"user manual"
Contents
1. Portable Unit not filled correctly DOC 98 09 Disconnect the Portable Unit and clean the connecting faces with a clean cloth and then refit unit If leaks persist contact the Service Provider Ensure the vent valve is closed and leave unit to allow ice to melt naturally Do not use e force to remove Portable Unit e a hair dryer to melt the ice Clean and dry connecting faces with a clean cloth after the unit is removed For major leaks e stay away from the unit e open windows to ventilate room e immediately inform the Service Provider For minor leaks e reconnect Portable Unit to the Base Unit with vent valve closed e wait two minutes e disconnect Portable Unit e check if leak stops If leak stops e clean and dry connecting faces with a clean cloth after unit is removed If leak continues e reconnect Portable Unit with the vent valve closed and inform Service Provider Replace the felt pad with a dry unit Remove and empty condensate receiver Clean the receiver before replacing Refill Portable Unit correctly Check the Portable Unit level indicator that the gauge indicates Full Leak on Portable Unit 18 Inform Service Provider Inform Service Provider MGC DOC 98 09 Appendix 3 Typical Patient Equipment Checklist and Acknowledgement Form PATIENT EQUIPMENT CHECKLIST AND ACKNOWLEDGEMENT FORM GENERAL Patient and or carer present who will nee2. Leak of water from the Base Unit Duration of use from the Portable Unit shorter than usual Base Unit empties too quickly Ice in the fill valve or worn damaged connector Water condensate adsorbing pad on the Portable Unit is saturated from condensation Condensate receiver full Portable Unit not filled correctly DOC 98 09 For major leaks refit Portable Unit and remove the units from inside patient s home and allow unit to empty in a safe place by opening vent valve For minor leaks demonstrate to the patient how to e reconnect the Portable Unit to the Base Unit with vent valve closed wait two minutes disconnect the Portable Unit and check if leak stops if leak stops re emphasise to the patient how to clean and dry connecting faces with a clean cloth after portable unit is removed If leak continues reconnect Portable Unit with vent valve closed and replace unit Demonstrate to patient how and when to replace the water condensate adsorbing pad with a dry unit Demonstrate to the patient how and when to remove and empty condensate receiver and to clean before replacing Demonstrate to the patient how to refill the Portable Unit correctly and to check the Portable Unit level indicator indicates Full Leak on Portable Unit Replace the Portable Unit The Base Unit vacuum is inadequate Replace the Base Unit Leaks on the external pipe work 16 Recti
3. SAFE SUPPLY OF TRANSPORTABLE MEDICAL LIQUID OXYGEN SYSTEMS BY HOMECARE SERVICE PROVIDERS MGC Doc 98 09 E Revision of Doc 98 03 EUROPEAN INDUSTRIAL GASES ASSOCIATION AISBL al AVENUE DES ARTS 3 5 B 1210 BRUSSELS Tel 32 2 217 70 98 Fax 32 2 219 85 14 E mail info eiga eu Internet http www eiga eu MGC Doc 98 09 E SAFE SUPPLY OF TRANSPORTABLE MEDICAL LIQUID OXYGEN SYSTEMS BY HOMECARE SERVICE PROVIDERS PREPARED BY Jan STRYBOL AIR PRODUCTS MANAGEMENT Mercedes FRANCO CARBUROS METALICOS David OWERS LINDE GROUP Cl ment MAKOWIECKI AIR LIQUIDE SANTE Renato COMI VIVISOL Nik DE CORTE MESSER GROUP Garcia PRIETO PRAXAIR Disclaimer All technical publications of EIGA or under EIGA s name including Codes of practice Safety procedures and any other technical information contained in such publications were obtained from sources believed to be reliable and are based on technical information and experience currently available from members of EIGA and others at the date of their issuance While EIGA recommends reference to or use of its publications by its members such reference to or use of EIGA s publications by its members or third parties are purely voluntary and not binding Therefore EIGA or its members make no guarantee of the results and assume no liability or responsibility in connection with the reference to or use of information or suggestions contained in EIGA s publications EIGA has no co
4. Use the portable unit only as shown in the Instruction Manual 8 To turn on your liquid oxygen vessel turn the oxygen flow control valve anticlockwise 11 When transfilling the portable unit never leave it unattended until the unit is full If the unit will not disconnect easily never use force to remove it Wait a few moments to allow it to thaw and then try again 14 Select zero on the oxygen flow control valve after use Keep closed when the liquid oxygen vessel is not in use 21 3 Only use your liquid oxygen vessels and equipment in a well ventilated area Keep internal doors open whilst your oxygen vessels are in use 6 Do not use oils or grease with your liquid oxygen vessels or equipment Ensure that your hands are clean when using the vessels Only use authorised creams and moisturisers when using your medical oxygen 9 Set the flow control valve to the flowrate prescribed by your Doctor Check for any leaks on the tubing connection after selecting the correct flowrate 12 Never touch any cold parts on either vessel or allow liquid oxygen to come into contact with 2 your skin This could cause a serious burn Immerse affected parts in tepid water if you receive a cold burn reason call wone TD your Service If either liquid Provider immediately oxygen vessel fails for any Never try and repair any fault u
5. Some TLOS have an integrated conserving device It is a normal function of the TLOS that where it is not in continuous use it will eventually start to vent oxygen gas to atmosphere The base unit is fitted with a liquid oxygen transfer connector to allow it to be filled by the Homecare Service Provider and to permit the transfilling of the portable unit by the patient or carer The portable unit shall be designed to be filled to a specific type of transfilling connector on the base unit The Homecare Service Provider shall only supply the patient a portable unit that is compatible with the base unit 8 Initial Installation of the Transportable Liquid Oxygen Systems 8 1 Initial Assessment When planning the installation and storage arrangements for TLOS whether used in healthcare facilities or by domiciliary patients at home an assessment of the property shall be carried out in accordance with the document MGC 89 09 This should ensure that the patient or healthcare worker MGC DOC 98 09 are not subjected to undue risk in the event of any incident with a liquid oxygen vessel that is in use or being stored For domiciliary patients the person supplying the TLOS could carry out this assessment From the results of the assessment any special circumstances identified for that patient shall be evaluated and the appropriate required actions identified and notified to the patient or their carer If the patient s premises are considered to be u
6. Guide for the Homecare Service Provider is given in Appendix 1 12 MGC DOC 98 09 16 References MGC 89 09 Medical Oxygen Systems for Homecare Supply IGC 141 07 Planning oxygen supplies for respiratory patients when travelling EN ISO 18777 Transportable Liquid Oxygen Systems for medical use Particular Requirements BCGA TIS No 14 Safety Precautions and Risk Management when dealing with Domiciliary Oxygen Incidents CGA P 27 Guide for the Safe storage Handling and Use of small portable liquid oxygen Systems in Health Care facilities EN 1251 2 Cryogenic vessels Transportable vacuum insulated vessels of not more than 1000 litres volume Part 2 Design Fabrication Inspection and Testing EN 1251 3 Cryogenic vessels Transportable vacuum insulated vessels of not more than 1000 litres volume Part3 Operational requirements Directive 93 42 EC Medical Device Directive as amended by Directive 2007 47 13 MGC Appendix 1 DOC 98 09 TLOS Troubleshooting Guide Service Provider at the Patient s Home Typical Troubleshooting Guide for Transportable Liquid Oxygen Systems Abnormal Operational Condition Pressure too low No flow from the unit Flow appears to be too low Wrong indication of the liquid level For the Service Provider at the Patient s Home Possible Cause Liquid too cold and not at the required saturated pressure defined by the Manufacturer Corrective Action
