Medical Gas System Testing, Part 2
By Arif Subhan, MS, CCE, FACCE
In this column, which is a continuation of the July 2013 CCE Prep column on medical gas system testing, I will discuss the testing requirements found in the NFPA 99 Health Care Facilities Code, 2012 edition. The previous column covered the Joint Commission medical gas system testing requirements, NFPA 99 definitions related to medical gas and vacuum systems, and the requirements for the three categories in those systems.
Section 18.104.22.168: This section of NFPA 99 discusses maintenance of category 1 medical gas, vacuum, waste anesthetic gas disposal (WAGD), and medical support gas systems. It requires health care facilities with medical gas, vacuum, WAGD, or medical support gas systems to develop and document periodic maintenance programs for these systems and their subcomponents.
Section 22.214.171.124.2.1: Inventories of medical gas, vacuum, WAGD, and medical support gas systems must include as a minimum all source subsystems, control valves, alarms, manufactured assemblies containing patient gases, and outlets.
Sections 126.96.36.199.2.2 and 188.8.131.52.2.4: The scheduled maintenance and inspections for equipment and procedures must be established through facility developed risk assessment, with consideration to the original equipment manufacturer (OEM) recommendations and recommendations required by the authority having jurisdiction (AHJ).
Section 184.108.40.206.2.3: The facility must use any inspection procedures or testing methods that are established through their own risk assessment.
Section 220.127.116.11.2.5: The qualifications of persons maintaining the medical gas systems may be any of the following:
- Training and certification through the health care facility in which the person is employed to be able to work on the specific equipment installed at the facility.
- Credentialing to the requirements of ASSE 6040, Professional Qualification Standard for Medical Gas Maintenance Personnel.
- Credentialing to the requirements of ASSE 6030, Professional Qualification Standard for Medical Gas Systems Verifiers.
Section 18.104.22.168.3: This section covers the inspection and testing of medical air, medical vacuum, WAGD instrument air, manifold bulk cryogenic liquid sources, final line regulation for all positive pressure systems, valves, alarms and warning systems, and station outlets/inlets.
Section 22.214.171.124.3.2: This section covers the manufactured assemblies employing flexible connection between the user terminal and the piping system. Nonstationary booms and articulating assemblies (other than head walls utilizing flexible connectors) should be tested for leaks, per manufacturer’s recommendations, every 18 months, or at a duration determined by a risk assessment.
The system pressure to nonstationary booms and articulating arms shall be maintained at operating pressure until each joint has been examined for leakage by effective means of leak detection that is safe for use with oxygen. Safe working condition of the flexible assemblies should be confirmed. DISS connectors internal to the boom and assemblies shall be checked for leakage.
Leaks, if any, shall be repaired (if permitted), or the components replaced (if required), and the equipment retested prior to placing the equipment back into service. Additional testing of nonstationary booms or articulating arms should be performed at intervals defined by documented performance data.
Section 126.96.36.199: For medical gas and vacuum systems maintenance and record keeping, permanent records of all tests must be maintained in the organization’s files.
Section 188.8.131.52.2: The supplier of the bulk cryogenic liquid system shall, upon request, provide documentation of vaporizer(s) sizing criteria to the facility.
Section 184.108.40.206.3: talks about an annual review of bulk system capacity that shall be conducted to ensure the source system has sufficient capacity.
Section 220.127.116.11.4: discusses the central supply systems for nonflammable medical gases. They should be inspected annually, maintained by a qualified representative of the equipment owner, and a record of the annual inspection shall be available for review by the authority having jurisdiction.
Section 18.104.22.168.5: discusses periodic testing procedures for nonflammable medical gas and vacuum and related alarm systems.
Section 22.214.171.124.6: Whenever modifications are made that breach the pipeline, any necessary installer and verification test specified in 5.1.12 should be conducted on the downstream portions of the medical gas piping system.
Section 126.96.36.199.7: Procedures for the maintenance program for the medical air compressor supply system must be established in accordance with the manufacturer’s recommendations. Facility testing and calibration procedures that ensures carbon monoxide monitors must be calibrated at least annually, or more often if recommended by the manufacturer. There must be a maintenance program for both the medical-surgical vacuum piping system and the secondary equipment attached to medical-surgical vacuum station inlets to ensure the continued good performance of the entire medical-surgical vacuum system, as well as for the WAGD system to ensure performance.
Section 188.8.131.52.8: Audible and visual alarm indicators must be periodically tested to determine their functionality, and records of the tests must be maintained until the next test is performed.
Section 184.108.40.206.9: Medical-surgical vacuum station inlet terminal performance, as required in 220.127.116.11.10.4, should be tested on a regular preventive maintenance schedule as determined by the facility maintenance staff. 24×7
1) NFPA 99 requires that the schedules for maintenance and inspection for medical gas system equipment be established using:
a) Facility developed risk assessment
b) Original equipment manufacturer (OEM) recommendations
c) recommendations required by the authority having jurisdiction (AHJ)
d) All of the above
2) NFPA 99 requires the facility to use inspection procedures or testing methods for medical gas system that are:
a) Established through their own risk assessment
b) Recommended by the equipment manufacturer
c) Recommendations required by the authority having jurisdiction (AHJ)
d) All of the above
3) NFPA 99 specifies the following qualifications of persons maintaining the medical gas systems:
a) Training and certification through the health care facility in which the person is employed covering the specific equipment installed at the facility
b) Credentialing to the requirements of ASSE 6040, Professional Qualification Standard for Medical Gas Maintenance Personnel
c) Credentialing to the requirements of ASSE 6030, Professional Qualification Standard for Medical Gas Systems Verifiers
d) Any of the above
4) NFPA 99 requires inventories of medical gas systems to include at least:
a) All source subsystems
b) Control valves
d) All of the above
See answers below.
Arif Subhan, MS, CCE, FACCE, is the chief biomedical engineer at the VA Greater Los Angeles Healthcare System, Calif; adjunct assistant professor, biomedical engineering, University of Connecticut; and a member of 24×7’s editorial advisory board. The suggestions and views expressed here are those of the author. They do not represent the views of the Department of Veterans Affairs or the University of Connecticut. For more information, contact email@example.com.
Answers: 1-d; 2-a; 3-d; 4-d