The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts


Scott E. Leonard, MBA, BA,RRT Health First Holmes Regional Medical Center, 1350 South Hickory Street,Melbourne Florida, 32901-3276

Background: Holmes RegionalMedical Center is a full service 468-bed major medical center with a level IItrauma center and a level II Neonatal Intensive Care Unit. Situated in MelbourneFlorida, a coastal community, Holmes Regional is custom to external disasterthreats such as hurricanes. With this in mind the current oxygen delivery systemwas evaluated to insure uninterrupted oxygen delivery to the entire hospitalfacility. Concerns were identified with the current supply tank, reservoir tankand delivery piping connections between the tanks and the facility. Would theybe able to withstand a category 4 or 5 hurricane?

Method: It was then decidedto create an alternative internal oxygen delivery system, which could be initiated,monitored and discontinued from within the facility. The oxygen riser diagramswere pulled from our plant operations department and determined that the facilitycould be back-fed from three entrance points. All three-entrance points werelocated within the facility on the first and second floor. It was then determinedthat liquid oxygen provided the greatest delivery amount and practical easeof use. Three manifolds were then constructed and installed at the three oxygenentrance points. Each manifold allowed for a manual switch to allow liquid oxygento back feed into the internal oxygen delivery system. Each manifold containedsix quick connections to connect to the cryogenic dewars.

Results: Once the manifoldswere installed it was then time to test the system. Eighteen dewars were deliveredin which six were placed by each manifold. Connections were made and the internalsystem was then allowed to back feed oxygen to fifty-five psi, (current externalsystem was set at fifty psi). With the psi now at fifty-five psi, the externaldelivery system was no longer supplying the facility. The internal system wasmonitored for four hours and determined to discontinue and resume to the externaldelivery system. The test was considered a success.

Experience: During the testingexercise it was determined that the availability of eighteen liquid dewar tankswas limited. As with any external disaster other facilities would require oxygenback up tanks as well, thereby limiting the supply. It is our recommendationthat the facility purchase and maintain its own dewar tanks to insure availabilityfor outside gas companies to fill when needed.

Conclusions: Holmes RegionalMedical Center has developed a way to insure the continuous delivery of oxygenduring unexpected catastrophic interruptions.