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Health care facilities managers know that their internal hospital systems need to be sized to intake the amount of oxygen being demanded by ventilators.Image by Getty ImagesThe novel coronavirus, known as COVID-19, is a pandemic that has caused health care facilities managers to take unprecedented steps in managing building systems. One system in particular, the bulk medical oxygen system, can be greatly impacted.What we are learning and want to share with health care facility managers is the increased high flow oxygen demand within the hospital can be the cause of ice accumulation on the vaporizers that will reduce bulk medical oxygen supply system capacity, which can be relieved with methods known by oxygen suppliers and discussed below. However, most importantly and despite these efforts, the key is that health care facility managers know that their internal hospital systems need to be sized to intake the amount of oxygen being demanded by ventilators.If the hospital system does not have the capacity to handle a surge of oxygen demand, the hospital can experience a reduction in oxygen pressure or a shutdown of their entire oxygen delivery system. To assist in determining the demand, Medical Air and Oxygen Capacity Tools have been posted to the ASHE COVID-19 Resources webpage.Extraordinary usageExtreme pressure has been put on the system due to the patient treatment efforts of COVID-19. According to Patricia Covelle, associate chief nursing officer at Beverly Hospital, an urban facility and a member of Beth Israel Lahey Health System, just outside Boston. “The novel coronavirus attacks the lungs of infected patients, resulting in extraordinary usage of oxygen within the hospital,” she says.Fortunately, the supply of medical oxygen to hospitals is not currently a concern. Rich Gottwald, the president and CEO of the Compressed Gas Association (CGA), says, “There is no shortage of medical oxygen, nor do we anticipate any shortage.” That is partly because companies such as Airgas USA LLC, Linde plc and Air Products have ramped up production and shifted capacity to serve the most hard-hit areas of the country, he says. The concern is hospital bulk medical oxygen systems may not be sized for the COVID 19 pandemic demand.On April 17, 2020, Beverly Hospital received a letter from their medical oxygen supplier, Airgas, which reminded the hospital that the bulk medical oxygen supply system installed at their facility has limitations on the amount of vaporized medical oxygen that it can deliver to patients due to the capacity of the customer’s oxygen delivery system.CGA also encouraged gas customers to understand the facility’s oxygen supply system maximum operating capacity, considering tank volume, vaporizer capacity and in-house piping flow limits. An unprecedented increase in medical oxygen demand (the number of patients needing oxygen above normal conditions) under certain circumstances can lead to shutdown of the hospital’s oxygen delivery system as a whole due to an inability for the hospital’s system to process the required oxygen.Related to a potential accumulation of ice, systems constructed to the National Fire Protection Association's NFPA 99, Health Care Facilities Code,

An invisible lifeline flows in the bustling corridors of hospitals and the quiet rooms of home care. It’s not the latest wonder drug or cutting-edge medical device—it’s oxygen. At nexAir, we’ve long recognized the paramount importance of this elemental gas in healthcare. From emergency rooms to long-term care facilities, oxygen is crucial in ensuring patient safety and delivering effective care.Understanding Oxygen TherapyOxygen therapy is more than just providing air. It’s a precise medical intervention that can mean the difference between life and death. When patients struggle to breathe due to conditions like COPD, pneumonia, or severe asthma attacks, supplemental oxygen becomes their lifeline. By increasing the oxygen concentration in inspired air, we help ensure that vital organs receive the oxygen they need to function.The Impact of Oxygen in HealthcareWhile respiratory support might be the most well-known use of medical oxygen, its applications extend far beyond. In surgical suites, oxygen is a constant presence, helping maintain patient stability during procedures. Neonatal units rely on carefully controlled oxygen environments to support premature infants whose lungs aren’t yet fully developed. Even in wound care, oxygen plays a role, with hyperbaric oxygen therapy accelerating healing in certain types of injuries.Oxygen Delivery SystemsDelivering oxygen to patients isn’t as simple as opening a valve. It requires sophisticated systems and rigorous safety protocols. At nexAir, our expert KnowHow™ extends to the entire oxygen delivery chain. From the production and purification of medical-grade oxygen to the design of delivery systems, every step is critical.Modern oxygen therapy employs a range of delivery methods. Nasal cannulas provide low-flow oxygen for patients with mild to moderate needs. For those requiring higher concentrations, non-rebreather masks can deliver nearly pure oxygen. In intensive care settings, mechanical ventilators precisely control oxygen delivery, pressure, and flow rates, tailoring support to each patient’s unique needs.Oxygen in Emergency CareIn emergency situations, rapid access to oxygen can be life-saving. From first responders equipped with portable oxygen units to emergency room crash carts, oxygen is a critical component of urgent care. Conditions like cardiac arrest, severe trauma, and acute respiratory distress all require immediate oxygen support. Our role at nexAir is to ensure that this vital resource is always available when and where it’s needed most.Home Oxygen TherapyAs healthcare increasingly moves beyond hospital walls, home oxygen therapy has become a lifeline for millions. Patients with chronic respiratory conditions can now receive the oxygen they need while maintaining their quality of life at home. This shift presents unique challenges regarding equipment reliability, patient education, and ongoing support—challenges that we at nexAir are committed to meeting head-on.Managing Oxygen SafetyWhile oxygen is essential for life, it also presents inherent risks in healthcare settings. As a strong oxidizer, oxygen can accelerate combustion, making

Area located across a campus road on the other side of the central power plant was made to make observations of the current condition. The following is a picture showing a hospital bulk medical oxygen system with vaporizer showing signs of icing.Increased high flow oxygen demand within the hospital can be the cause of ice accumulation on the vaporizers.Photo by Edmund LydonWithin a short period of time, the facilities staff began the deicing process using steam from the central power plant. Water, hot water, steam are all acceptable approaches to removing the ice buildup. Application of such deicing methods must be done in accordance with the gas supplier so that it is done safely. For example, it is very hazardous to use a mallet or hammer to knock ice from a vaporizer.The second most immediate step was a visual daily monitoring of the hospital medical gas oxygen system. In a similar situation, according to WIRED.com, “Two hospitals in Queens, New York, moved 10 COVID-19 patients to a Navy hospital ship docked offshore last week, after their ventilators couldn’t supply as much oxygen as the patients needed. The problem was not with the hospitals’ total oxygen supply or with the ventilators themselves, but with coils of aluminum in which oxygen changes from a liquid into a gas. The fix came from the hoses of the New York Fire Department.”Pressure regulators. The hospital must work with their gas supplier to evaluate current and projected peak flows and make necessary adjustments to the system regulators. Potentially, a system upgrade or even supplemental supply might be needed. Coordination with hospital personnel is critical to monitor the pressure at the source and in the hospital during the demand and after.Other elements. Emergency oxygen supply connections (EOSC) are required by NFPA 99 and should be checked that they are readily accessible to allow connection of a temporary auxiliary mobile source and that all facility and security staff are aware of the location. Work with suppliersFor additional information, facility managers should work with medical oxygen suppliers and review the applicable content in the governing codes for medical supply systems and health care facilities (NFPA 99 and NFPA 55, Compressed Gases and Cryogenic Fluids Code). This is to ensure safe elements of the medical oxygen installation continue to be in place, such as safe distances from oxygen hazards, delivery access and security. Edmund Lydon, CHFM, FASHE, is senior director of facilities and support services at Beverly Hospital, a member Beth Israel Lahey Health System. He can be reached at [email protected].