7. Oxygen Systems The transport of liquid oxygen vessels by the Homecare Service Provider is covered by the conditions of the ADR regulations These regulations do not affect the transport of liquid oxygen vessels by the patient in their own vehicle However national legislation may affect the carriage of liquid oxygen in privately owned vehicles The document IGC 141 07 also gives safety cards for using oxygen whilst travelling There are potential risks involved with the transport and use of liquid oxygen vessels in patient s motor vehicles Where a medical liquid oxygen vessel is used in a motor vehicle the patient shall be advised to e only carry sufficient medical liquid oxygen for the patient to complete the journey Under normal circumstances only one portable unit should be carried in the vehicle e prohibit smoking by anyone in the vehicle e both the patient and the driver are adequately trained in the correct method of operation of the TLOS whilst in use in the vehicle and the appropriate precautions to be taken in the event of an incident It is important to highlight the risks associated with oxygen enrichment within the vehicle e keep the base unit and portable unit upright unless the unit is designed to be used in other orientations and adequately restrained to ensure that the TLOS is kept safe and that it can not move should the vehicle brake harshly or be involved in an accident e preferably do not keep the TLOS in the
8. Service Provider Check the pressure in the unit If unit pressure is very low replace unit at the patient s home with correctly filled unit If pressure is only slightly low leave unit standing until the natural evaporation rate increases the pressure to its minimum operating level Unit empty Refill the unit or replace with a full unit Vent valve left open too long after filling Leave unit standing until the natural evaporation rate increases pressure to its minimum operating level Leaks from the unit Identify leak and rectify if simple to fix Otherwise replace unit Other malfunctions Flow regulating valve set at zero Replace unit Set the flow to the prescribed level Check flow from outlet by placing tubing in water and check for bubbles If conserving device is fitted remove device or switch to continuous flow and check for flow Unit empty Refill the unit or replace with a full unit Components not fitted correctly Check fitting of the tubes to humidifier Check that the tube is not kinked Check that humidifier is not blocked Check by removing humidifier and see if flow continues Blockage of components Base unit pressure too low Replace faulty unit Refer to the Low Pressure section Flow controller set too low Check setting of Flow Controller to prescribed flowrate Follow instructions in No Flow Blockage of interna
9. any combustible materials such as curtains The patient or carer should be informed that it is normal for some liquid to escape from the vent valve of the portable unit at the end of the filling e during the refilling operation the person filling the portable unit shall be instructed to briefly close and open the portable unit vent valve during the filling process to dislodge any ice that may have formed in the outlet e ifa minor liquid oxygen leak occurs after the portable unit is disengaged from the base unit it shall be refitted immediately to the base unit This procedure will help to dislodge any ice or other obstruction in the transfilling connector When the portable unit is subsequently disconnected the leak should be cured e after filling if the portable unit will not separate easily from the base unit never use undue force to separate the portable unit as the units may be frozen together Never use a hair dryer to melt the ice Leave the units connected for a short period with the portable unit vent valve closed to allow the transfill connector to warm and the ice to melt which will generally allow the units to separate easily e The patient carer shall be instructed to always adhere to safety guidelines when transfilling the portable unit Should a major liquid oxygen leak occur on either unit the patient carer shall be instructed as per the above paragraph Emergency Actions 14 Travelling with Transportable Liquid
10. or open fires away from areas where medical oxygen is used or stored e It is advisable that No Smoking symbols and instructions shall be displayed on TLOS e When handling the TLOS never touch any frosted parts or allow liquid oxygen or frosted pipe work to come in contact with the skin or non protective clothing If suffering from a cold burn the affected part should immediately be immersed in tepid water and a doctor contacted immediately for further advice e Never use oils and grease on any oxygen equipment because these materials will burn in an oxygen enriched environment with explosive violence e TLOS shall only be used and stored in areas away from sources of ignition such as lighted cigarettes gas cookers electrical toys and equipment or open fires e Oxygen equipment shall only be handled or operated with clean hands and tools and the equipment shall be kept clean taking specific care to keep the filling couplings clean e Where available the filling coupling cover should be fitted when not in use e Petroleum jelly or hand and face creams containing petroleum based ingredients shall never be used with medical oxygen e Instructions shall be given the patient carer or Healthcare Facility representative to e only handle or operate medical liquid oxygen equipment with clean hands and tools and to keep the oxygen equipment clean and free from any oils or grease e where the patient requires to use a moisturiser or cre
11. passenger compartment of the car when not in use e keep the outlet valve shut when the TLOS is not in use e avoid using the TLOS whilst the vehicle is being re fuelled e never leave the TLOS unattended in the vehicle e keep the vehicle ventilated when the TLOS is in use preferably by opening at least one window to prevent oxygen enrichment of the air within the vehicle e preferably set the ventilation system in the vehicle to draw fresh air into the car and not to recycle the air 11 MGC DOC 98 09 e the patient is advised to fit an anti static strip to their vehicle to reduce possible build up of static electricity e Itis not recommended to transport base units greater than 15I capacity inside private cars It is the responsibility of the patient to determine whether the transport provider will permit the carriage and use of liquid oxygen vessels on public transport such as buses trains ships and planes Where several patients using TLOS are meeting or resident in the same location such as a restaurant or hotel it is the responsibility of the patients to inform the owner manager of the facility about precautions needed to be followed when using liquid oxygen 15 Maintenance and Cleaning of the Transportable Liquid Oxygen Systems The patient or healthcare staff shall not be permitted to carry out any maintenance to the TLOS other than any routine operations defined in the Users Manual Only authorised and trained persons sh
12. training session to ensure that they are all competent to complete the task As part of the training the Homecare Service Provider shall ensure that the portable unit is filled by the patient or carer The Homecare Service Provider shall supply information required for operating and handling of the TLOS and transfilling the portable unit including the manufacturer s Instructions for Use The Homecare Service Provider shall agree with the patient carer on a safe location for the base unit and the area where the portable unit will be transfilled The base unit should not be positioned in doorways or access routes out of the building MGC DOC 98 09 In order to ensure that the medical oxygen flow rate remains satisfactory The total length of the flexible unsupported tubing from supply source to the connection to the nasal cannula or mask shall be kept to a minimum but in any case no more than 15 meters If tubing is fixed to the walls to provide outlets in different rooms this shall be with no constrictions at corners etc Where the transfilling is carried out on an adsorbent surface such as a carpet the patient carer shall be informed to ensure that the area is well ventilated to prevent the surface becoming enriched with oxygen in the unlikely event of a spillage If transfilling is done in the open it shall never be carried out on an asphalt surface The Homecare Service Provider shall instruct the patient carer Healthcare Faci
13. when to replace ancillary equipment OXYGEN DEVIVERY AND EMERGENCIES Explain normal delivery procedures for supplies of oxygen and provide telephone number Explain emergency breakdown procedures and provide telephone number if different Explain when to use the 24 hours service PATIENT CARER CONFIRMATION Patient Information Pack and telephone numbers supplied to Patient Carer Confirmation that the Service Provider have gone through all the points mentioned above have understood all the instructions given to me by the Service Provider including that smoking is prohibited in the vicinity of either unit Patient Signature _____________________ Date Technical Installer Signature ___________________ rCDatte OOO OO OO OOO OOOO OOOOOO Oooo 19 MGC DOC 98 09 Appendix 4 Patient User Instruction Card PATIENT USER INSTRUCTION CARD USE OF MEDICAL LIQUID OXYGEN IN THE HOME 1 3 Always At ER Aae N Use Read No Naked In A Instructions Flames Ventilated Area 4 5 6 Avoid ES Keep Oxygen Upright Use Oil Enrichment or Grease 7 Connect Oxygen Open Open Tubing Flow go Control 10 Check For Flow 13 Only lt Select Clean Zero With a Flow Assistance Damp Cloth After Use If Required MGC Appendix 5 PATIENT USER TRAINING CARD DOC 98 09 Patient User Training Card USE OF MEDICAL LIQUID OXYGEN IN THE HOME 1 Read the User Instruction Manual car
14. C DOC 98 09 cryogenic burns or frostbite When handling the TLOS do not allow liquid oxygen or frosted pipework to come in contact with the skin or non protective clothing e Moisture can accumulate on exposed surfaces of equipment containing liquid oxygen forming ice causing components such as valves or filling couplings to freeze open or shut If moisture is permitted to enter liquid oxygen lines or systems it will freeze and may prevent components such as pressure relief devices or control valves from functioning properly which could result in a potentially unsafe condition e One volume of liquid oxygen at standard atmospheric pressure when vaporised will produce approximately 860 volumes of gaseous oxygen at ambient temperatures The large volume of gaseous oxygen resulting from the vaporisation of liquid oxygen has the potential if trapped in a closed circuit not adequately protected by pressure relief devices to generate gas pressures high enough to cause explosive rupture of containers transfer piping or other system components Care shall be taken to avoid blockage of the outlets of vent lines ports and safety relief devices for instance by dirt or ice e Due to the extremely cold temperature of liquid oxygen it will constantly absorb heat through the vessel walls which will produce gaseous oxygen Any gaseous oxygen produced in excess of the patient s requirements will be automatically vented generating an oxygen enriched atm
15. Patient User Instruction Card that can be supplied to the patient and or carer when the equipment is initially installed at the patient s home or Healthcare Facility is given in Appendix 4 Appendix 5 gives a typical Patient User Training card that can be used by the Homecare Service Provider to instruct the patient or carer It covers the correct operation of the unit and the safety precautions that shall be followed It may be appropriate for both Cards to be left with the patient or carer to provide additional information In addition the TLOS User Manual shall also be provided to the patient carer Where the User Manual specifies a different way of using handling or transfilling the TLOS the information provided to the patient should be reviewed to ensure that there is no contradiction between the information supplied and the manufacturer s instructions The basic precautions to be given to the patient carer Healthcare Facility representative shall cover the following information e Most serious incidents involving the use of medical oxygen are caused by the patient smoking e Instructions shall be given to the patient carer or Healthcare Facility representative to e never smoke whilst using their medical oxygen equipment e never allow any other person to smoke in the vicinity of the patient using their medical oxygen MGC DOC 98 09 e keep sources of ignition including lit cigarettes gas cookers electrical toys and equipment
16. Service Provider to change Failure of the liquid level gauge system Flow setting too high Inform Service Provider Reset flow setting to the prescribed flowrate Flow setting correct Water in Humidifier dirty Normal operation of the unit no action required Inform Service Provider Clean the humidifier and replace with clean water Cannula dirty Replace the cannula if dirty Water condensate adsorbing pad on the Portable Unit dirty Replace pad on Portable Unit Other components dirty Base cover on Portable Unit still in place where fitted Inform Service Provider Remove base cover from Portable Unit Cover on the Base Unit fill connector still in place where fitted Safety valve venting 17 Remove cover from Base Unit Normal operation no action MGC Leaks when connecting the Portable Unit to the Base Unit Problems disconnecting the Portable Unit from the Base Unit Portable Unit leaking after disconnection Leak of water from the Portable Unit Leak of water from the Base Unit Duration of use from the Portable Unit shorter than usual Any other problems Dirt on the connecting faces or worn damaged connector on Portable or Base Unit Ice on the connecting faces Ice in the fill valve or worn damaged connector Felt pad on the Portable Unit is saturated from condensation Condensate receiver full
17. all be permitted to carry out maintenance on the TLOS The patient or carer is only responsible for the routine hygiene maintenance of the equipment including the humidifier nasal cannulas face masks water condensate collectors and the external surfaces of the TLOS These actions should be defined in the manufacturer s User Manual The patient carer shall be instructed that if any part of the TLOS fails to operate correctly they should contact the Homecare Service Provider immediately so that an authorised person can diagnose the fault and implement the appropriate corrective action Appendix 2 gives typical questions asked by the patient and provides the appropriate corrective actions to be taken by the patient Under no circumstances shall any piece of equipment be disassembled by the patient or carer other than the routine changing of any of the consumable items of the breathing circuit Where batteries are used for the level indication the patient carer shall be responsible for changing them only where they are instructed to do it by Medical Oxygen Healthcare Service Provider The patient carer shall be instructed to never lubricate any part of the equipment with oil or grease and to ensure that hands are clean and free from oils and creams when handling the oxygen equipment When cleaning the equipment the patient or carer shall be instructed to always turn off the oxygen supply and to never use any solvents or other flammable prod
