general condition & be gas specific (noninterchangeable indexing).

Annex material is not enforceable as code and is meant for reference only however, that doesn’t mean that an AHJ (Authority Having Jurisdiction) will not use annex material for a given facility or situation.  Just be aware of the additional requirements located in the annex for this section and take them into consideration when doing your risk assessments and writing your medical gas outlet testing policy.

Risk Assessment Services

When patients and doctors are dependent upon medical gas equipment for
their safety, nothing becomes more important than ensuring said equipment is
functioning perfectly.

EMGS, Inc. offers risk assessment services and consulting to your hospital
personnel. We can carefully craft a user-friendly report to provide to your staff
displaying the potential hazards and failures of the equipment they are in charge
of maintaining. This report will document the common causes of equipment issues,
and the control measures that can be put in place to prevent these issues. We will
also show who is typically responsible for ensuring these measures are attended to.

This report will prove invaluable to your staff. Let EMGS, Inc. help put you on the
path to superior safety and performance so the doctors and nurses can rest easy in
providing care to their patients.

EMGS Overseas

Earlier this year EMGS was given the privilege of having the opportunity to travel overseas to Bagram Air Field near Kabul, Afghanistan to inspect the medical gas System at SSG Heathe N. Craig Joint Theater Hospital.  We have done many jobs on military bases here in the United States, but being able to go to a forward operating base was truly an experience that I will never forget, and one that I am truly grateful for.

This facility obviously has many hurdles that typical hospitals would never even imagine having to overcome due to its location and the type of patients it serves, but   I want to focus on two of them: the ability to produce and store oxygen in a remote location, and the ability to maintain a vacuum system in the environment and climate in which the facility is located.

Craig Joint Theater Hospital (CJTH) is located approximately 50 mile from Kabul, Afghanistan. There are no oxygen production facilities anywhere near here, and in order to maintain a reliable oxygen system to serve the facility they had to utilize an oxygen generation system. Essentially, they take air and filter out the nitrogen and other elements in order to increase the oxygen content of the gas. As they compress the gas it is pushed through filters increasing the percentage of oxygen. The oxygen content would top out between 91-93% as opposed to the typical 99.5-99.9% coming off of Oxygen bulk tanks here in the States.  In order to have a back up system the facility would use this gas to fill standard “H” cylinders and hook them up to emergency headers. As you can imagine this system is quite large and requires a tremendous amount of energy to function.

The facility also has a constant fight to maintain the vacuum pump systems. The systems face two obstacles at all times. The fine dust and dirt in the area that the hospital is located, and the fact that the hospital is located nearly 5000 ft. above sea level.  The pumps themselves required maintenance at more regular intervals than typical systems due to the dust, and there is a higher stress load on the pumps because of the altitude.  At close to 5000 ft. above sea level the correction factor for the vacuum load is 20% more than a system at sea level.

The facility was designed with these challenges and many others in mind. The typical medical gas system has redundancies built in to ensure that a medical gas is never totally lost, but CJTH takes this to another level. The facility has two sets of source equipment with each one serving half of the hospital. They have an intricate system in which they can feed the entire facility from either set of source equipment.

With all of the additional obstacles that a facility like this one faces it was clear to see that the prevention of a loss of medical gas to the patient was something that was of high priority.