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chas  
#1 Posted : 05 January 2012 16:31:03(UTC)
Rank: Super forum user
chas

I'm looking for some straight forward guidance/weblinks to how bottles of oxygen and entonox should be stored correctly in a small medical room or small healthcare premises. I am talking about very small quantities here, say one or two small bottles of each. There is a lot of information covering general gas bottle storage and storage on a larger/industrial scale but I cannot find anything relevant for the situation currently being faced. Thanks in advance.
HeO2  
#2 Posted : 06 January 2012 06:51:36(UTC)
Rank: Forum user
HeO2

You need to basically follow medical O2 storage procedures for small cylinders, Entonox has a few changes, as it needs to stored in slightly warmer conditions as the 2 constituents separate in cold conditions causing problems.
It also needs protecting against theft to prevent misuse.

A quick summary as to how Ambulance services store small quantities at stations is below.

If you need any more info let me know.

ENTONOX cylinders should be:
stored under cover, preferably inside, kept dry and clean
not stored near stocks of combustible materials
not subjected to extremes of heat or cold
stored separately from industrial and other non-medical cylinders stored to maintain separation between full and empty cylinders
used in strict rotation so that cylinders with the earliest filling date are used first
stored separately from other medical cylinders within the store
F size cylinders and larger should be stored vertically. D size cylinders and smaller may be stored horizontally.
Ensure ENTONOX cylinders are maintained at a temperature above 10°C for at least 24 hours before use to ensure the gases are mixed correctly. If this is not possible D, CD and ED size cylinders may be used immediately if inverted three times before use to ensure mixing.
Warning notices prohibiting smoking and naked lights must be posted clearly in the cylinder storage area and the emergency services should be advised of the location of the cylinder store.
Precautions should be taken to protect cylinders from theft. Care is needed when handling and using ENTONOX cylinders.

Phil
leadbelly  
#3 Posted : 06 January 2012 07:36:26(UTC)
Rank: Super forum user
leadbelly

Phil

Gases that separate on standing! Is this an established fact?

LB
stevedm  
#4 Posted : 06 January 2012 08:20:49(UTC)
Rank: Super forum user
stevedm

Lead
It would only be if you stored the cylinders below the recommended temperature. Good stock rotation should cure that. C, CD, D & E size should be stored horizontally.

That was always the problem with storing liquid air over a long period (large vessels) it used to separate over time.

Worked for major industrial gas supplier in a previous life, working now in medical NHS setting...

HeO2  
#5 Posted : 06 January 2012 08:40:56(UTC)
Rank: Forum user
HeO2

Yes lead,

As Stevedm elluded to its only a problem if storage temperatures are not considered. Not usually a problem indoors (unless its a really cold room), it becomes a problem during winter months when cylinders are stored in uninsulated boots of fast response cars. Its cured by inverting the cylinder several times, and is not an issue as long as the operator is aware of this limitation.

Even if the gas becomes an anaesthetic rather than an analgesic agent due to the non mixing, it has suc a short half life its not usually an issue.

Security should be taken seriously, as people have become addicted to the euphoric effects of the gas. Healthcare Professionals have been struck off for this issue of theft to feed their Entonox habit!!

It shouldn't be dismissed as an analgesic though, its very very effective, and if used properly can have all of the pain relieving effects of opiate based drugs, but without any of the problems. Its very underused.

Phil
teh_boy  
#6 Posted : 06 January 2012 08:49:07(UTC)
Rank: Super forum user
teh_boy

HeO2 wrote:
Yes lead,
Even if the gas becomes an anaesthetic rather than an analgesic agent due to the non mixing, it has suc a short half life its not usually an issue.
Phil


O2 is lighter than N2O and will sit at the top when separation occurs. The universe wants chaos and so the gases will tend to mix unless as stated they are stored for prolonged periods at low temps.

The trouble is a patient given unmixed gas will look really happy at first as they breath 100% O2, then half way through the tank a few deep lungfuls of pure N2O and......

HeO2  
#7 Posted : 06 January 2012 09:30:38(UTC)
Rank: Forum user
HeO2

This is also another reason why the gas MUST be self administered by the patient, by a patient held demand valve.
So that in the event of breathing either pure N2O or too much of Entonox the demand valve that is held by the patient will be dropped as the patient becomes unconscious an instantly will be breathing normal room air again.
As the gas has such a short half life this happens very quickly, before the patient is further harmed from hypoxic effects.

Studies have shown that Entonox can have the same analgesic effects as 15mg of morphine, but without the sometimes nasty side effects.

Phil
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