ran out of O2

GilaRRT · Jul 29, 2007

Perhaps you can push through a policy of maintaining a reserve in your tanks. Many places require between a 200-500 psi reserve. This could solve your problems.

rjflyn, ASN, RN · Jul 29, 2007

I work in a busy 30 bed ER. I came on shift yesterday and there was one portable full 02 tank for the ENTIRE ER. The current policy is we have 4 portable tanks for 30 beds.RT is suppose to be paged when the tanks are empty and will only fill empty tanks, if it is even slightly below 1/4 they will not refill it, they want it empty.I have spoken to my manager re this issue ( ONE MCI or FIRE in the ER!!! and then there will be more tanks.) as when i worked on medicine we had a patient die who was sent up from ER, and his O2 ran out. This was bad as the floor blamed the ER and the ER blamed the floor.Any experiences along this line would br greatly appreciated as I know this , unfortunatly,is more common tan anyone thinks.

Well there is your problem right there only 4 tanks for 30 beds???? Almost every ER I have ever been in has a portable tank under every bed. Then there are spares to replace those as needed. For example where I currently work we have a rack that holds 20 extra tanks. The nice thing here is our tanks come with a permanently attached flow meter. If we run one dry we replace it, RT only gets involved when the second rack of 20 tanks back in the store room goes dry- it has not happened in the 2 yrs at this facility. All of our wheelchairs also have a mount for a tank and about half actually have a tank most of the time as well. A tank is considered empty at 500# of pressure by policy as well, so if someone runs one dry they violated policy. Our ER is 36 beds not include using spots in the hall.

So I guess my suggestion is you need to get a tank for every bed, get alot more spares and lastly not rely on RT to change the tanks for you.

Rj

Altra, BSN, RN · Jul 29, 2007

Well there is your problem right there only 4 tanks for 30 beds???? Almost every ER I have ever been in has a portable tank under every bed. Then there are spares to replace those as needed.
...
So I guess my suggestion is you need to get a tank for every bed, get alot more spares and lastly not rely on RT to change the tanks for you.

Ah, but one of the major brouhahas that erupted after our last visit by the health dept. was over O2 tanks under ER stretchers -- they mandate no O2 tanks in hallways and since we routinely use all available hallway spots, this has been interpreted to mean that we can't keep O2 tanks on the stretchers anymore.

SSDD ...

kmoonshine, RN · Jul 29, 2007

We have 1 tank per bed, plus 10+ reserve tanks should we need them. I think it's such a pain when a tank is empty under a bed - but all I need to do is get a new one. I can't imagine struggling with having only 4 tanks, 3 of which are nearly empty...

allnurses Guide · Jul 29, 2007

Can I ask what may sound like a silly question but don't you have wall O2, we only use bottled O2 for transporting patients otherwise it is from huge central O2 tanks plumbed into every patient bay or bed area. With this we keep 1-3 cylinder in each area depending on the size of the area. Our Surgical EU has 13 bays, Medical EU has 20 bays and Majors and Minors have 20 bays.

casualjim · Jul 29, 2007

If you want a bottle filled at 1/4 full and R/T wont touch it, I say bleed it down to empty from a quarter and then call 'em to fill the bottle.

Jim

P_RN, ADN, RN · Jul 29, 2007

I guess I've been spoiled with wall o2 and the very small hand carried ones Rt uses when assisting with transport.

bellasage · Jul 29, 2007

Don't work ER but I agree with having a reservoir on floor, or what about wall units? I know will units are not possible in busy ER (rows of beds, no rooms except for shock rooms).

Is there a nurse to check off on tanks? Check them every 2 hours or so? O2 going at 2-10 L /min would still take some time to run out... Sounds to me that the people before you should have been more observant of the O2 levels in the tanks. I know they don't fill them until they are empty due to safety precautions but they should also have some full on stand by so when a call comes in they can just come exchange it with you. ????

woody62, RN · Jul 29, 2007

I see you are from Canada. Does your facility rely on tanks or do you have wall units. I remember being in an ER, in Montreal, and when transported to x-ray, they switched me to a small tank. Otherwise I was on a wall unit. If they will not full them til empty, bleed off those less than 1/4.

Woody:balloons:

kmoonshine, RN · Jul 31, 2007

"Can I ask what may sound like a silly question but don't you have wall O2, we only use bottled O2 for transporting patients otherwise it is from huge central O2 tanks plumbed into every patient bay or bed area."

Earlier I had replied that we have 1 tank per bed, plus 10+ reserve tanks should we need them. We use these for transport. We do have wall units, 2-3 oxygen wall units in our major trauma rooms, 1-2 oxygen wall units in our other rooms. Sorry I forgot to mention the wall units! :lol2: