Never drop an oxygen tank or allow it to strike another surface. If the neck of the bottle or regulator is damaged, the tank may become a self-propelled projectile and can cause serious injury. Always secure tanks in a stand or carrier when upright.
Oxygen tanks can be heavy and cumbersome to handle. Do not drag, slide, or roll a tank. Use a portable carrier to move it to the point of use.undefined#ref2">2
To prevent the risk of fire, do not allow oxygen tanks, valves, regulators, and fittings to come into contact with oil, grease, or highly flammable liquids.
Always use an appropriate-shape tool when opening and loosening or closing and tightening the fittings on the oxygen tank.
Always read the label on the tank to confirm that it contains the desired gas. In the United States, oxygen tanks may be green, or they may be silver or chrome with green around the valve stem. In other countries, oxygen tanks are white, or black with white shoulders.
Oxygen tanks (also called cylinders) are used to provide supplemental oxygen when the patient is away from home or when the patient’s condition does not allow the use of a concentrator. Different sizes of oxygen tanks are identified by letter(s). Many sizes are available, including the E-cylinder (Figure 1), which is one of the most common sizes of tanks used in homes.
The regulator (sometimes called the adjustable regulator, flowmeter, or control valve) reduces, controls, and measures the flow of oxygen to the patient to ensure a safe and effective working pressure. The regulator and flowmeter usually are coupled together into one mechanical fitting on the oxygen tank. A yoke holds the regulator in place.
Additional safety features include the pin index system. Each gas uses a unique combination of pins on the regulator that correspond to the holes on the valve stem (sometimes called the post valve or cylinder post) of the intended tank. The pin indexing system is used as a safety feature to prevent a cylinder containing another type of gas (such as air or nitrous oxide) from being connected to an oxygen regulator. A sealing washer (also called a washer, O-ring, or gasket) helps ensure a tight connection between the regulator and the valve stem (Figure 2).
The valve stem is opened and closed by means of an appropriate-shape wrench (also called a key) (Figure 3) or by turning a regulator knob. The regulator yoke is tightened or loosened with a T-bar; sometimes a wrench is used to provide extra leverage on the T-bar.
Rationale: Using the support stand avoids damage to tank parts during transport and storage. Pressurized oxygen may turn the tank into a self-propelled projectile if damage occurs to the regulator, tank, or valve stem.2
Rationale: This action clears (cracks) the valve and eliminates any dust or foreign materials.
Use only a wrench with a rectangular opening (Figure 3) to open and close the valve stem.
Rationale: Using a hexagonal wrench could result in inadvertent loosening of the retaining nut on the stem of the tank, which could cause injury or death.
Rationale: The Pin Indexing Safety System (PISS) uses two indexing pin and hole combinations for an oxygen cylinder: 2 and 5. This system is used to prevent connection errors and the delivery of incorrect gases.2
Tank life (in minutes) = (Tank pressure [in psi] – Safe residual pressure [500 psi]) × Cylinder factor ÷ Flow rate (L/min)2
Example: An E-cylinder oxygen tank pressure is 1000 psi. Residual safe pressure is 500 psi. The nurse wishes to transport a patient receiving oxygen at 4 L/min. Each cylinder size has its own cylinder factor (Table 1); the factor for an E-cylinder is 0.28.2
(1000 – 500) × 0.28 ÷ 4 = 35 minutes of reliable tank life2
To prevent an accidental readjustment of oxygen flow, never drape anything over the tank or the regulator.
Rationale: Ball-type flowmeters are constructed to be used in an upright position. Laying them on their side will affect the accuracy of the reading but not the accuracy of the actual flow. An obstruction to the flow (e.g., crimped or pinched tubing) causes the ball to drop to the actual flow reaching the patient.
To avoid a falsely high flow reading, ensure that the flow is unobstructed.
Rationale: Removing the pressure decreases the danger of the tank becoming a missile if it is inadvertently knocked over or dropped with the regulator in place.
Rationale: Using the support stand will avoid damage during transport and storage. Pressurized oxygen may turn the tank into a self-propelled projectile if damage occurs to the regulator, tank, or valve stem.2
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