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Hyperbarics > Equipment And Safety > Flashcards

Equipment And Safety Flashcards

0
Q

What is ASME

A

ASME – American Society of Mechanical Engineers

o Organization that generates the documents regarding safe pressure vessel design

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1
Q

Chamber classifications

A 
• Based on NFPA standards
• Class A – multiplace​
o Multiple human occupancy
o Must maintain less than 23.5% oxygen inside of multiplace chambers
• Class B – monoplace
• Class C – animal
o No human occupancy
• Duoplace – air filled two person chamber.  Follows the class A rules
• Lock – chamber compartment
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2
Q

What is BPVC

A

• BPVC – Boiler and pressure vessel code
o Governs material selection, fabrication, testing and stamping.
o Dictates the pressure relief required in chambers

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3
Q

What is PVHO

A

PVHO – pressure vessels for human occupancy

o Governs the acrylics and design standards.

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4
Q

What is hydrostatic pressure testing?

A

Fill with water, leaving small air space
o Pressurize the air space, if it fails, water sprays out, chamber does not explode.
o Done on new chamber designs to ensure safety.

Performed by BPVC

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5
Q

What are pressure relief valves

A

• Pressure relief valves – pop off valves
o Required by ASME
o Releases excess pressure from the chamber

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6
Q

What do you need to do with acrylics

A

• Acrylics – view ports and windows
o Rules for acrylics based on PVHO standards.
o Life is shortened by:
• Physical stress of compression and decompression
• UV radiation – sunlight
• Organic solvents – alcohol, adhesive remover (acetone is very hard on acrylics)
• Cleaners and disinfectants
o Easily gouged by hard objects – jewelry, external fixators, etc.
o Crazing – visual sign of weakness in physical structure of acrylic (tiny cracks in surface)

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7
Q

What are penetrators and name a special penetrator

A

• Penetrators
o Pipe, tubing, or wiring that crosses the pressure boundary of the chamber
o Can’t add new penetrators to chambers
o Special penetrator – light pipe or Canty light
• Invented by Mr. Canty
• Light shines onto a piece of acrylic that goes into chamber via a penetrator.
• Lighting for multiplace chambers, provides light without heat or electricity

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8
Q

Who is the CGA and what do they do?

A
  • CGA – compressed gas association provides guidelines for gas handling
  • Safe gas handling guidelines governing transport, connection, storage
  • Standardized gas connectors
  • Dictates the color marking and labeling of cylinders.
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9
Q

What is the color coding for gas cylinders? And who dictates it?

A 
CGA Dictates the color marking and labeling of cylinders.
o Air – yellow
o Oxygen – black
o Nitrogen – black
o Nitrox – black with green band
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10
Q

What things is the CGA worried about with gases?

A

o Compression gas sources
o Breathing gas source
o Chamber environment

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11
Q

Why is liquid oxygen used in HBO, and how is it stored?

A
  • Utilized in HBO because it has a 600:1 ratio – 1 L of LOX = 600 L of oxygen gas
  • LOX stored at -273, released into evaporators where it becomes a gas
  • As LOX becomes a gas, builds up in lines and creates pressure
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12
Q

How is compressed air used in HBO?

A

• Compressor - typically used
• Volume tank – holds the compressed air
• Typically have 2 compressors and 1 volume tank in multiplace setup
o Air compressor intakes located outside
o Located away from source of contaminants – ex car exhaust
o Periodic sampling of air required by NFPA standards

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13
Q

What grade air is used in multiplayer chambers? Who governs it?

A

• CGA – Grade D air specifications are specifications followed in multiplace chambers
o Oxygen required to be between 19.5-23.5%
o Carbon dioxide – 1000 parts per million
o Carbon monoxide – 10 parts per million
o Methane – none
o Oil/particles – 5 gm/ m3
o Odor – none

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14
Q

What do you do with an oxygen analyzer?

A

Oxygen analyzer
• Verify the oxygen content of LOX or cylinders
• Verify breathing gas delivered
• Sample chamber environment
o Multiplace chambers to maintain less than 23.5% oxygen

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15
Q

What are req on oxygen ventilation?

A

Chamber ventilation
• NFPA has minimum ventilation requirement for all chambers
• 3 actual cubic foot per person (acfm not square cubic foot per min) – depends on # of occupants
• Removes exhaled carbon dioxide
• Could use an carbon dioxide scrubber

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16
Q

What is BIBS and what kinds are there?

A 
BIBS – built in breathing system
• Hood or mask
o Hoods most commonly used in multiplace
o Isolated from chamber
• Demand Mask
o Breathing gas does not flow until you inhale
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17
Q

What is an overboard dump and how does it work?

A

• Overboard Dump
o Exhaust breathing gas to the outside
o Keeps carbon dioxide from building up inside the chamber
o Uses pressure differential for suction

18
Q

What is a vacuum relief dump?

A

o Necessary in overboard dump
• Prevents suction injury from mask
• Prevents “shrink wrap” in the hood

19
Q

What is a fire suppression system?

A
  • Also known as FSS or FES
  • NFPA code requires it for multiplace chambers
  • Fire suppression water must be a higher pressure than the max pressure of the chamber
  • Required to have a deluge system and a hand held line or hose
20
Q

What are fss specs?

A 
FSS performance specs
• Function testing required semi-annually (Q 6 months)
• Deluge system
o Water must deliver in 3 seconds
o 1 gal/min per sq foot of floor area
o Last for 1 min
• Hand lines
o 50 psi over max chamber pressure
o Deliver 5 gal/min simultaneously – 2 hand lines min.
21
Q

Typical monoplane configuration?

A

Each chamber has individual gas and exhaust system

• If patients are getting air breaks, will have breathing system for air breaks

22
Q

What is typical multiplace configuration?

