55IqTBuku Sistem Mekanikal MOH v3 PDF

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Manual Book of
Mechanical System
Medical Gas
Pipeline System
ENGINEERING SERVICES DIVISION
MINISTRY OF HEALTH MALAYSIA
VERSION: 1.0
MOH/ESD/2018-2
Disclaimer: Any pictures of equipment, brand and model of equipment depicted in this guideline shall not
be considered as an acceptance or approval from the Ministry of Health Malaysia. It shall only serve as an
example or illustration for the relevant issues and matter of interest.
Buku Sistem Mekanikal MOH v3.indd 1 29/08/2019 10:28 AM

Manual Book of Mechanical System
Medical Gas Pipeline System
ACKNOWLEDGEMENT
The CPD Mechanical Committee, Ministry of Health would like to express the warmest
gratitude to all the contributors in any forms from various organizations as well as all
Ministry of Health Mechanical Engineers towards the successful drafting, formation and
completion of this manual book of mechanical system.
The greatest appreciation to the organizing and review committee comprising of following
personnel mechanical engineer from various sections in the Engineering Services Division,
State Health Offices and Hospitals in putting enormous effort and thoughts in the process
of completing this document in particular those who were involved in the workshop
BENGKEL MANUAL ASAS REKABENTUK & PENYELENGGARAAN SISTEM MEKANIKAL DI
PREMIS KESIHATAN held at Bukit Fraser, Pahang.
Engineering Services Division, Ministry of Health Malaysia (MOH)
1. Ir. Tauran Zaidi bin Ahmad Zaidi

2. Ir. Rosmahadi bin Ali
3. Ir. Suhaimi bin Rashid
4. En. Mohd Kamalluddin bin Hashim
5. En. Mohd Fairuz bin Mohd
6. En. Abu Bakar bin Abdullah
7. En. Mohd Fahril bin Mokhy
8. En. Mohd Hilmi bin Abdullah
9. En. Alif Riduan bin Khalid @ Othman
10. Ir. Rasyidi bin Mohd Tahir
11. En. Amir Ikram bin Muhammad
12. Ir. Zulfadli bin Mohd Jais
13. En. Yusuf bin Zubir
14. En. Adie Azhar bin Rustam
15. Ir. Ts. Mohd Hisam bin Sa’at (Editor)
16. Ir. Mohammad Faizal bin Khalid (Member of Editorial Board)
17. En. Adli Faiz bin Ramli (Member of Editorial Board)

CONTENT
1. Introduction
1.1. Standard And Regulations 5
1.2. Tenets Of Medical Gas Safety 6
1.3. Type Of Medical Gas 6
1.4. Coloring Coding And Orientation 7
2. Type Of Systems
2.1. Oxygen System

2.1.1 Overview Of Oxygen System 8
2.1.2 Vie Tank 10
2.1.3 Manifold 14
2.1.4 Main Parameter 16
2.1.5 Alarm Indication 17
2.2. Nitrous Oxide (N₂O) And Entonox (N₂O + O₂)

2.2.1 Overview Of Nitrous Oxide And Entonox 18
2.2.2 Components Of Nitrous Oxide And Entonox System 19
2.2.5 Nitrous Oxide And Entonox Inspection 22
2.3. Medical Air (Ma4) And Surgical Air (Sa7)

2.3.1 Overview Of Ma 4 And Sa 7 System 23
2.3.2 Component Of Ma 4 And Sa 7 System 26
2.3.5 Ma 4 And Sa 7 System Inspection 28
2.4. Vacuum System

2.4.1 Overview Of Vacuum System 31
2.4.2 Component Of Vacuum System 33
2.4.4 Alarm Indicator 35
2.4.5 Vacuum System Inspection 36

2.5. Aneastethic Gas Scaveging System (AGSS)

2.5.1 Overview Of Agss 39
2.5.2 Component Of Agss 39
2.5.5 Agss Inspection 41
3. Operation And Maintenance
3.1. Rules And Responsibility 44

3.2. Alarm Indication Check 45
3.3. System Test – Leakage Test 46
3.4. Avsu Zoning Test 47
3.5. Valve Closure Test 48
3.6. Inspection Checklist 49
3.6.1 Oxygen System (Vie) 49
3.6.2 Oxygen System (Manifold) 53
3.6.3 Nitrous Oxide System 55
3.6.4 Entonox System 57
3.6.5 Medical Air (4 Bar) 59
3.6.6 Surgical Air (7 Bar) 64
3.6.7 Vacuum System 69
3.6.8 Aneastethic Gas Scaveging System (Agss) 73

FRAME WORK FOR MANUAL BOOK

OF MECHANICAL SYSTEM
MEDICAL GAS PIPELINE SYSTEM
1. INTRODUCTION
1.1 STANDARD & REGULATIONS
List of references:
• Factory and Machinery Act (FMA) 1967
• MS 2675-1:2017 Medical Gas Systems – Part 1 : Code of Practice For The

Design, Installation, Validation and Verification
• MS 2675-2:2017 Medical Gas Systems – Part 2 : Code of Practice For Operation

and Maintenance
• Health Technical Memorandum 02-01 : Medical Gas Pipeline Systems, Part A :

Design, installation, validation and verification
• Health Technical Memorandum 02-01 : Medical Gas Pipeline Systems, Part B :

Operational management
• Health Technical Memorandum 2022 : Medical Gas Pipeline Systems, Part A :

Design, installation, validation and verification
• Health Technical Memorandum 2022 : Medical Gas Pipeline Systems, Part B :

