Wow.  Thought this would be a simple one....

So: in an attempt to reduce this to a 6060 mini lecture:

There is no such thing anymore as a "Category 1 Facility" we must make all these decisions by Category of the Patient Care Space(s).  Al is also remembering the old language "vital life support and critical care" which gave us more "wiggle room". Au revoir to that.

Zones valves are required by any of:

1. paragraph 5.1.4.6.2,

2. paragraph 5.1.4.6.1,

3. because the facility specifically desired one. 

Alarms don't have an equivalent to item 2, so therefore is entirely possible to have patient care spaces which will have a zone valve but no alarm.   

Remember though - it it NOT our decision.  This is explicit in 2021 NFPA 99 1.3.4.1 and for 6060's it is essential this be understood: 

"the health care facility's governing body ... shall establish ... category"

So, the Designer must be told by the G.B. what Category.  If they say Category 1, then that attracts the requirement for a zone valve (5.1.4.6.2) and an alarm (5.1.9.4). If they say Category 2 or Category 3, there may be a Zone valve - for either of the other two reasons, and there may be an alarm because the facility particularly desires it, but neither is required because of the Category.

As Verifiers, we need to know the instruction that was provided the Designer so we can correctly evaluate the Patient Care Space:

1. What Category,

2. Is it an anesthetizing location,

3. If so, what depth of anesthesia.

As a side note, FGI's imaging classes really have no direct relationship in this. Nowhere does NFPA require they be considered.  Naturally, the G.B. may include that in their decision making, but it would be their call. 

I have always in the past, tried not to quote the ANNEX.

But that was the past, today and in the future.

If the question comes up !

? Do all medical gases, medical support gas and/or medical surgical vacuum Zone Valve Boxes require an area alarm panel ?

This is what, I will send or verbalize to the industry:

NFPA 99 THE 2021 EDITION ANNEX Explamatory Material

A.3.3.140 Patient Care Space. Business offices, corridors,
lounges, day rooms, dining rooms, or similar areas typically are
not classified as patient care spaces.

A.3.3.140.1 Category 1 Space. These spaces, formerly known
as critical care rooms, are typically where patients are intended
to be subjected to invasive procedures and connected to line-
operated, patient care-related appliances. Examples include,
but are not limited to, special care patient rooms used for

critical care, intensive care, and special care treatment rooms such
as angiography laboratories, cardiac catheterization

laboratories, delivery rooms, operating rooms, post-anesthesia care
units, trauma rooms, and other similar rooms.

A.3.3.140.2 Category 2 Space. These spaces were formerly
known as general care rooms. Examples include, but are not
limited to, inpatient bedrooms, dialysis rooms, in vitro

fertilization rooms, procedural rooms, and similar rooms.

A.3.3.140.3 Category 3 Space. These spaces, formerly known
as basic care rooms, are typically where basic medical or dental
care, treatment, or examinations are performed. Examples
include, but are not limited to, examination or treatment
rooms in clinics, medical and dental offices, nursing homes,
and limited care facilities.

A.3.3.140.4 Category 4 Space. These spaces were formerly
known as support rooms. Examples of support spaces include,
but are not limited to, anesthesia work rooms, sterile supply,
laboratories, morgues, waiting rooms, utility rooms,
and lounges. (FUN)

We (as verifiers) need not turn ourselves into pretzels trying to solve this issue.  The issue isn't ours to solve, as Mark stated it is the Governing Body (GB) of the Healthcare Facility (HCF).  

So back to my original question, and I should've added the sentence in blue when I first asked it.

The question below needs to be posed to the GB of the HCF:

What will the impact to the patient be if the oxygen is lost while they are undergoing care inside of this x-ray room?

Will the loss of gas result in:

1.) major injury or death

2.) minor injury

3.) not likely to cause injury, but may cause discomfort

4.) no impact on patient care

Cary brings up an important point.  This is up to the hospital.

I would just add the other question to ask is will deep sedation or general anesthesia be administered in the space.  That is also an easy way to determine if it is category 1 or not.

Wow, so glad Ohio is stuck in 2015 and I will be retired by the time they move on to 2027.