A

Compression system for air compressor – separate line for each lock
• Each compartment has separate exhaust system
• Oxygen source for each lock for oxygen delivery
o Multiple hoods or air masks for oxygen delivery
• Backup air and oxygen system
• Fire suppression system

23
Q

What is a sound powered phone?

A

Sound powered phone
• No battery or electrical component
• Backup communication in multiplace and diving systems
• Not usually used in multiplace chambers

24
Q

What are monoplace equipment requirements? Who governs that?

A

• Monoplace equipment limited by NFPA standards to wiring and equipment is limited to communications and physiologic monitoring leads.

25
Q

How is equipment used in monoplace chamber?

A

Equipment is outside the chamber in a monoplace
o Use penetrators to separate the patient interface from the rest of the equipment
o Might be able to have equipment inside multiplace but can have outside multiplace as well

26
Q

What concerns are there for equipment in multiplace chamber?

A

o Potential hazards
• Pressure breaks the equipment (Boyle’s law)
• Heat or spark production (NFPA limits which equipment can go inside the chamber for this reason.)
o Malfunction
• Potential that equipment won’t operate at all
• Touch pad buttons all press at once due to the pressure
• Incorrect rate or volume may be delivered

27
Q

Where can EKG monitoring be performed?

A
  • Can be done outside the chamber if penetrator port available for the leads, as no electricity will enter the chamber
  • Monitor might be ok inside a multiplace chamber if meets criteria
28
Q

Considerations for taking BP with chambers

A

Blood Pressure – “NIBP”
• Special NIBP monitor compensates for pressure differential
• Only 1 machine can do this
• In multiplace – most brush monitors in NIBP machines not allowed by NFPA, but BP can be taken manually.

29
Q

Where is TCOM performed?

A

• Done from outside of the chamber.

30
Q

IV therapy in monoplace chamber

A

IV therapy
• Special IV pump – must pump harder to overcome the chamber pressure.
• Special IV tubing – fits penetrators in the chamber, pressure tubing, back flow precaution, locking connectors

31
Q

IV therapy in multiplace chamber

A

• Drip rate affected by chamber pressure
• Multiplace
o Can hang IV to gravity and let it drip
o Can’t use glass bottles in the chamber, will fill with compressed gas and potentially explode
o Drip column is affected by pressure
• During compression the drip column space will fill with fluids and you won’t be able to see the drips
• During decompression the column is affected by pressure and air can be pushed into tubing.

32
Q

Ventilators in chambers

A

Ventilators
• Pneumatic vents are the most common
o Do not use electricity, only gas pressure
o Performance is affected by pressure change – may not get the same volume you do at surface.

33
Q

Suction and HBO

A

Suction
• At 3 ATA, the vacuum created by pressure difference between chamber interior and outside the chamber is 30 psi. Normal wall suction is 4 psi
• This difference requires that suction inside the chamber has a “back pressure regulator” to reduce the vacuum force.

34
Q

Defibrillation and HBO

A
  • Should be done outside of the chamber after decompression in the monoplace chamber
  • Possible to have a defibrillator wired into a multiplace chamber, but that is not common.
  • In either chamber, need to move the patient away from the oxygen source (chamber door)
  • Strip off the O2 saturated clothing and bedding
  • Wait about 30 seconds after that before defibrillating to help clear some of the O2
35
Q

What do you so with drains in HBO?

A

• Need to open any drains that require suction in the chamber during the pressure change (hemovac, penrose, Jackson-pratt drains)

36
Q

What do you do with trachs and ET tubes?

A

Air cuff used to hold into place will shrink during decompression (Boyle’s Law)
• Will need to replace air with fluid

37
Q

Fire information

A

Fire Safety
• For a fire need O2, an ignition source, and a fuel source. Prevent fire by not allowing an ignition source into chamber.

Burning rate increases in an HBO chamber
• From the pressure
• From the higher oxygen %
Ignition Material
Temperature F in air
Temperature F in HBO
Paper drape
879
770
Cotton Sheet
869
680
Treated cotton sheet
1067
590
Nomex fabric
71112
968
38
Q

Potential ignition sources

A
  • Arc from electric wiring
  • Open flame
  • Discharged of stored energy (battery, capacitor)
  • Hand warmer or pocket warmer (either a chemical or flame warmer)
39
Q

Historic chamber fires

A

• Before 1980
o Mostly caused by electrical sources
• After 1980
o Mostly caused by things introduced into the chamber – toys, hand warmers, etc.

40
Q

What are fire safety standards?

A

NFPA (National Fire Protection Associates) – governing body for fire safety
o NFPA 99 standards govern our operations – the section on health care facility
o Chap 20 governs hyperbaric facilities

41
Q

What does NFPA 99 chap 20 govern?

A

Minimum standards for the protection of patients
• Focuses on prevention of fire
o Limits the type of burnables allowed in chamber
o Limites the quantities of burnables allowed in chamber
o Keeps energy levels in the chamber low
o Tightly control ignition sources

42
Q

Grounding requirements by NFPA standards

A

“The chamber shall be grounded to the building”
• “Resistance shall not exceed 10 hm”
• “All furniture permanently installed in the hyperbaric chamber shall be grounded.”
• A patient grounding strap or wrist strap is required by NFPA 99 standards when O2 is > 23.5% (monoplace chambers)

43
Q

NFPA limits

A

NFPA 99 limits:
• 23.5% of O2 in a mutliplace chamber
• 185 F is max temp of equipment in a multiplace chamber
• 140 F is the max temp of equipment in the monoplace chamber
• 28 volts allowed in the communication system
• No petroleum products are allowed in the chamber

Hyperbarics (12 decks)

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