Operational management


1.2 TENETS
OF MEDICAL GAS SAFETY
1.2 TENETS OF MEDICAL GAS SAFETY
There are four (4) tenets of medical gas safety should be done in practice of Medical Gas
There are four 1.2
(4) tenets of medical gas safety
TENETS OF MEDICAL GASshould be done in practice of
SAFETY
and Pipe System.
Medical Gas and Pipe System.
There are four (4) tenets of medical gas safety should be done in practice of
1. Adequacy – accurate
Medical Gas and Pipe System. Adequacy
assessment of demand and
2.
– accurate assessment of demand and appropriate of
appropriate of plant selection;
Continuity – continuity of
1. Adequacy – accurate
plant selection;
supply is achieved, assessment
duplicate of demand and
component, emergency appropriate
or reserveof plant selection;
Continuity
supply, with alarm system;
2. Continuity – continuity of
3. – continuity of supply is achieved, duplicate component,
Identity – non detachable
supply gas-
is achieved, duplicate
specific connectioncomponent,
(TUs, emergency or reserve
emergency or reserve supply, with alarm system;
connectors, etc); supply, with alarm system;
4. Quality – correct 3. supply of – non detachable gas-
Identity
gases and maintain specific
Identity
cleanliness connection (TUs,
– non detachable gas-specific connection (TUs,
throughout the installation and etc);
connectors,
complete T&C
connectors, etc); 4. Quality – correct supply of
gases and maintain cleanliness
Quality throughout the installation and
complete T&C
– correct supply of gases and maintain cleanliness
throughout the installation and complete T&C
ACIQ
Figure 1: Tenets of Medical Gas Safety ACIQ
1.3 TYPE OF MEDICAL GAS Figure 1: Tenets of Medical Gas Safety
Figure 1: Tenets of Medical Gas Safety
There are seven

1.3(7) type OF
TYPE of medical
MEDICALgases
GASthat been use in hospital. They
1.3
are: TYPE OF MEDICAL GAS
There are seven (7) type of medical gases that been use in hospital. They
are:
There are seven (7) type of medical gases that been use in hospital. They are:
O Oxygen (O2)
N Nitrus Oxide (N2O)
E Entonox (N2O+O2)
ONE47VA 4 Medical Air(MA4)
7 Surgical Air (SA7)

Figure 2: Type of Medical Gas
Page 7 of 86
V Figure 2: Type of Medical Gas
Vacuum
Page 7 of 86

A Anesthetics Gas Scavenging System (AGSS)
Figure 2: Type of Medical Gas

standard in orientation of the medical gas for wall mounted and pendan
OLOUR CODING AND ORIENTATION

ch of the medical
gas type been identify with different colour code. These

e the colour code for the cylinder
1.4 COLOUR CODING and the pipeline. There are also
AND ORIENTATION
1.4 COLOUR CODING AND ORIENTATION
ndard in orientation of the medical gas for wall mounted and pendant.
Each of the medical gas type been identify with different colour code. These
Each of the medical gas type been identify with different colour code. These are the

are
theforcolour
colour code the code and
cylinder for thethepipeline.
cylinderThere and are thealsopipeline. There
standard are alsoof the
in orientation
1.4 COLOUR CODING AND ORIENTATION
standard
medical gas forinwall
orientation
mounted ofand
thependant.
medical gas for wall mounted and pendant.
Each of the medical gas type been identify with different colour code. These

are the colour code for the cylinder and the pipeline. There are also

standard in orientation of the medical gas for wall mounted and pendant.

CYLINDER_COLOUR

IDENTIFY
CYLINDER_COLOUR

IDENTIFY

CYLINDER_COLOUR

CYLINDER_COLOUR

CYLINDER_COLOUR

IDENTIFY
CYLINDER_COLOUR
IDENTIFY

CYLINDER_COLOUR

IDENTIFY

CYLINDER_COLOUR

IDENTIFYIDENTIFY

IDENTIFY

Figure 3: Colour coding and orientation

Page 8

7

Page 8 of 86

Page 8 of 86
Page 8 of 86


2. TYPE OF SYSTEMS
2.1 OXYGEN SYSTEM
2. TYPE OF SYSTEMS
2.1.1 OVERVIEW OF OXYGEN SYSTEM
2.1 In
OXYGEN
oxygen,SYSTEM
there are two type of system that normally been use in hospital
2.1.1depends on the
OVERVIEW OFcapacity of oxygen usage. These are the type of oxygen
OXYGEN SYSTEM
system:
In oxygen, there are two type of system that normally been use in hospital depends on the
capacity of oxygen usage. These are the type of oxygen system:
PROPOSE
PROPOSE AND
AND AREA OF AREA
OXYGENOF OXYGEN SYSTEM
SYSTEM
1) Ventilation therapy
1) Ventilation therapy
Operating
• • Operating theatres
Theatres
• Intensive Care Units
• Intensive Care Units
• Recovery Rooms
• • Surgical
RecoveryWards
Rooms
2) • Surgical
Inhalation Wards
therapy
• Emergencies
• Ambulances
2)
• Inhalation therapy
Hospital Departments
• Emergencies
• Ambulances
• Hospital Departments


Figure 4: Central Medical Gases for Oxygen System - Manifold and ERM
Figure 5: Central Medical Gases for Oxygen System - VIE and ERM
Page 10 of 86

Page 10 of 86
9

2.1.2 VIE TANK
• Process for liquid oxygen refill, it shall be topup before operating alarm signal level
(before risk assessed stock – 25%) and every refilling liquid oxygen, it shall be full
level (90%).

Nominal
VIE Tank Pressure
10.5~16 bar
(refer to
Pressure
manufacturing
Gauge templated)
Full Level
Liquid
Contents
Min Level Gauge
Figure 6: VIE tank and accessories
10

• Make sure pressure in tank within nominal pressure (10.5 ~ 16 bar) (refer to
manufacturing templated).
• The range of level (min level & max level) shall be marked on Liquid Contents Gauge
for supervision and monitoring purpose.
• Icing on vaporizer need to be remove regularly. The ideal condition of icing is not
more than 1/3 of vaporizer length size.