18. am to prevent their nostrils from drying out to only use an acceptable oil free product that is suitable for use with medical oxygen e Where it is suspected that clothing carpets or bedding has become saturated with oxygen it shall be well ventilated to ensure that the oxygen enrichment is cleared e ventilate any clothing or bedding where it is suspected that it has become saturated with oxygen to ensure that any oxygen enrichment is cleared It may take at least 15 minutes to adequately ventilate clothing or 30 minutes to ventilate bedding before it is safe to approach sources of ignition e never use the ambulatory unit under clothing Where an ambulatory unit is carried in a bag or holder it must be specifically designed for the unit and be made from appropriate material and provide adequate ventilation The design shall allow any oxygen that leaks out of the container to escape to reduce the possibility of oxygen enrichment e to prevent any unnecessary enrichment of the air it is important that patients carers are instructed that the oxygen system must be turned off when not in use e Only trained persons shall be allowed to operate the medical oxygen equipment Special care needs to be taken to ensure that children are not allowed to tamper with the equipment e In order to ensure that the medical oxygen flow rate remains satisfactory The total length of the flexible unsupported tubing from supply source to the connection to the
19. d to operate equipment Provide relevant patient information including details about the delivery service Explain the prescription to the patient and need to only use the correct flowrate Advise that no one shall attempt to repair or adjust equipment SAFETY INFORMATION Explain oxygen is non flammable but will assist all sorts of materials to burn vigorously Explain about fire hazards and describe ignition sources such as smoking fires cookers etc Explain never to smoke or allow anyone else to smoke in presence of oxygen Explain never to use grease or oil on any oxygen equipment and only to use approved creams Explain the need for adequate ventilation and to not cover the units or use under clothing Explain the effects of cold liquid on skin and eyes BASE UNIT OPERATION Agree safe location of Base Unit for storage and use Explain correct operation of Base Unit Advise that slow escape of oxygen from relief valve is normal evident by hissing noise Confirmation that the Patient Carer has operated the Base Unit correctly PORTABLE UNIT OPERATION Explain correct operation of Portable Unit and duration of use at the prescribed flowrate Explain never to carry or use Portable Unit under clothing Confirmation that the Patient Carer has successfully filled the portable unit ANCILLARY EQUIPMENT Provide nasal cannula or mask humidifier and show how to use ancillary equipment correctly Demonstrate how to clean dry and
20. ed to supply medical liquid oxygen to patients at home or in healthcare facilities as a stand alone therapy supply system It includes the operational specification of the TLOS to provide the patient with the prescribed flowrate but excludes its basic design requirements which are detailed in EN 1251 2 Cryogenic vessels Part 2 Design Fabrication Inspection and Testing Other relevant documents are MGC 89 09 Medical Oxygen Systems for Homecare Supply IGC 141 07 Planning oxygen supplies for respiratory patients when travelling EN ISO 18777 Transportable Liquid Oxygen Systems for medical use Particular Requirements BCGA TIS No 14 Safety Precautions and Risk Management when dealing with Domiciliary Oxygen Incidents This document specifically does not cover e the filling and handling of the TLOS base unit by the Medical Oxygen Healthcare Service Provider e the Good manufacturing Practice GMP and traceability requirements concerned with the supplies of medicinal gases which are covered by the EIGA document Good Manufacturing Practice Guide for Medicinal Gases e the traceability of medical equipment which is covered by EC Directive 93 42 EEC as amended by EC Directive 2007 47 e the requirements for liquid oxygen vessels used on manifold systems to supply medical oxygen to healthcare facilities via a pipeline system which is covered by EN ISO 7396 1 Medical Gas Pipeline Systems Part 3 Pipeline Systems for Compr
21. eeeeeeeeeeeeeseteaeeeeeeeeeeeees 9 10 3 Service Provider Checks for the Disposable Accessories ccceceeeeeeeeeeecaeeeeeeeeeteees 9 12 Operation and Use of the Transportable Liquid Oxygen SysteMS cc cceeeeeeeeeteeeeeeenaees 10 13 Transfilling of the Portable Uinits iccctsessecesic Hcceasbbaceugid ctegeudhbgiceea bob ieen tl attend lebiseuasadl ERES 10 14 Travelling with Transportable Liquid Oxygen SystemS cccceeeeeeeeeeneeeeeeeneeeeeeenaeeeeeenaeeeeeeaas 11 15 Maintenance and Cleaning of the Transportable Liquid Oxygen Systems 0 ceeeeeeeeees 12 16 IRETEKEN CES 2 ocitrre tid caste ein eres coke eres Ceres ok Ath a eve th 20 eto ene des agra tare 13 Appendix 1 TLOS Troubleshooting Guide Service Provider at the Patient s Home 14 Appendix 2 Typical Patient Questions concerning TLOS c ccecccceeeeeeeeeeeeeeeeeeeeeeeeeensnsaeeeeees 17 Appendix 3 Typical Patient Equipment Checklist and Acknowledgement Form 0 0 cesee 19 Appendix 4 Patient User Instruction Card cececccceccececeeeeeeeneeeeeeeeeee ce eaeaeceeeeeeeseceueaeeeeeeeeeneenaees 20 Appendix 5 Patient User Training Cardia eerie aariaa ee rodea aan iaae edia taparai 21 MGC DOC 98 09 1 Introduction Medical Liquid Oxygen is a well established method of supplying patients with supplementary oxygen either in their homes or in healthcare facilities where permitted according to the national regulati
22. eeseeeaeeeeeneaeeeseeaeeeeeeaeees 3 6 Emergency ActionS 0 2c020ueAciidaaiieh aol aii a date eh odin EVADA adnan 5 7 General Description of Equipment cccccccceceeeeeeeenee cece eeeeeeeeeaaaeeeeeeeeeseccaaeeeeeeeeeesetennisaeeeeeeteees 5 8 Initial Installation of the Transportable Liquid Oxygen Systems ceccececceeeeeeeeeeeeeceeeeeeeeeeteees 5 8 1 INItAl ASSCSSIMENE aemm eme a a e aa aa E a e macs fected aeeai 5 8 2 Equipment Preparation ccccccccccceeeeeeeceneeeeeeeeeeeceeaaecaeceeeeesesceaeaeeeeeeeseseccueeeeeeeeeseeenneaeas 6 8 3 Initial nstallat O e ts eee recas tei recbee ct sane etch tec a sucht a aa e a macs fe Ea aN 6 8 4 High Flowrate Requirement cccceeeeeeeeeeeeeeeeeeneeee ee enneeeeeeineeeee ENEA RAEE ESEA REEERE NAAR EA 7 9 Storage of the Transportable Liquid Oxygen Systems ecccceeeeeeeeceeeeeeeeeeeeeeeeeeeeeeseeaeeeeeeeaees 8 9 1 Storage of the TLOS at the Patient s HOME 0 ee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeaeeeseeeaeeeeeeaaeees 8 9 2 Storage of the TLOS at the Healthcare Facility 0 0 0 cc ceeceeeeeeeeeeeeneeeeeeeeneeeeeeeneeeeseeaees 8 10 Service Provider Checks for the TLOS ccccccceeeeeeceeceeeeeeeeeeeeeaeeececeeesecaeaeeeeeeeeesetsenieaeeeees 9 10 1 Service Provider Checks for the Base Uniit ccccccececesecceeeeeeeeeeeeeaeeeeeeeeeseccaeaeeeeeeeeeeeees 9 10 2 Service Provider Checks for the Portable Unit cccccccceceeeeeeeene
23. efully before operating your liquid oxygen vessels and equipment Pay special attention to information where the hazard symbol is shown 4 Never place your 6 oxygen vessels near curtains or cover them with clothing as this will gt restrict air circulation Materials become oxygen enriched if any leak occurs with no ventilation Never use or carry the portable oxygen vessel under any clothing 7 Attach the oxygen tubing to the outlet connector on the liquid oxygen vessel Ensure that the length of the tubing does not exceed 15 metres 15 meters max 10 Check for flow by placing the end of the tubing in a glass of water and watch for bubbles If no bubbles appear check a flow has been selected and there are no leaks If a flow is still not evident contact your Service Provider 13 Use only a clean damp cloth to clean your liquid oxygen vessels or any associated equipment Only use mild non abrasive cleaning materials Allow the liquid oxygen vessels to dry after wiping down 2 Materials burn much more vigorously in oxygen than air ma N Never smoke or let someone else smoke near you whilst using your oxygen equipment Do not use your oxygen vessels near open fires or naked flames 5 Follow the advice Your Service Provider has given you where to safely store and use your liquid oxygen vessel Use and store your liquid oxygen base unit upright