Fire safety a top priority in oxygen-rich environments. From proper storage and handling of oxygen cylinders to educating patients and caregivers about safety protocols, managing these risks is integral to oxygen therapy.The Future of Oxygen in HealthcareAs we Forge Forward in medical technology, the role of oxygen in healthcare continues to evolve. Research into oxygen-carrying blood substitutes promises new possibilities for trauma care and surgery. Advances in oxygen generation and purification technologies are making oxygen supply more reliable and cost-effective, even in resource-limited settings.Smart monitoring systems are also transforming oxygen therapy. IoT-enabled devices can now track patient oxygen levels in real-time, automatically adjusting flow rates and alerting healthcare providers to potential issues. This level of precision and responsiveness was unimaginable just a few years ago.nexAir’s Commitment to HealthcareAt nexAir, we understand that every breath counts. Our commitment to healthcare goes beyond simply supplying oxygen. We partner with healthcare providers to optimize oxygen delivery systems, enhance safety protocols, and improve patient outcomes. From major hospital systems to small clinics and home care providers, we’re dedicated to ensuring that oxygen—this most fundamental element of life—is always available, always pure, and always safe.As the healthcare landscape continues to evolve, so too will the applications and delivery of medical oxygen. Whether you’re a healthcare administrator looking to upgrade your facility’s oxygen systems or a home care provider seeking reliable oxygen solutions for your patients, nexAir is here to help you breathe easy. Let’s work together to ensure that every patient receives the oxygen they need, when needed, with the safety and reliability they deserve.

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803, include device-related death and serious injury or illness. Page 20: Limited Warranty NFORMATION Limited Warranty ZOLL warrants the device to be free from all defects in material and workmanship for a period of one (1) year from the date of delivery to the original purchaser. During the warranty period, ZOLL will repair or replace the device or any part which upon examination is shown to be defective. Page 21: Service • Returning a unit for service Before sending a unit to the ZOLL Technical Service Department for repair, obtain a service request (SR) number from the service representative. The Lithium ion battery should remain inside the unit. Follow directions provided on the RGA. Page 22 ENERAL NFORMATION For customers Return the unit to In other locations The nearest authorized ZOLL Medical Corporation representative. To locate an authorized service center, contact the International Sales Department at ZOLL Medical Corporation 269 Mill Road Chelmsford, MA 01824-4105 Telephone: 1-978-421-9655 1-16 www.zoll.com... Page 23: Product Overview Chapter 2 Product Overview ZOLL Ventilator Models The ZOLL Critical Care ventilator is designed to manage infant through adult patients with acute or chronic respiratory failure or during resuscitation by providing continuous positive-pressure ventilation. (See “Indications of Use”) The ventilator comes in five models: EMV+ •... Page 24: Emv The AEV ventilator is built for managing ventilator support patients during ambulance transport. It’s ventilation modes (AC, CPAP with PS and NPPV) are specifically chosen to be consistent with pre-hospital care provider’s operating procedures. AEV Ventilator www.zoll.com 906-0731-01 Rev. J... Page 25: Eagle Ii 12 ft. MRI patient circuits and can be mounted on an available MRI conditional roll stand. Eagle II MRI Ventilator Note: The Pulse Oximeter cannot be used in an MRI environment. 906-0731-01 Rev. J ZOLL Portable Critical Care Ventilator... Page 26: Ventilator Controls And Indicators RODUCT VERVIEW Ventilator Controls and Indicators The following illustration shows the ZOLL ventilator’s main features: ZOLL Ventilator Features www.zoll.com 906-0731-01 Rev. J... Page 27: Zoll Ventilator Features Displays the unit’s settings, patient data, and alarm information Alarm Message Center Displays active alarms and mitigation information Control Panel Access to the unit settings Battery Compartment Contains the unit’s rechargable lithium ion battery 906-0731-01 Rev. J ZOLL Portable Critical Care Ventilator... Page 28: Pneumatic Diagram RODUCT VERVIEW Pneumatic Diagram The following image is a diagram of the ZOLL ventilator’s pneumatic design. Pneumatic Diagram www.zoll.com 906-0731-01 Rev. J... Page 29: Connector Panel AIR INTAKE Connector Panel The connector panel for the ZOLL ventilator unit has the following components: Oxygen Input -- connects the unit to the output of an appropriate oxygen regulator attached to a medical-grade (USP) oxygen cylinder. The OXYGEN IN fitting has a male oxygen Diameter Index Safety System (D.I.S.S.)