Length on
Allowable length
vaporizer, which
of icing on
should be no icing
vaporizer
at all time
2/3 1/3
Figure 7: Icing on VIE vaporizer
11

Rules & Responsibility Of Supplier/Gas Provider, Concession And Hospital During VIE
Tank Refilling
Work Parties Rules
Request Concession To inform hospital pharmacy for ordering liquid oxygen

with estimation amount.
Ordering Hospital Hospital pharmacy contact supplier/gas provider for

delivery liquid oxygen with estimation amount.
Delivering Supplier/ Gas To confirm date and time of delivery to hospital pharmacy
Provider and concession
Concession • Unlock the plant and escort gas provider during

refilling
• Check and witness the receipt of filled amount
complete with Certificate of Conformity (COC)
• To monitor VIE are refilling process until the pressure
stable and everything in order.
• Pass the receipt to hospital
Receiving
Supplier/ Gas • Contact concession when reach to VIE plant.

Provider • Filling the liquid oxygen until full capacity of VIE tank.
• Inform concession if any problem/failure during refill
• Provide the receipt of filled amount complete with
Certificate of Conformity (COC)
Record Hospital • To verify the receipt of filled amount complete with

Certificate of Conformity (COC)
• Plan and contact supplier/gas provider for next
refilling or receive request from concession or which
ever come first.
12

Basic Vessel Construction & Pressure Relief
Figure 8: VIE Tank Vessel
• Nominal Pressure for VIE Tank is 10.5 ~ 16 bar (refer to manufacturing templated).
• Once pressure on VIE tank built up and reach to 16.5 bar, the safety valve will purge
first, then if the pressure still increasing and reach to 24.5 bar, the bursting disc will
active and burst.
• In this situation, immediate action shall be taken to manually change over the valve
on bursting disc to another side.
• If the pressure still increasing and over to 24.5 bar, other side of bursting disc will
active and burst.
13

2.1.3 MANIFOLD
Figure 9: Central Medical Gases for Oxygen System - Manifold and ERM Diagram
Figure 10: Cylinder Manifold System
14

Figure 12: Flow for Oxygen System
• Area Valve Service Unit (AVSU) is function to isolate the or continuously source of
supply by using Non-Interchangeable Screw Thread (NIST) during maintenance/
rectification works or in the event of emergency.
15

2.1.4 MAIN PARAMETER
VIE tank
• Gas pressure 10.5~16 bar
• Duplicated Pressure Relief Valve 16.5 bar
• Busting Disc 24.5 bar
Automatic Manifolds and Emergency Reserve (Manual) Manifolds

• Cylinder Bank Pressure (Duty or Standby): ~13700kPa / 137 bar
• Line Pressure Gauge: between 410kPa and 420kPa
• Low Pressure Alarm: 370kPa
• High Pressure Alarm: 500kPa
• Reserve Low Alarm: 1400kPa / 14.0 bar
• Pressure Safety Valve Setting: 530kPa
Gas Terminal Units (GTUs)

• Operating Pressure: 400kPa ± 10kPa / 4.0 ± 0.1 bar
• Operating Flow: 10 litres per minute (lpm).
Area / Local Alarm Panel at User Departments

• Low Pressure Alarm: 3.6 bar
*Note: 1.0 bar = ~100kPa = 14.7 psi
16

2.1.5 ALARM INDICATION
2.1.5.1 VIE ALARM INDICATION
Figure 13: VIE Liquid Level Classification and Alarm Signal
2.1.5.2 MANIFOLD SYSTEM ALARM INDICATION
Figure 14: Oxygen Manifold Alarm System
17

2.2.1 OVERVIEW OF NITRIOUS OXIDE AND ENTANOX
Nitrous Oxide (N2O) is a sedative agent used for anaesthetic and analgesic
purposes,
Medical Gas when
Pipeline mixed with air, oxygen, and nebulised agents.
System
They OXIDE
2.2 NITRIOUS are commonly
(N2O) &used in:
ENTONOX (N2O +O2)
• Delivery / Labour Suites
2.2.1 OVERVIEW OF NITRIOUS OXIDE AND ENTONOX
• Operating Theatres.
Nitrous Oxide (N2O) is a sedative agent used for anaesthetic and analgesic purposes,
• Oral Surgery Facilities,
when mixed with air, oxygen, and nebulised agents.
• Burns Units,
• They are commonly used in:
• • Critical
Delivery / Labour SuitesCare Areas,
• Operating Theatres.
• Resuscitation Rooms at Accident & Emergency Department,
• Oral Surgery Facilities,
• Burns Units,• Diagnostic Departments (MRI, CAT, Angiography & Endoscopy
• Critical Care Areas,
• Units)at Accident & Emergency Department,
Resuscitation Rooms
• Diagnostic Departments (MRI, CAT, Angiography & Endoscopy Units)
Where
Where nitrous nitrous
oxide (N2O) oxide for(N
is provided 2O) is purposes,
anaesthetic providedscavenging
for anaesthetic
systems shall purposes,
be installedscavenging
to minimise occupational exposure.
systems shall Where nitrous
be installed oxide (N2O)occupational
to minimise is provided for exposure.
analgesic purposes, mechanical ventilation is sufficient for controlling its pollution.
Where nitrous oxide (N2O) is provided for analgesic purposes, mechanical
Colour of Nitrous Oxide (N2O) Cylinders: Blue
ventilation is sufficient for controlling its pollution.
Colour of Entonox (N2O + O2) Cylinders: Blue + White
Colour of Nitrous Oxide (N2O) Cylinders: Blue

Colour of Entanox (N2O + O2) Cylinders: Blue + White
Nitrous Oxide (N2O)

Nitrous Oxide (N2O)
• • Pain
Painkiller
killer
• • Operation
OperationTheatre (OT)
Theatre(OT)
Entonox (N2O
Entonox (N+OO+2)O ) 2 2
• • Pain
Painrelease
release
• • Labour
LabourRoom
Room
18
Page 20 of 86


