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NYC oxygen system failure. What happened?

  • Friday, April 10, 2020 7:23 AM
    Message # 8891475

    I just came across this info. Very vague. Does anyone know the real story? 


    https://www.npr.org/sections/coronavirus-live-updates/2020/04/09/831288797/number-of-patients-at-overflow-hospitals-in-new-york-has-doubled


    The failure of the oxygen system at two hospitals in Queens on Tuesday evening is one reason for the larger number of critically ill patients being treated at the temporary hospitals.


  • Saturday, April 11, 2020 12:56 AM
    Reply # 8892895 on 8891475

    If the demand was too great they may have passed liquid into the regulators and damage them. That’s one of the fallacies of running two regulators simultaneously rather than keeping one as a back up.

    Last modified: Saturday, April 11, 2020 1:35 AM | Don Holden
  • Saturday, April 11, 2020 8:08 AM
    Reply # 8893274 on 8891475

    The problem was not the failure of the regulators it was an overloaded vaporization system. Where the lines were frosting in to the hospital. I spoke with homeland security about the problem. The following is from an email that I received the following day.


    Chalk up another win for the St. Peter's team:

     

    Last night, just before Dr. Hanks mentioned on the 5pm call that several patients were coming from NYC, we got a request from the Director at the NYS Division of Homeland Security and Emergency Services (DHSES) looking for some expertise on hospital oxygen systems. Apparently the reason for the patient transfers was related to the oxygen system problem.  George Seabury responded immediately and spoke with the Director, Matt Franklin, and connected Matt with Bob Sutter, VP and Chief Technical Officer with B&R Compliance.  Bob was able to trouble shoot the problem with the Director at DHSES. 

     

    The Director, Matt Franklin, replied:

     

    "Thank you for looking into this for me.  The info was incredibly helpful and I was able to walk them through it all last night. He nailed it - that's the exact problem.  They brought the fire dept in to start hosing it down and remove the ice."

     

    And that's how they fixed the oxygen problem in NYC.   

     

    I know the gas companies will fight it (again) the vaporization system is the weak link in the cryogenic systems at health care facilities. While I hate to say this we need stronger language in the NFPA codes on the sizing and design of vaporization systems. Systems where switching vaporization has been installed they are able to make it through this time of increased usage with less iceing problems than non-switching systems.  

  • Saturday, April 11, 2020 2:16 PM
    Reply # 8893728 on 8891475

    Great information Bob. I have been asked if using the ESOC would help take some of the pressure off of the vaporizers and regulators and my comment is yes.

  • Sunday, April 12, 2020 9:47 AM
    Reply # 8894591 on 8891475

    Great job Bob – thanks for helping them out. You’ve always been my go-to guy for bulk 02 systems.


    Why is this the perfect storm for high oxygen consumption?


    -The obvious - unlike the flu season when fewer patients are admitted over the much longer flu season, we’re seeing a significantly greater number of 02 patients all at the same (patient surge) and they are sicker.


    -Consistently higher inspired oxygen concentration – 75 to 100%


    -Higher ventilator patient minute volume


    -Patients on high 02 concentration (with sometimes high volume) and higher number of non-ventilator respiratory care devices before, after and sometimes instead of ventilators


    - And most importantly, is the average patient time on ventilators - usual 2-3 days or maybe a week. Two NYC area hospitals are reporting their patient vent averages at 13 days and 21 days. This means that as hospital COVID-19 patient admissions decrease, the hospital still must work through the long vent use times before the pressure is off clinicians and 02 consumption.


    Unfortunately, we’re also seeing higher ventilator patient mortality rates – 70 to 80%


    Happy Easter to you and yours. Stay safe everyone.

     

    Last modified: Sunday, April 12, 2020 8:15 PM | George Scott
  • Monday, April 13, 2020 7:40 AM
    Reply # 8895851 on 8891475

    Thanks George. After this is all over when the reviews of what worked and what failed is done. I hope there is reconsideration to the requirements around vaporization systems. Systems that had switching as a part of their design have faired better through these times of increased usage than non-switching systems. While it was a requirement in the 2005 edition two of the major gas companies were not in favor of it and had it removed in the following cycle. Now the NFPA 99 Technical Committee has changed the clearance requirement from 3' on all sides to 3' clearance on three sides this allows the vaporizer to be placed next to another surface further restricting airflow. This change is also in conflict with the requirements in NFPA 55. This restricts the ability to safely deice the vaporizer if required. One of the major vaporizer manufactures in the country requires 2 meters of clearance around a vaporizer for deicing. See attached.

    My best to you Bev and the rest of the family. I hope you all stay safe during this time.


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