24. essed Medical Gases and Vacuum The general requirements for the supply and safe use of medical oxygen are given in MGC Document 89 09 MGC DOC 98 09 2 2 Purpose The purposes of this document are to give guidance on e the specific safety issues related to the handling and use of medical liquid oxygen e safety precautions recommended for the Homecare Service Provider for installing handling and maintaining the TLOS e safety precautions recommended to be given to the patient carer when using and handling the TLOS and transfilling the portable unit 2 3 Definitions Homecare Service Provider An organisation company that provides the medical oxygen and the medical oxygen equipment for treating patients either in their home or supplied direct to the Healthcare Facility treating the patient Healthcare Facility An organisation company providing the medical oxygen therapy to the patient on their premises where they are responsible for the care of the patient e g hospital or Care home TLOS Transportable Liquid Oxygen System comprising of the base unit and the portable unit that can be filled from the base unit Base Unit A mobile device that is vacuum insulated intended to store oxygen and maintain it in the liquid state for the purpose of refilling portable units and that can include an internal vaporiser and a flow control valve for the direct supply of gaseous oxygen to the patient Portable Unit A portable device
25. fy leak if possible or replace Base Unit MGC Appendix 2 DOC 98 09 Typical Patient Questions concerning TLOS Typical Patient Questions concerning Transportable Liquid Oxygen Systems No Typical Question No Flow from the Unit Flow Appears to be Too Low Wrong Indication of the Liquid Level Gaseous oxygen temperature appears too cold Oxygen has bad odour Problems connecting Portable Unit to Base Unit Hissing noise from either unit Possible Cause Flow Regulating Valve set at zero Corrective Action to be taken by Patient Set the flow to the correct setting Check the flow from the outlet by immersing in water and checking for bubbles If conserving device is fitted remove device or switch to continuous flow and check for flow Base Unit empty Check contents gauge If empty call Service Provider to refill the Base Unit Components not fitted correctly Check the fitting of the tubes to the humidifier Check that the tube is not kinked Check that the humidifier is not blocked check by removing the humidifier and see whether if the flow continues Blockage of components Leaks from the humidifier or tubing Flow controller set too low Battery flat where used Inform Service Provider Refit humidifier and tubing connectors Check setting of Flow Controller to prescribed flowrate Follow instructions in No Flow Replace battery or arrange for
26. here there are no open flames e Where ever possible keep the TLOS at least 3 metres away from o open fires and any naked flames o heating sources or stoves with open flames e When selecting a storage place at the patients home avoid placing the TLOS o in corridors and hallways or near doorways o where they could impede patient s or carers movement o where they may be bumped into or tipped over 9 2 Storage of the TLOS at the Healthcare Facility When planning the storage of TLOS in a Healthcare Facility the following additional advice concerning the storage of significant numbers of base units they shall be advised that the storage area shall be e covered preferably inside and not subjected to extremes of heat e kept dry clean and well ventilated with ventilation grilles preferably at both high and low level e designed to have a floor constructed covered with a non flammable material e large enough to allow for segregation of full and empty vessels with the different storage areas being well signed e totally separate from any non medical gas storage areas e sited to have good access for the delivery vehicle to enable vessels to be off loaded safely onto a reasonably level floor e located away from any sources of heat or ignition and storage tanks containing highly flammable materials and other combustible materials e designed to prevent unauthorised entry to protect vessels from theft e provided with warning notices prohibi
27. including a vacuum insulated cryogenic vessel to maintain liquid oxygen at cryogenic temperatures an internal vaporiser and a flow control to provide gaseous oxygen to the patient The portable unit can be filled from the base unit by the patient 3 Characteristics of oxygen The basic characteristics of oxygen are e Oxygen is an essential requirement to sustain life and is normally supplied from the earth s atmosphere which is made up of approximately 20 9 oxygen e Gaseous oxygen is a colourless odourless tasteless gas with a specific density of 1 1 relative to air e Liquid oxygen is a light blue liquid that flows like water e Liquid oxygen has a boiling point of 183 0 C at atmospheric pressure and has a specific density of 1 14 relative to water e One volume of liquid oxygen will generate 860 volumes of gaseous oxygen at atmospheric pressure and temperature e Oxygen in gaseous or liquid form is a non flammable non toxic powerful oxidiser 4 Hazards with handling Liquid Oxygen When making the initial supply of medical liquid oxygen advice shall be given to the patient carer or Healthcare Facility representative to explain the general hazards when using medical liquid oxygen in a TLOS and shall include the following information e Liquid oxygen is extremely cold and boils at 183 0 C at atmospheric pressure Touching any cold surfaces on the TLOS such as the valves pipes or couplings can cause sever MG
28. l components Replace faulty unit Blockage of ancillary equipment Leaks from the humidifier or tubing Battery flat where used Remove any obstructions or replace faulty ancillary equipment Refit humidifier and tubing connectors Replace battery or replace unit where not practicable to replace on site Failure of liquid level gauge system 14 Replace faulty unit MGC Gaseous oxygen temperature appears too cold Oxygen has bad odour Problems connecting the portable unit to the Base Unit Leaks when connecting Portable Unit to Base Unit Problems disconnecting the Portable Unit from the Base Unit Hissing noise from either unit Portable Unit fills too slowly Flow setting too high DOC 98 09 Reset flow setting to the prescribed flowrate Flow setting correct Water in Humidifier dirty Explain to patient that this is the normal operation of the unit or arrange for a second unit to be installed Demonstrate to patient when to clean humidifier and how to refit it including refilling with clean water Cannula dirty Instruct patient how and when to replace cannula if dirty Felt on the portable unit dirty Instruct patient how and when to replace felt pad on portable unit Other components dirty Base cover on portable unit still in place where fitted Demonstrate to the patient how to clean the external surface of the