2.2.2. COMPONENTS OF NITROUS OXIDE AND ENTONOX SYSTEMS
a. Nitrous Oxide (N2O) / Entonox (N2O + O2) Cylinders come with Cylinder Valve
b. Automatic Manifold, comprising:
c. Emergency Reserve (Manual) Manifold, typically comprising:

Nitrous Oxide (N2O)

Figure 15: Central Medical Gases for N20

Entonox (N2O + O2)
19

2.2.3. MAIN PARAMETERS
Automatic Manifolds and Emergency Reserve (Manual) Manifolds
• Cylinder Bank Pressure (Duty or Standby): ~13700kPa / 137 bar

• Line Pressure Gauge: between 410kPa and 420kPa
• Low Pressure Alarm: 370kPa
• High Pressure Alarm: 500kPa
• Reserve Low Alarm: 1400kPa / 14.0 bar
• Pressure Safety Valve Setting: 530kPa
Gas Terminal Units (GTUs)
• Operating Pressure: 400kPa ± 10kPa / 4.0 ± 0.1 bar

• Operating Flow: 10 litres per minute (lpm).
Area / Local Alarm Panel at User Departments
• Low Pressure Alarm: 7 bar
*Note: 1.0 bar = ~100kPa = 14.7 psi
20

2.2.4. ALARM INDICATION
User Area Plant

Area
Alarm Status @ Nitrous Oxide (N2O) Manifold Plant
Check that none of the following alarms are activated:
o Change Cylinders (duty bank empty, standby running)
o Change Cylinders Immediately (duty bank empty, standby low @ 10% capacity)
o Reserve Low (signal turns on when Emergency

- Reserve Manifold is at 14 bar)
o Pressure Fault (pipeline pressure fault)
o System Fault (alarm panel faulty)
21

2.2.5 NITROUS OXIDE AND ENTONOX INSPECTION
Cylinder
Manifold System

Figure 17: Nitrous Oxide and Entonox Manifold Inspection
22

2.3 MEDICAL AIR (MA4) AND SURGICAL AIR SYSTEM (SA7)
2.3.1 OVERVIEW OF MA4 AND SA7 SYSTEM
2.3.1.1 CONFIGURATION OF MEDICAL SUPPLY SYSTEMS
PRIMARY SUPPLY SECONDARY SUPPLY REVERSE SUPPLY

(THIRD SOURCE OF SUPPLY)
Duplex compressor Automatic manifold Automatic manifold system
system system.
May be sized to support high- dependency
To come on-line area or whole size
automatically in the event
of plant failure. OR
Number of cylinders Locally based integral valve cylinders with

based on ability to regulators/ flow meters attached.
provide 4 hours supply at
average use.
Two compressors of Third compressor of a Automatic manifold system.
a triplex compressor triplex system. To support whole size.
system
Two compressors of Other two compressors of Automatic manifold system.
a quadruplex system. a quadruplex system. To support whole size.
Note :
Duplex – 2 Compressor
Triplex – 3 Compressor
Quadruplex – 4 Compressor
23

2.3.1.2 PROPOSE AND AREA OF USES FOR MEDICAL AIR (MA4) AND SURGICAL AIR
SYSTEM
MEDICAL AIR (MA4) SURGICAL AIR (SA7)

Medical air is mainly used in respiratory Surgical air (of medical air quality) is also
therapy as a power source for patient used, at a higher pressure, to power a variety
ventilators, and for blending with oxygen. It of surgical tools and other devices such as
is also used as the driving gas for nebulised tourniquets. (As an alternative, nitrogen can
drugs and chemotherapy agents. be used for this purpose.)
• Ventilator; • Driving of medical devices;
• Driving of such medical devices; • Surgical tools;
• Operation of OT Pendant (selectable);
• All wards (Bedhead panel) • Operation Room
• A&E
• Operation Room
• Maternity
• Radiology
• Critical Care Area
• HDW
• Renal
• Dental
Colour Code Piping
• Colour Code Cylinder
24

2.3.1.3 LAYOUT OF MEDICAL AIR PLANT
Figure 19: Overview Layout of Medical Air Plant Room
Figure 20: Layout of Medical Air Plant Room
25

2.3.2 COMPONENT OF MEDICAL AIR (MA4) AND SURGICAL AIR SYSTEM
MA4 & SA7

Main Components

Compressor Dryer

Bedhead Panel Air Receiver Ot Pendant

Regulator Bacteria Filter Dust/Carbon Filter
26

MEDICAL AIR (MA4) SURGICAL AIR (SA7)

AUTOMATIC i- Cylinder bank pressure (Duty i. Cylinder bank pressure (Duty
MANIFOLD AND and Standby) :~13700kPa and Standby) :~13700kPa
EMERGENCY ii- Line pressure gauge: 410 kPa- ii- Line pressure gauge: 410 kPa-
RESERVE (MANUAL) 420kPa 420kPa
MANIFOLD iii- Low pressure alarm: 370kPa iii- Low pressure alarm: 650kPa
iv- High pressure alarm: 500kPa iv- High pressure alarm:
v- Reserve low alarm: 1400kPa 1050kPa
vi- Pressure Safety Valve Setting: v- Reserve low alarm: 1400kPa
530kPa vi- Pressure Safety Valve Setting:
1100kPa
GAS TERMINAL i. Operating pressure: 400kPa ± i. Operating pressure: 700kPa ±
UNITS (GTUs) 10kPa / 4.0 ± 0.1bar 10kPa / 7.0 ± 0.1bar
ii. Operating flow: 10 litres per ii. Operating flow: 10 litres per
minute (lpm) minute (lpm)
AREA / LOCAL Low pressure alarm : 3.6 bar Low pressure alarm :6.5 bar
ALARM PANEL AT
USER DEPARTMENTS
2.3.4 ALARM INDICATION

27

2.3.5 MA 4 AND SA 7 SYSTEM INSPECTION
i. Compressor Panel
Figure 21: Checking Item on Compressor Panel
28

ii. Dryer Panel
Figure 22: Checking Item on Dryer Panel
29

iii. Emergency Supply Manifold
Figure 22: Checking Item on Dryer Panel
30

iv. NIST connector.
• Pressure switch
on both banks
• Non-return valves on header

and line
!
• Pin indexed tail pipes with

NIST to header
Figure 24: NIST connector
2.4 VACUUM SYSTEM
2.4.1 OVERVIEW OF VACUUM SYSTEM
In vacuum system, there are three type of system that normally been use in hospital
depends on the capacity of vacuum usage. These are the type of vacuum system:
31

Figure 25: Vacuum System - Duplex
Figure 26: Vacuum System - Triplex
Figure 27: Vacuum System -Quadruplex
32

2.4.2 COMPONENTS OF VACUUM SYSTEM
VACUUM
Main Components
Vacuum Pump Air Receiver

Bacteria Filter OT Pendant Regulator

Bedhead
33

Component Pump Receiver Bacteria Filter Pressure Terminal unit

switch
Symbol
Parameter Cut-in= 450 mmHg Shall be in N/A 300mmHg

500 mmHg green mark 40L/min
Cut-out=
650mmHg
Other All systems Valid Cert of Complete with Working in a N/A

requirement should PMT No. drainage flask setting range
comprise
pumps and
motors of
identical
type that are
suitable for
continuous
running and
stop/start
operation
1. Running Amp (Amp meter)

2. Start/Stop Button Auto/Manual Selector
3. Start/Stop/Fault Indicator
4. Running Hours
5. Pressure Reading (mmHg)
34

2.4.3 ALARM INDICATOR
Supply Alarm conditions Legend Colour Audible

System System
Medical Normal – all system / components Normal Green No

vacuum function
plant
Plant fault – any fault due to Plant fault Yellow Yes
pumps/control panel/motor trip/
other safety devices
Plant emergency - receiver vacuum Plant emergency Yellow Yes

has fallen,
for example, by 50 mm Hg below

the cut-in
setting for the pump;
Pressure Fault - pipeline vacuum Pressure Fault Red Yes

less
than 360 mm Hg.
35

2.4.4 VACUUM SYSTEM INSPECTION
36

37

Notes:
Pump operating and indicating System
• Pneumatic components should have ventilation. All functions should be appropriately

identified. Indicators should have a design life of at least five years. The operating
system should be capable of automatically restarting after reinstatement of the
power supply.
• The vacuum supply system should be connected to the stand-by electrical supply. The
control system should ensure that pumps restart in sequence to avoid overloading
the power supply.
Plant status monitoring
• A monitoring system must be provided to detect the following faults in the vacuum
supply system:
a) Plant fault for each pump:
i. Control circuit failed;

ii. Motor tripped;
iii. Pump failed to go on load;
iv. Activation of other safety devices supplied by the manufacturers;
b) Plant emergency – receiver vacuum has fallen, for example, by 50 mmHg below
the cut in setting for the pump;
c) Pressure fault (pipeline) – pipeline vacuum less than 360 mmHg.
38

2.5 ANEASTETHIC GAS SCAVEGING SYSTEM (AGSS) –
2.5.1 OVERVIEW OF AGSS
AGGS
• Active AGSS Systems provide full removes of waste gas
• Installed in operation theatres and where N20 is used
#Extraction of waste anaesthetic gases at :

• Operating Theatre
• Delivery Room
• Point Use
2.5.2 COMPONENTS OF AGSS
• Collecting System
• Transfer System
• Receiving System
• Disposal System
Figure 28: AGSS System
39

Figure 29: AGSS System
40

2.5.4 ALARM INDICATOR
A simplified (alarm) system is required for the AGSS, with the warning/indication panel
located in the operating room referring to HTM 02-01 Part A
Alarms are triggered by a pressure switch or some other type of flow monitor
2.5.5 AGSS INSPECTION
41


Figure 30: AGSS Checking Item
Figure 30: AGSS Checking Item
Plant Plant
controlcontrol indication
indication - indicators
- should be should beto indicators to show
show the following the following
conditions:
conditions:
a) green “mains on”
b) a) “air
green green “mains
flow” on”;
normal; inititated by either a pressure switch or air flow detection
device
b) at the pump.
green “air flow” normal; initiated by either a pressure switch or air
c) yellow “duty pump failed” (palnt fault)
d) flow failed”
red “system detection device
(plant at the pump.
emergency)
c) yellow “duty pump failed” (plant fault);
d) red “system failed” (plant emergency).
42
Page 49 of 86

3.
Max Static Vacuum -20kPa

Flow 80-130 litres min
Discharge Outlets
Discharge - sited
outlets - sitedatatroof
roof level, wellaway
level, well awayfrom
from ventilation
ventilation inlets,
inlets, opening windows
and other apertures, to prevent pollution re-entering the building.
opening windows and other apertures, to prevent pollution re-entering
the building.
43

3.0 OPERATION AND MAINTENANCE
3.1 RULES AND RESPONSIBILITY
3.1.1 Responsibilities of the authorised person (MGS) for the permit-to work
procedure
The responsibilities of the authorised person (MGS) are as follows:
a) Obtaining permission for interruption of supplies and affixing “do not use” or other
prohibition notices;
b) Preparing permit;
c) Supervising isolation of section on which work is to be carried out;
d) Explaining details of work to competent person (MGS);
e) Supplying drawings of existing sections of the installation “as fitted”;
f) Supervising performance, cross-connection and identity tests of completed work as
appropriate;
g) Supervising purging with working gas;
h) Final testing, assisted by the QC in the case of high hazard work;
i) Final testing in the case of low and medium hazard work;
j) Restoring service;
k) Supervising or making final connection of any extension;
l) Notifying designated medical officer or designated nursing personnel of completion
of work and removal of “do not use” notices;
m) Obtaining corrected copy of drawings;
n) Supervising amendments of office copy of ”as-fitted” drawings;
o) Retaining original copy of permit and all permit books; and
p) Obtaining designated medical or nursing personnel signature on Part 6 and return
the system to service.
44

3.1.2 Responsibilities of the competent person (MGS) for the permit-to work
procedure
The responsibilities of the competent person (MGS) are as follows:
a) signing Part 2 of the permit, acknowledging responsibility for the work;

b) Obtaining and understanding instructions on work to be done;
c) Isolating section of system on which work is to be carried out, under direct supervision
of authorised person (MGS);
d) Carrying out the work;
e) Carrying out system integrity tests on completed work under direct supervision of
authorised person (MGS); and
f) Signing Part 3 on both the original permit (held by the authorised person (MGS)) and
the copy 1 declaring that the work is completed as indicated on the permit.
3.2 ALARM INDICATION CHECK
– Check that the Visual Indicators and Sounder / Buzzer are working normally - there is
a “test” button which may be pressed.
i. Check the physical condition of pressure switches. To test the functionality

and setting of the low-pressure switches at user departments, shut off the gas
supply at the AVSU and purge the nitrous oxide (N2O) gas at any GTU until the
pressure reaches 3.6 bar, at which the low-pressure alarm shall be raised. The
pressure switches shall be tested at least once a year.
ii. Open the Alarm Panel to inspect the connection modules – ensure there are no
bypasses.
45

3.3 SYSTEM TEST – LEAKAGE TEST
46

3.4 AVSU ZONING TEST
47

3.5 VALVE CLOSURE TEST
48

3.6 INSPECTION CHECKLIST
3.6.1. OXYGEN SYSTEM (VIE)

SENARAI SEMAK PEMERIKSAAN SISTEM MEKANIKAL
KHIDMAT SOKONGAN HOSPITAL
SISTEM BEKALAN GAS PERUBATAN - LIQUID OXYGEN :
DELIVERY INFORMATION
SEKSYEN OPERASI HOSPITAL
CAWANGAN PERKHIDMATAN
BAHAGIAN PERKHIDMATAN
KEJURUTERAAN
KEMENTERIAN KESIHATAN MALAYSIA
HOSPITAL : _____________________________________
Month
Dis 2015 Jan-16 Feb-16 Mac 2016
Liquid Liquid Liquid Liquid

Date Content Content Content Content
Level Quantity Level Quantity Level Quantity Level Quantity
before of Topup before of Topup before of Topup before of Topup
Topup (m3 gas) Topup (m3 gas) Topup (m3 gas) Topup (m3 gas)
(Inch of (Inch of (Inch of (Inch of
Water) Water) Water) Water)
10
49

11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Total 0 0 0 0 0 0 0 0
PREPARED BY (MoH) : _______________________________ DATE OF PREPARED : _______________________________

(name & signature)
PREPARED BY (CONCESSION) : _______________________________ DATE OF PREPARED : _______________________________

(name & signature)
50


SISTEM BEKALAN GAS PERUBATAN - OKSIGEN (VIE)
KEJURUTERAAN

NAME OF HOSPITAL : DATE OF INSPECTION :
_____________________________________ ______________________________________
INSPECTED BY (MoH) : ACCEPTED BY (CC) :
_____________________________________ ______________________________________
(name & signature) (name & signature)
No Item Yes No Remarks

1 Vacuum Insulated Evaporator (VIE)
1.1 Plant Room is locked and
secured
1.2 The compound and external
area is clean and free from
combustible materials
1.3 Safety signage and instruction
is available and in good
condition.
1.4 Log Book & Log Sheet are
available and updated
1.5 PMT No. is appear & visible on
VIE Tank
1.6 Validity of certificate of fitness PMT No. : _______________________________
(PMT). Record the expiry date Expired Date : ___________________________
1.7 Vessel physical are clean and
in good condition (no fungal/
mold on outside tank)
1.8 VIE Tank under working Working Pressure (bar) : __________________
pressure (record the pressure) (Nominal pressure : 10.5 ~ 16 bar)
1.9 Liquid in stock level (record Liquid Level : ___________________________
reading) (Inches Of Water : 120)
1.10 A pipework and installation
diagram (P&ID) of the plant is
displayed clearly to indicate
the appropriate valves that are
necessary to operate the plant
safely.
51

1.11 All valves in good condition

without any leakage indicator
1.12 Build up pressure regulator
in good condition and clean
without any leakage.
1.13 Vessel pressure relief valve in
good condition
1.14 Vessel bursting discs in good
condition
1.15 Vaporizer physical are clean
and in good condition (no
fungal/mold)
1.16 Minimal ice and frost
accumulated on piping and
vaporizer is acceptable
condition and pressure
building coil and piping are
free from dents and damage.
1.17 Liquid low level signal to
Engineering Control Room is
working properly, if applicable.
1.18 Other findings :
1.19 Recommendations :
52

3.6.2. OXYGEN SYSTEM (MANIFOLD)

SISTEM BEKALAN GAS PERUBATAN - OKSIGEN (MANIFOLD)
KEJURUTERAAN

_____________________________________ ______________________________________
_____________________________________ ______________________________________
1 Cylinder Manifold Oxygen

secured
1.2 Lighting is adequate and

functioning

condition.
1.4 Fire detector (smoke) are

install and working properly/
in good condition in plant (if
applicable)

