To prevent the risk of fire, do not allow the tank to come into contact with oil, grease, or highly flammable liquids.
Use only a wrench with an appropriate-size rectangular opening (Figure 1) to open and close the valve stem. Using a hexagonal wrench (Figure 2) could result in inadvertent loosening of the retaining nut on the stem of the tank, which could cause injury or death.
Never drop a tank or allow it to strike another surface. Make sure all oxygen tanks are secured in an appropriate oxygen stand and never left standing on end unsecured.
Oxygen tanks (also called cylinders) are used to provide portable oxygen when no piped oxygen source is available. The different sizes of oxygen tanks include the D cylinder, the E cylinder (Figure 3), the H cylinder, the K cylinder, and the M cylinder. E cylinders are the most common tanks used in the emergency department. D cylinders are commonly used for prehospital emergency medical services transport. M cylinders are used for many home health patients.
The reducing valve (sometimes called the adjustable regulator or control valve) reduces the tank pressure to a working pressure. The combination of a flowmeter with a reducing valve is called a regulator.undefined#ref2">2 The flowmeter controls and measures the flow of oxygen to the patient. In most cases, the regulator and flowmeter are coupled into one mechanical fitting for the oxygen tank. A yoke holds the regulator in place.
Another safety feature is the pin index system. Each gas uses a unique combination of pins on the regulator that corresponds to the holes on the valve stem (sometimes called the post valve or cylinder post) of the intended tank. A sealing washer (also called a washer, O-ring, or gasket) helps ensure a tight connection between the regulator and the valve stem (Figure 4).
The valve stem is opened and closed by means of an appropriate-shape wrench (also called a key) (Figure 1) or by turning a regulator knob. On removable regulators, the regulator yoke is tightened or loosened with a T-bar; a wrench may be used to provide extra leverage on the T-bar.
To eliminate the need to apply or replace a regulator on an oxygen tank, integrated oxygen tanks have been developed that can supply a high-pressure oxygen device. These newer systems include a built-in, nonremovable regulator with adjustable flow mechanisms (Figure 5).
Each tank must be labeled with its contents. Always read the label on the tank to confirm that it contains the desired gas.
Do not drag, slide, roll, or drop a tank or allow it to strike another surface.
Use only a wrench with an appropriate-size rectangular opening (
Figure 1) to open and close the valve stem. Using a hexagonal wrench (
Figure 2) could result in inadvertent loosening of the retaining nut on the stem of the tank, which could cause injury or death.
Rationale: Using the support stand avoids damage to the tank during transport and storage.
Be aware that pressurized oxygen may turn the tank into a dangerous projectile if the regulator, the tank, or the valve stem is damaged.
Rationale: Misplaced or defective plastic washers can cause fires.
Rationale: Debris and dirt can interrupt flow in the tank.
Rationale: Opening and closing the valve stem quickly clears (cracks) the valve and eliminates dust or foreign materials.
Example: An E-cylinder oxygen tank pressure is 1000 psi. The patient is receiving oxygen at 4 L/min.
(0.28 × 1000) ÷ 4 = 70 minutes of reliable tank life
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 affects the accuracy of their 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.
Rationale: Removing the pressure decreases the danger of the tank becoming a torpedo if it is inadvertently knocked over or dropped with the regulator in place.
Be aware that pressurized oxygen may turn the tank into a torpedo if the regulator, the tank, or the valve stem is damaged.
Rationale: Oxygen tanks should be stored according to the organization's practice.
USA Safety. (n.d.) Gas cylinder safety regulations and guidelines. Retrieved July 24, 2020, from https://www.usasafety.com/regulations.php (Level VII)
*In these skills, a "classic" reference is a widely cited, standard work of established excellence that significantly affects current practice and may also represent the foundational research for practice.
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