UK and Ireland Anaesthesia bodies have recommended nitrous pipelines be decommissioned and cylinders used in lieu. AusHFG guidelines no longer recommend reticulated nitrous oxide for all new facilities. So how to go about decommissioning your likely leaky nitrous pipes? A proposed phased approach outlined below.
Phase 1 – Cut off dead wood
Disconnect and decommission nitrous pipeline from all areas which do not use nitrous oxide. Examples may include outpatients, emergency departments, radiology areas and areas connected for historical reasons. Portable entonox cylinders can be available for use in clinical areas
Removing unused limbs of the pipeline is important. Every metre of pipeline removed is a metre less that can leak
Keep pipeline active for operating theatres with children and birthsuites
Phase 2 – Cylinders for theatres
Stop using pipelines for operating theatre nitrous oxide. Provide N2O cylinders, with regulator either connected directly to anaesthetic machine, or available to be brought in on a trolley and connected to nitrous oxide gas hose when required.
Keep pipeline active only for birthsuites. Maintain theatre pipeline to provide reassurance to staff until trial complete.
Phase 3 – Cylinders for all
The birthsuite can be supplied by local entonox cylinders which are mobile, allowing better access to N2O in shower or areas of room. Nitrous oxide pipeline can be decommissioned.
It may be that a well maintained small manifold system for a birthsuite is easy to maintain, test and keep leak proof, depending on your facility resources.
Do you have a better way of phasing out your leaky nitrous pipelines? Let us know!
To learn more about cylinders on anaesthetic machines – check out this page