1.6 Noise level is adequately Noise level : <80dB

controlled or hearing
protection provided (if
applicable)
1.7 Ventilation is adequate and Room Temp : <35°C

functioning (if applicable)
1.8 Cylinders are sitting Right Bank Cylinder : _____________

adequately and properly in the
right/left bank. Record right Left Bank Cylinder : ______________
and left bank contain cylinder.
53

1.9 Additional cylinders for one

complete bank change should
be held in the manifold room
1.10 Line valve on both bank shall

be Turn-On at all time
1.11 All stage regulators (1st 1st stage regulator for right bank pressure (bar):
& 2nd stage regulator) __
are functioning and good 2nd stage regulator for right bank pressure (bar):
condition without any leakage. __
Record right and left bank 1st stage regulator for left bank pressure
contain pressure. (where (bar): __
applicable) 2nd stage regulator for left bank pressure
(bar): __
1.12 Auto changeover function and

in good condition
1.13 Non-return valve are install

and in correct operation
1.14 All joints and tailpipes are free

from leakage
1.15 Master/Area alarm panel are

tested and in good working
condition.
1.16 Line pressure relief valve in

good condition
54

3.6.3. NITROUS OXIDE SYSTEM

SISTEM BEKALAN GAS PERUBATAN - NITRUS OKSIDA N2O
(MANIFOLD)
KEJURUTERAAN

_____________________________________ ______________________________________
_____________________________________ ______________________________________

1 Cylinder Manifold Nitrus Oxyde
secured
functioning
condition.
Plant Room is free from
1.4 Fire detector (smoke)
are installed and working
properly/in good condition in
plant (if applicable)
applicable)
1.8 Cylinders are properly stored /
Right Bank Cylinder : _____________
secured in the right/left bank.
Record right and left bank
Left Bank Cylinder : ______________
contain pressure.
55

1.9 Cylinders on both banks are

Turn-On to regain normal
supply to hospital
1.10 All stage regulators (1st 1st stage regulator for right bank pressure
& 2nd stage regulator) (bar) : __
are functioning and good 2nd stage regulator for right bank pressure
condition without any leakage. (bar) : __
contain pressure. (where (bar) : __
(bar) : __
1.11 Auto changeover is functioning
and in good condition
1.12 Non-return valve are installed
from leakage
condition.
good condition
56

3.6.4. ENTONOX SYSTEM


SISTEM BEKALAN GAS PERUBATAN - ENTONOX (MANIFOLD)
KEJURUTERAAN

_____________________________________ ______________________________________
_____________________________________ ______________________________________

1 Cylinder Manifold Entonox
secured
functioning
condition.
Plant Room is free from
applicable)
1.8 Cylinders are properly stored /
Right Bank Cylinder : _____________
secured in the right/left bank.
Left Bank Cylinder : _____________
contain pressure.
57


supply to hospital
are functioning and good 2nd stage regulator for right bank pressure (bar)
condition without any leakage. : __
(bar) : __
from leakage
condition.
good condition
58

3.6.5. MEDICAL AIR (MA4)


SISTEM BEKALAN GAS PERUBATAN - MEDICAL AIR (4 BAR)
KEJURUTERAAN

_____________________________________ ______________________________________
_____________________________________ ______________________________________

1 Medical Air System (Compressor)
secured
functioning
condition.
applicable)
applicable)
1.8 Compressor oil are change
accordingly as per schedule
and tagout.
59

1.9 Oil filter and air filter are

change accordingly as per
schedule and tagout.
1.20 All pressure gauges are
functioning and in good
condition
1.21 Motor and compressor
housing are clean
1.22 After-cooler intake grill fins are
clean
1.23 After cooler auto drain valve
and solenoid are functioning
1.24 Motor aligned and without
any abnormal vibration. Drives
coupling/pulleys and belt
tension are in good condition
1.25 Observe motor & compressor Running current (amp) : ___________
running accordingly. Record Pressure setting (cut in) for MA4 (bar) : _____
motor running current & (nominal pressure setting for cut in : 9 ~ 9.5bar)
pressure setting Pressure setting (cut off) for MA4 (bar) : ____
(nominal pressure setting for cut off : 10 ~
11bar)
1.26 All control panel, indicator
light and alarm panel are
functioning
1.27 All joints and connection is
free from any leakage
2 Medical Air System (Receiver)
2.1 Auto drain and manual bypass
valve are functioning in good
condition
2.2 Safety valve are functioning
2.3 Discharge vent from safety
valve is satisfactory and not
obstructed
2.4 All external part of receiver
are clean
2.5 Strainer are clean if applicable
60

2.6 External sign of damage or

wear and for secure supports
are in good condition
2.7 Validity of certificate of fitness PMT No. : ___________________________
2.8 Record receiver pressure Receiver Pressure (bar) : _____
(nominal pressure : 7 ~ 10 bar)
3 Medical Air System (Dryer, Filter,
Regulator)
3.2 Automatic air release on
column prior to drying out
process are functioning
properly
3.3 Check automatic re-
pressurization of column after
drying out process
3.4 Change over sequence operate
accordingly
3.5 Desiccant are in good
condition and replaced
accordingly
3.6 Heating element drying
out column are operate
accordingly if applicable
3.7 Thermostatic controls of
heating element are operating
accordingly if applicable.
3.8 All gauges are functionality
3.9 Bacteria pressure in
acceptable limit
4 Medical Air System (Cylinder
Manifold)
secured
functioning
condition.
61


applicable)
applicable)
adequately and properly in the Left Bank Cylinder : ______________
right/left bank. Record right
and left bank contain pressure.
Turn-ON to regain normal
supply to hospital
are functioning and good 2nd stage regulator for right bank pressure (bar)
condition without any leakage. : __
(bar) : __
in good condition
from leakage
condition.
good condition
4.16 Ice formation on vaporizer
under supervise (by spraying
water) and pressure building
coil and piping fee from dents
or damage.
62


