NFPA 99 2012 Medical Gas Outlet Testing Requirements – Existing Facilities

NOTE: All references are taken from NFPA 99 – 2012 edition, this is an update from the original post which was made on September 3rd, 2015


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 help bring more clarity to this issue. Subsection 5.1.2 through and
shall apply to new health care facilities or facilities making
changes that alter the piping. Paragraph through and 5.1.13
through 5.1.15 shall apply to existing health care facilities.

NOTE: TIA 12-4 from NFPA 99 – 2012 edition changed the wording from and gave (10) paragraphs that apply to existing healthcare facilities.  These are listed below: The following subsections of this chapter shall apply to the operation, management, and maintenance of Category 1 medical gas and vacuum systems in existing facilities:

(1) 5.1.2
(9) 5.1.14
(10) 5.1.15

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 & System Verification)  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: Maintenance of Medical Gas, Vacuum, WAGD, and
Medical Support Gas Systems.* 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. General. The elements in 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. 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.

Medical Gas Emergency Response

Failure of critical medical gas and vacuum systems definitely leads to a stressful situation.  For this reason medical gas and vacuum equipment must be is redundant to prevent a catastrophic failure to the patient care environment.  However, there are always situations where the redundancy may not be sufficient.  Recently, we had a situation where a facility had a quadruplex medical vacuum system that needed 2 of its 4 pumps to maintain a sufficient vacuum.  One of the 4 pumps had been down for over a month waiting on repairs by another medical gas company.  During that time the system experienced another failure and lost another vacuum pump.  So now the facility was left with no reserve being forced to run the remaining two pumps non-stop to maintain proper medical vacuum.  So what caused this to happen?

The failed check valve in the picture below caused the most recent failure. The oil was pulled out of the pump causing the pump to run hot and “cook” the remaining oil.

Failed check valve at inlet of vacuum pump

Due to the lengthy time of repairs by the other medical gas company, EMGS was called to help resolve the situation.  The call was received about 3pm one afternoon and by 6:00 am on the following day a temporary vacuum rental unit was installed at the facility.  The facility was now back to 4 working pumps, less than 24 hours later.  EMGS has several rental medical air, vacuum and gas manifold systems to meet customer demands during emergencies or planned outages.

Medical Gas Backfeed

Medical air is one of the most crucial medical gases serving an NFPA 99 Category 1 facility or space. It is typically responsible for keeping ventilators and blenders running and downtime of any length is simply not acceptable.


When work must be performed on the air compressor source, especially within the control panel, power may have to be disrupted to safely complete that job. One way that EMGS helps ensure that the medical air supply remains uninterrupted is to provide a back feed manifold setup located just downstream of the medical air dryers but upstream of the source valve (or at an auxiliary valve, if available, immediately downstream of the source valve).

The back feed manifold is a fairly simple setup while still allowing for change out of one cylinder at a time. The manifold can be extended to more cylinders if the facility flow is very high, or the duration of shutdown is long enough to require it.

Feel free to contact us if you have any questions about medical air or any other medical gas or vacuum temporary setups. We offer rental manifolds, rental medical vacuum systems and rental medical air systems to help with your next shutdown.

Do medical gas cylinders have to be protected from direct sunlight?

NOTE: All references taken from NFPA 99 – 2012 edition

We get this question from customers with medical gas manifolds installed outdoors sometimes. NFPA 99 addresses this question directly in chapter 11 where it talks about protecting gas cylinders stored outdoors:

Note: sub-paragraph (3) Cylinders stored in the open shall be protected as
(1) Against extremes of weather and from the ground beneath
to prevent rusting
(2) During winter, against accumulations of ice or snow
(3) During summer, screened against continuous exposure
to direct rays of the sun in those localities where extreme
temperatures prevail

If you have a gas manifold installed outdoors then you need to ask yourself this question: am I in a location where extreme temperatures prevail?  If the answer is yes then you should take steps to protect those gas cylinders from direct sunlight, if the answer is no then maybe you’re fine.  Keep in mind that the AHJ (Authority Having Jurisdiction) will ultimately determine if you’re in a location where extreme temperatures prevail.  It may be worth asking your AHJ what they think if you have the relationship with them where that is feasible.

Sub-paragraph (1) & (2) from this reference should not be ignored either.  Rust on cylinders is a common problem so ensure that your concrete pad is well drained and free of dirt & mud.  Ice & snow buildup can be a major issue in the northern states, being diligent and keeping the pad clear so that it can be navigated by personnel is important after a big snowstorm.

If you have any further questions regarding outdoor cylinder storage or any other aspect of NFPA 99 please give us a call at 1-888-256-EMGS (3647)