29. lity representative to e Not place any form of cover over the equipment as this will restrict ventilation Specifically do not drape clothing or any other material over the vessel nor store the base unit near curtains as they may become oxygen enriched and burn vigorously if ignited For the same reason the portable unit shall never be carried or used under any clothing e Not to block the outlets of the relief valves e Not apply any labels or markings to the TLOS e Not repair any part of the TLOS When the installation is complete and the training completed satisfactorily the patient carer should be requested to sign the Equipment Checklist and Acknowledgement Form see typical example in Appendix 3 8 4 High Flowrate Requirements In the majority of circumstances a single TLOS will be able to supply an adequate flowrate for the patient Where the patient requires higher flowrates it is preferable to use a single unit with a higher output provided that it does not lead to icing up of the base unit Where the prescribed flow exceeds the flowrate capabilities of a single base unit or leads to icing up of the unit two or more units may be connected to provide the patient s requirements As this type of patient normally requires high flowrates at all times they can be supplied with a specifically designed high flowrate portable unit or any other alternative high flowrate system for exceptional ambulatory use It is not recommended to co
30. liver the flowrate required As addition oxygen is being stored in the patient s home it is important to consider the storage and ventilation requirements when carrying out the assessment MGC DOC 98 09 9 Storage of the Transportable Liquid Oxygen Systems 9 1 Storage of the TLOS at the Patient s Home The TLOS shall always be stored in a covered area and preferably indoors but in any case in a secure place away from the public The most suitable locations for installing the TLOS at the patient s home will normally be either in a living room or bedroom but when agreeing the storage arrangements in the patient s home the patient carer shall be advised to consider the following requirements e As the TLOS will periodically release small amounts of oxygen gas keep the units in a well ventilated area Allow air circulate around the unit at all times to prevent any significant oxygen enrichment in the vicinity Never store the TLOS in small and closed areas such as cupboards e Never store the TLOS within the immediate vicinity of sources of ignition because the atmosphere around the TLOS may become oxygen enriched by the venting of the vessel e Storage position of the TLOS should be sited so that the delivery vehicle can safely offload onto a level floor e Where ever possible keep the TLOS at least 1 5 metres away from o electrical appliances such as televisions air conditioning fans or hair dryers o heating sources or stoves w
31. n oxygen enriched atmosphere use a flood of water to extinguish the flame as just smothering the flame from oxygen enriched materials will not extinguish the fire e If a fire occurs where the TLOS is present immediately evacuate the area and call the fire brigade It is important to advise the fire brigade that oxygen is in the premises even though it may not be involved in the fire After the incident If clothing bedding or furniture has been exposed to a high concentration of oxygen avoid any sources of ignition until they have either e been removed e been thoroughly aired to remove any excess oxygen for at least 15 minutes and at least 30 minutes for bedding furniture e been drenched with water Further information can be read in the BCGA document TIS No 14 Safety Precautions and Risk Management when dealing with Domiciliary Oxygen Incidents 7 General Description of Equipment The TLOS consists of two units e A base unit that holds the principal supply of liquid oxygen and is filled by the Medical Oxygen Healthcare Service Provider e A portable unit usually intended for ambulatory use that can be filled by the patient or carer from the base unit The oxygen supply to the patient can be supplied from the flow regulating device either on the base unit or the portable unit In some cases the TLOS is designed so that the portable unit has to be fitted to the base unit in order to supply the oxygen gas to the patient
32. nasal cannula or mask shall be kept to a minimum but in any case no more than 15 meters If tubing is fixed to the walls to provide outlets in different rooms this shall be with no constrictions at corners etc e The TLOS shall never be covered with material or stored adjacent to curtains as they may become oxygen enriched e The TLOS shall be kept in a well ventilated area to avoid the generation of oxygen enriched atmospheres They shall also be kept away from combustible materials and protected from exposure to heat sources which may accelerate the venting of gaseous oxygen from the vessel e Care shall be taken to avoid blockage of vent lines ports and safety relief devices e TLOS shall be handled with care and should never be knocked violently dropped or allowed to fall over e These basic precautions shall also be followed by the Homecare Service Provider when installing handling transfilling or maintaining the TLOS at the patient s home healthcare facility MGC DOC 98 09 6 Emergency Actions The Homecare Service Provider shall provide the patient carer or Healthcare Facility representatives with the following emergency action advice Emergency Actions e Ifa sustained release of liquid oxygen occurs stay out of the vapour cloud and the immediate surrounding area open all external doors and windows and evacuate all persons from the area and contact the Homecare Service Provider immediately e f clothing ignites in a
33. nless specifically instructed by your Service Provider
34. nnect two portable units to supply high flowrates for practical reasons When connecting multiple units together the following points need to be considered e The units shall be connected using appropriately designed fittings that will allow the entire system to provide a safe and adequate supply e To set up the system the multiple units should be connected with Y connectors from the patient outlet on the base units e f a humidifier is required a single unit shall be used fitted after the Y connection to prevent the backflow of water into any of the units due to pressure differences The total flowrate from multiple connected TLOS may not be the simple summation of the flowrates set on each individual flow regulation device To avoid inaccurate flow control it is advisable to connect an additional flow regulating device downstream of the interconnection and to control the flow to the patient at the prescribed flowrate having fully opened the flow selector valves on both units The multiple units should be installed as close as possible to the patient to minimise the pressure drop in the supply line If a humidifier is required it shall be installed downstream of the additional flow regulating device Use base units of the same size so that the units can be refilled at the same time to prevent one unit emptying before the other unit leading to a reduced flowrate Ensure that the oxygen tubing is of a sufficient size to be able to de
35. nsuitable for the storage and use of the TLOS the Medical Oxygen Homecare Service Provider shall inform the patient s prescriber that an alternative method of supplying medical oxygen is required Excessive stocks of full TLOS will increase the potential of any incident that may occur on site The Homecare Service Provider shall determine the size and number of the base units to suit the patient s requirements at the prescribed flowrate and delivery frequency 8 2 Equipment Preparation Prior to installing any equipment in the patient s home or healthcare facility it is the responsibility of the Homecare Service Provider to verify that the equipment is functioning correctly including that the e vessels are within their periodic statutory test date e exterior condition of the TLOS is clean and not damaged to an extent which impairs the correct functioning of the unit e transfilling connector is clean not leaking and has no visible sign of damage e receiver for collecting condensation on the base unit is both empty and clean e patient outlet is clean and in good condition e flow control valve is mechanically functioning correctly e level indicator including battery where fitted is operational e TLOS is labelled correctly e portable vessel s vent valve is easy to operate e portable vessel will connect satisfactorily to the base unit Where the TLOS is found to not conform to any of the above checks the Homecare Service Provider
36. ntrol whatsoever as regards performance or non performance misinterpretation proper or improper use of any information or suggestions contained in EIGA s publications by any person or entity including EIGA members and EIGA expressly disclaims any liability in connection thereto EIGA s publications are subject to periodic review and users are cautioned to obtain the latest edition EIGA 2009 EIGA grants permission to reproduce this publication provided the Association is acknowledged as the source EUROPEAN INDUSTRIAL GASES ASSOCIATION AISBL Avenue des Arts 3 5 B 1210 Brussels Tel 3222177098 Fax 322 21985 14 E mail info eiga eu Internet http www eiga eu MGC DOC 98 09 Table of Contents AS IMROGUGUON Ss sctecivecatetes hei et E nal din eaten ia toe eee ad aa ee et cet tal 1 2 Scope and Purpose cccccccecceeceececcececeeeeeeeeanaeceeeeeeeeseqsanaeceeeeeeeceqeanaeceeeeesasecqanaeeeeesesaeennaneeeeeeess 1 2 1 DCOPO sea Are eave mene eter A dean tite ea A A wauh A A Atecravesede Seog a a E EE 1 2 2 PUDOS Sinear Nati E EA a e a a a E aa E a Ea A a aa 2 2 3 RIEA TE EEA east E EA E hee EATA AE E A T 2 3 Charactenstics OF OXYGEN oeeo seeds RAE ied te BEREE SAA ANERER AERA AT ARAARA FARTAS A EEEE 2 4 Hazards with handling Liquid Oxygen c ce eeeececeee eee eeeeeeneeeeeeaeeeeetaeeeeeeaeeeeeesaeeeeesaeeeeesneeeeeeaes 2 5 Precautions when Handling Liquid Oxygen 0 ececceeeceeeeeeeeeeeeeeeeeeeeeeeeeeeeee
37. ons Liquid Oxygen for medical oxygen therapy is supplied in a Transportable Liquid Oxygen System TLOS which comprises a base unit and its associated portable unit The equipment used with medical oxygen therapy shall be CE marked to indicate that they comply with the requirements of the Medical Device Directive 93 42 EEC as amended by EC Directive 2007 47 valid for all equipment purchased after the 14th June 1998 In addition this equipment is required to comply with the European Agreement on the Transport of Dangerous Goods ADR regulations and shall be tr marked to show compliance with the Transportable Pressure Equipment Directive TPED 1999 36 EC when put on the market after 1 July 2001 It is the responsibility of the doctor to prescribe the correct flowrate for the patient and the responsibility of the Homecare Service Provider to supply a package that ensures that the patient receives the prescribed flowrate As a part of this responsibility the Homecare Service Provider shall also instruct the patient on how to use the equipment correctly and how to select the prescribed flowrate In addition this document provides a simple guide for the Homecare Service Provider to give to the patient carer or healthcare facility staff to emphasise the safe use and storage requirements for medical liquid oxygen supplies both in the home and in healthcare facilities 2 Scope and Purpose 2 1 Scope This document covers the use of TLOS us
38. osphere It is important to keep the TLOS in a well ventilated area to avoid the generation of oxygen enriched atmospheres and to keep it away from combustible materials and protected from exposure to heat sources which may accelerate the venting of oxygen from the vessel e The density of the low temperature gas vented from a TLOS is heavier than air and will accumulate in low lying areas if not adequately ventilated e Materials that burn in air will burn much more vigorously in oxygen and burn at a higher temperature in an oxygen or oxygen enriched atmosphere Most serious incidents involving the use of medical oxygen are caused by the patient smoking e Oils and grease burn in an oxygen enriched environment with explosive violence Ignitions may occur with oxygen equipment if it has been contaminated with oil or grease This can be caused by handling equipment with hands that have been contaminated with petroleum jelly or hand face creams containing petroleum based ingredients or using tools contaminated with oil or grease e Absorbent materials such as clothing or bedding when saturated with oxygen will readily ignite These materials remain oxygen enriched for some time after removal from the oxygen source 5 Precautions when Handling Liquid Oxygen To ensure the safe operation of TLOS the following instructions shall be provided to the patient carer Healthcare Facility representative in the form of operating instructions A typical
39. ovider Checks for the Portable Unit Each time the Homecare Service Provider supplies the patient with a full base unit the Homecare Service Provider shall ensure that the portable unit e is clean and in good condition e will connect satisfactorily to the base unit without leaking e vent valve is easy to operate Where the portable unit is found to not conform with any of the above checks the Homecare Service Provider shall follow the appropriate procedures to either rectify or replace the unit The Homecare Service Provider shall periodically ensure that the patient carer is still competent to refill the portable unit safely and effectively It is advisable to observe the patient carer filling the portable vessel 10 3 Service Provider Checks for the Disposable Accessories Each time the Homecare Service Provider supplies the patient with a full base unit they shall check e the cleanliness and condition of the disposable accessories e the cleanliness and condition of the humidifier specifically the connection of the water container to the humidifier cover Where the cleanliness of the accessories are considered to be inadequate the patient should be instructed how to clean exchange the equipment as specified by the manufacturer or the Homecare Service Provider 11 Handling of the Transportable Liquid Oxygen Systems The patient shall be advised to follow the precautions specified in Section 5 Precautions when Handling Liq
40. r being operated and cause liquid oxygen to be vented e not to put anything inside the shroud not put anything hot on the plastic shroud e turn off the oxygen supply when not in use to prevent any unnecessary enrichment of the air even for short periods of time e ensure that the oxygen tubing and accessories are attached correctly and the humidifier assembled correctly in order to avoid leaks e ensure that the oxygen tubing is sited correctly to prevent it becoming kinked or blocked by any heavy object being placed on it e check that the oxygen flows out of the nasal cannulas or the oxygen tubing when it is disconnected from the mask or conserving device by placing the outlet s just under the surface of water in a glass and flow will be indicated by bubbles Where oxygen conserving devices are used this test is not effective in determining whether the device is providing gas to the patient e keep the TLOS clean taking specific care to keep the connectors both clean and dry e only select the flowrate prescribed by the patient s doctor e Unless specifically designed the patient should not consume oxygen from the portable unit whilst left connected to the base unit 13 Transfilling of the Portable Unit As the portable unit only contains a relatively small volume the heat inleak into the vessel can lead to the product evaporating prior to it being required for use The patient shall be instructed that they should only fill the portable uni
