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Medical Vacuum Systems

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  • Wednesday, May 24, 2017 7:28 PM
    Message # 4850351
    Al Moon (Administrator)

    This section has been in the NFPA 99 Standard / Code for many years.

     

    5.1.14.1.4* The medical–surgical vacuum and WAGD systems shall not be used for nonmedical applications (e.g., vacuum steam condensate return). 

     

    So, my question is this.

     

    Can the medical surgical vacuum source, be used to supply suction in an Endo GI Equipment Scope Clean Room ?

     

     

  • Thursday, May 25, 2017 5:55 AM
    Reply # 4852150 on 4850351

    Al, there does not seem to be a universal interpretation on that.  I always teach it as "controversial".  I would be very interested in hearing the spectrum of opinions.

     

    These are the kinds of problems that I had hoped MGPHO would take up by establishing a more or less formal "interpretations" committee that members could use to guide their own decisions using the consensus of the group.  NFPA has no easy way to do this, and of course a MGPHO interpretation would have no legal standing, but at least we would all be able to have one song sheet to sing off of.

  • Thursday, May 25, 2017 1:55 PM
    Reply # 4853018 on 4850351

    5.1.3.5.1  General. Central supply systems shall be obtained from a supplier or manufacturer familiar with their proper construction and use and installed in accordance with the manufacturer's instructions.

    5.1.3.5.2  Permitted Locations for Medical Gases. Central supply systems and medical gas outlets for oxygen, medical air, nitrous oxide, carbon dioxide, and all other patient medical gases shall be piped only into areas where the gases will be used under the direction of licensed medical professionals for purposes congruent with the following: 

    (1) 

    Direct respiration by patients

    (2) 

    Clinical application of the gas to a patient, such as the use of an insufflator to inject carbon dioxide into patient body cavities during laparoscopic surgery and carbon dioxide used to purge heart-lung machine blood flow ways

    (3) 

    Medical device applications directly related to respiration

    (4) 

    Power for medical devices used directly on patients

    (5) 

    Calibration of medical devices intended for (1) through (4) 

  • Thursday, May 25, 2017 4:36 PM
    Reply # 4853203 on 4850351
    Al Moon (Administrator)

    Well that's a lot of information, but not one word concerning the location for the medical surgical vacuum suction inlets.

  • Thursday, May 25, 2017 7:26 PM
    Reply # 4853340 on 4850351
    Al Moon (Administrator)

    So here's my point.

    Everyone please again review my post on the NFPA 99 Code for this topic.

     

    Vote a Yes or No to next two questions.

     

    1)

    Per NFPA 99 can you install a medical vacuum inlet in a Endo GI Scope Equipment Clean Room ?

     

    2)

    Is using the medical vacuum system in a Endo GI Scope Equipment Clean Room

    considered a Medical Application ?

     

     

    Now also review the FGI (the old aia) 2014 Edition,

    Table #2.1.4

    Section #2.2-3.11.4

    Note #8

     

    And Vote Again.

     

     

    Kindest Regards 

  • Thursday, May 25, 2017 9:42 PM
    Reply # 4853481 on 4850351

     I thought it was pretty clear you cannot use medical vacuum or any medical gas in a G.I. lab for cleaning scopes. So my answer is NO. 

     If you want to use lab vacuum, plant air, portable vacuum compressor, portable air compressor, nitrogen I do not have a problem. Medical is for patient use only. 

  • Friday, May 26, 2017 1:44 AM
    Reply # 4853675 on 4850351

    Anything "Controversial", as Mark puts it, should be discussed.  There does seem to be a debate on this. 


    As I have repeatedly been chastised (i.e. dropped by clients) for strict interpretations of NFPA standards (codes) I found myself tonight simplifying the reasons  the code exists.    I believe it exists to maintain the integrity of (in this case) the medical vacuum system.


    Am I out of line to suggest we look at this from a risk perspective?  As we know NFPA has changed over the last couple of editions to decide certain aspects (Categories, maintenance) based on risk...  


    Based on Al's yes or no format, during the course of the cleaning.....


    1.  Is it likely that anything detrimental will be introduced into the vacuum system (fluids including cleaning solvents)?

    2.  If the answer to #1 is yes, with that introduction could the overall system fail (or be damaged) ?

    3.  If the overall system (#2 above doesn't fail), will the inlet used for cleaning fail?

    4.  If the single inlet (only used for cleaning) fails (#3 above) will it somehow contribute to a system failure?



    As I know nothing about the cleaning of scopes (other than the fact that if you are going to undergo a procedure you hope they are REALLY clean..) I will not try to offer an opinion, or even answer my own questions.


    Regardless of my admittedly limited knowledge of scope cleaning, I believe that having a suction inlet where scope cleaning takes place is common, and that the failure rate of the same vacuum may be higher than normal, but the extent of the failure has been limited to the same inlet.


    Others may have other experiences.  I would like to hear differing views..


    Bob W





  • Friday, May 26, 2017 6:09 AM
    Reply # 4854009 on 4850351

    Don puts the one side very clearly - nothing medical in these "support" areas.  "Support gases" A-OK.  That is clear from your citation 5.1.14.1.4. 

     

    Bob's very correct questions on first principles (i.e. what hazards do we create if we do this) leads us to the other case, found in 5.1.3.7.4.1 (3) which allows connection to a "laboratory" if appropriate fluid traps are provided. 

     

    Is CSSD a "Lab", a "nonmedical", a "medical support" or what kind of application exactly? 

     

    On balance, forced to vote, I would also go with Don's "No", but only because of the language and in contradiction to what I feel is the spirit.

  • Friday, May 26, 2017 8:47 AM
    Reply # 4854139 on 4850351
    Corky Bishop (Administrator)

    Hi Al,

     

    The paragraph you called out has an asterisk.  This little gem has been hiding in Annex A for some time:

     

    A.5.1.14.1.4 Other examples of prohibited use of medical–surgical vacuum would be scope cleaning, decontamination, and laser plume.

     

     

    A problem in my state of Oklahoma is that an Instrument Processing Room is required to have outlets for vacuum and compressed air.  They don't specify Medical Air or Medical Vacuum, but most designers default to them because they are readily available. 

     

    This is found in TITLE 310. OKLAHOMA STATE DEPARTMENT OF HEALTH CHAPTER 667. HOSPITAL STANDARDS in the section on Endoscopy Suites.

  • Monday, May 29, 2017 8:16 AM
    Reply # 4858252 on 4850351

    Building on Corky's comment above, NFPA 99 2012 5.1.14.1.3 is explicit in regards to introducing liquid to the system. 

     

    5.1.14.1.3* Liquid or debris shall not be introduced into the medical–surgical vacuum or WAGD systems for disposal. 

     

    So, whenever I find a vacuum inlet in GI/Endo, I include a comment referencing this.

     

     

     

     

     

    Last modified: Monday, May 29, 2017 8:17 AM | Luke Miller
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