41. shall follow the appropriate procedures to either rectify or replace the faulty unit Parts that can influence the cleanliness of the supply of the oxygen such as nasal cannula and oxygen tubing shall be renewed before the equipment is installed at a new patient location The specific manufacturer s instructions shall be followed when transferring any reusable accessories used with TLOS to another patient 8 3 Initial Installation Before use the patient carer or the Healthcare Facility representative shall be given adequate training in the operation handling and cleaning of the TLOS In addition they shall also receive instructions about the potential hazards and recommended safety precautions for handling the TLOS If the patient and carer are considered to be incapable of operating the TLOS safely the Medical Oxygen Homecare Service Provider shall inform the patient s prescriber that an alternative method of supplying medical oxygen is required For Healthcare Facilities it is the responsibility of their appointed representative to ensure that all patients and Healthcare Facility staff are trained in all of the appropriate procedures for handling the TLOS and refilling the portable unit Specific instructions shall be given to the patient carer for the transfilling of the portable unit This training shall be given personally to all persons who will be required to transfill the unit and an assessment shall be carried out at the end of the
42. t just before it is needed to avoid any unnecessary evaporation losses For most systems the portable unit should only be used when the unit is required for ambulatory use or when it is impracticable to use the base unit Transfilling of the portable unit requires the patient carer to take care as it can lead to the spillage of liquid oxygen and shall always be carried out in a well ventilated area Where the transfilling is carried out on an adsorbent surface such as a carpet the patient carer shall be informed to take extra care to ensure the area is well ventilated to prevent the surface becoming enriched with oxygen The portable unit shall never be left unattended during the transfilling process The manufacturer s transfilling instructions shall always be followed and specific attention shall be given to ensuring that e the portable unit is clean and the moisture adsorbing pad where fitted is clean and dry 10 MGC DOC 98 09 e the level indicator included battery where fitted is operational e the transfilling connectors are checked on both vessels to ensure that they are clean clean it with a lint free cloth and dry prior to refilling in order to avoid malfunction due to freezing e the portable unit is correctly aligned with the transfilling connector on the base without leaking and the portable vessel s vent valve is easy to operate e any vented gas is directed away from the person filling the unit and away from
43. ting smoking and naked flames within the vicinity of the store Where TLOS s are stored in remote in use storage areas nearer the point of use adjacent to patient ward areas the storage conditions above shall be observed Stocks in the in use stores should be kept to a minimum to reduce the potential risk to patients and staff should there be an incident MGC DOC 98 09 10 Service Provider Checks for the TLOS 10 1 Service Provider Checks for the Base Unit Each time that the base unit is supplied to the patient or to the Healthcare Facility the Homecare Service Provider shall check that the e exterior condition of the base unit clean and not damaged to an extent which impairs the correct functioning of the unit e transfilling connector is clean and in good condition e transfilling connector is not leaking e receiver for collecting condensation is both empty and clean e patient outlet is clean and in good condition e flow control valve is functioning correctly e level indicator included battery where fitted is operational e vessels have no cold spots indicated by frosting e TLOS is not leaking other than from the relief valve which is a normal function for a serviceable unit e base unit is labelled correctly Where the base unit is found to not conform with any of the above checks the Homecare Service Provider shall follow the appropriate procedures to either rectify or replace the unit 10 2 Service Pr
44. ucts to clean the equipment When carrying out routine cleaning of the equipment the patient carer shall be instructed to note the following issues e only use a clean dampened cloth using an approved type of non abrasive cleaning agent to wipe down the TLOS before use Abrasive substances or sharp objects shall never be used for cleaning e when cleaning equipment ensure that no residues are left after cleaning that could come in contact with the medical oxygen e donot allow free water to come into contact with the filling connector on the TLOS When either unit is in use moisture can accumulate on exposed surfaces of equipment caused by condensation This moisture could freeze causing components such as valves or filling connectors to stick open or shut It is important to instruct the patient carer to inspect the transfilling connection before use and to dry the connection if any moisture is present before the portable unit is filled The receiver fitted to the base unit for the collection of any water condensation should be regularly emptied and cleaned in accordance with the manufacturer s instructions The portable unit is fitted with a moisture adsorbing pad and where applicable this should be changed and dried to prevent excess moisture accumulating on the equipment The Homecare Service Provider shall carry out the periodic maintenance requirements as specified in the manufacturer s users manual A typical Troubleshooting
45. uid Oxygen In addition they shall be advised that the TLOS shall be handled with care and should never be knocked violently dropped or allowed to fall over MGC DOC 98 09 e where the base unit is required to be mobile a roller base should be used The roller base should be used only on level surfaces to prevent it from tipping over Where the base unit is required to be mobile advice shall be given to the patient of the safe locations in the property where the base unit can be used e the base unit shall always be kept upright at all times When moving the base unit up and down stairs the unit should only be moved by the Homecare Service Provider in an appropriately designed trolley Where a lift is available it may only be used provided that e the unit is in a safe condition and not venting gas e there are no other occupants in the lift whilst the vessel is being moved The patient shall be instructed that the portable unit shall only be e carried in the holder fitted to the portable unit or in an approved bag or trolley e kept upright at all times unless the unit is designed to be used in other specific orientations 12 Operation and Use of the Transportable Liquid Oxygen Systems The patient carer shall be instructed to follow the manufacturer s instructions when using the TLOS and specifically to e never place anything on top of the base unit or push down on the fill connector as it could lead to the fill connecto
46. unit Replace dirty components or replace unit as necessary Demonstrate to the patient how to remove base cover on portable unit Cover on the base unit fill connector still in place where fitted Dirt on the connecting faces or worn damaged connector on Portable or Base Unit Ice on the connecting faces Safety valve venting The Base Unit is empty Demonstrate to the patient how to remove cover on fill connector Demonstrate to the patient how to disconnect the unit and clean the connecting faces with a clean cloth If leaks persist replace the unit Demonstrate to patient how to check that vent valve is closed and how long to leave unit to allow ice to melt Ensure that excessive force is not used to remove portable unit Demonstrate to patient how to clean and dry connecting faces with a clean cloth after unit is removed Explain to the patient that this is normal operation and that no action is required Replace refill Base Unit The Base Unit pressure is too low Demonstrate to the patient how to leave the Base Unit for an hour and retry filling the unit If the unit still fills too slowly replace the Base Unit The Portable Unit vent valve is closed or only partially open 15 Demonstrate to the patient how to open the vent valve fully when filling the portable unit MGC Portable Unit leaking after disconnection Leak of water from Portable Unit
Download Pdf Manuals
Related Search