63

3.6.6. SURGICAL AIR (SA7)

SISTEM BEKALAN GAS PERUBATAN - SURGICAL AIR (7/10
BAR)
KEJURUTERAAN

_____________________________________ ______________________________________
_____________________________________ ______________________________________

1 Surgical Air System (Compressor)
secured
functioning
condition.
applicable)
applicable)
1.8 Compressor oil is change
and tag out.
schedule and tag out.
64


condition
1.21 Motor and compressor
housing are clean
1.22 After-cooler intake grill fins are
clean
1.23 After cooler auto drain valve
and solenoid are functioning
1.24 Motor aligned and without
any abnormal vibration. Drives
coupling/pulleys and belt
tension are in good condition
1.25 Observe motor & compressor Running current (amp) : ___________
running accordingly. Record Pressure setting (cut in) for SA7 (bar) : _____
motor running current & (nominal pressure setting for cut in : 9 ~ 9.5 bar)
pressure setting Pressure setting (cut off) for SA7 (bar) : ____
(nominal pressure setting for cut off : 10 ~ 11
bar)
Running current (amp) : ___________
Pressure setting (cut in) for SA10 (bar) : _____
(nominal pressure setting for cut in : 9 ~ 9.5 bar)
Pressure setting (cut off) for SA10 (bar) : _____
(nominal pressure setting for cut off : 10 ~ 12
bar)
1.26 All control panel, indicator
light and alarm panel are
functioning
2 Surgical Air System (Receiver)
2.1 Auto drain and manual bypass
valve are functioning in good
condition
2.3 Discharge vent from safety
valve is satisfactory and not
obstructed
2.4 All external part of receiver
are clean
2.5 Strainer are clean if applicable
65

2.6 External sign of damage or

wear and for secure supports
are in good condition
2.7 Validity of certificate of fitness PMT No. : ___________________________
2.8 Record receiver pressure Receiver Pressure (bar) : _____
(nominal pressure : 7 ~ 11 bar)
3 Surgical Air System (Dryer, Filter,
Regulator)
3.2 Automatic air release on
column prior to drying out
process are functioning
properly
3.3 Check automatic re-
pressurization of column after
drying out process
3.4 Change over sequence operate
accordingly
3.5 Desiccant are in good
condition and replaced
accordingly
3.6 Heating element drying
out column are operate
accordingly if applicable
3.7 Thermostatic controls of
heating element are operating
accordingly if applicable.
3.8 All gauges are functionality
3.9 Bacteria pressure in
acceptable limit
4 Surgical Air System (Cylinder
Manifold)
secured
functioning
condition.
66


applicable)
applicable)
adequately and properly in the Left Bank Cylinder : ______________
right/left bank. Record right
and left bank contain pressure.
supply to hospital
(bar) : __
in good condition
from leakage
condition.
good condition
4.16 Ice formation on vaporizer
under supervise (by spraying
water) and pressure building
coil and piping fee from dents
or damage.
67


68

3.6.7. VACUUM SYSTEM

SENARAI SEMAK PEMERIKSAAN SISTEM MEKANKAL
SISTEM BEKALAN GAS PERUBATAN - VACUUM SYSTEM

KEJURUTERAAN

_____________________________________ ______________________________________
_____________________________________ ______________________________________

1 Medical Vacuum System (Vacuum Pump)
secured
functioning
condition.
applicable)
applicable)
1.8 Motor oil is changed
and tag out.
schedule and tag out.
69


condition
1.21 Motor and pump housing are
clean
1.22 Observe pump motor running Running current (amp) : ___________
accordingly. Record hours run pump flow rate : _____ l/m
for each pump. Ensure no
signs of oil leakage.
1.23 Vacuum pump oil level is
visible between the top and
bottom edges of oil level sight
glass.
1.24 Plant control panels are

functioning and no alarm
conditions. All indicating lights
are functioning.
2 Medical Vacuum System (Vacuum
Vessel)
All pressure gauges are
condition
Panel board is functioning and
in normal condition
Vessel drain is functioning
3 Medical Vacuum System (Filter)
Bacteria filter is clean and not
contain liquid
4 Medical Air System (Cylinder
Manifold)
secured
functioning
condition.
70

4.4 Plant Room is free from

applicable)
4.9 Cylinders are properly stored / Right Bank Cylinder : _____________
secured in the right/left bank. Left Bank Cylinder : ______________
contain pressure.
Turn-ON to regain normal
supply to hospital
(bar) : __
from leakage
condition.
good condition
71

72

3.6.8. ANEASTETHIC GAS SCAVEGING SYSTEM (AGSS)

SENARAI SEMAK PEMERIKSAAN SISTEM MEKANKAL
SISTEM BEKALAN GAS PERUBATAN - ANEASTETHIC GAS
SCAVEGING SYSTEM (AGSS)
KEJURUTERAAN

_____________________________________ ______________________________________
_____________________________________ ______________________________________

1 Medical Air System (Compressor)
secured
functioning
condition.
applicable)
applicable)
1.8 Pump securing bolts are tight
condition
1.1 Motor and pump housing are
clean
73

1.11 Observe pump motor running Running current (amp) : ___________

accordingly. Record hours run pump flow rate : _____ l/m
for each pump. Ensure no
signs of oil leakage.
1.12 Motor windings and bearings
condition are in good
condition
1.13 Flow-regulating valve and
mesh filter in good condition
1.14 Low flow detector is
functioning
1.15 Plant control panels are
functioning and no alarm
conditions. All indicating lights
are functioning.
1.17 All indicating light are
functioning
74

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Buku Sistem Mekanikal MOH CVR OL copy.

pdf 1 03/09/2019 5:38 PM

Buku Sistem Mekanikal MOH v3.indd 1 29/08/2019 10:28 AM

Engineering Services Division, Ministry of Health Malaysia (MOH)

1. Ir. Tauran Zaidi bin Ahmad Zaidi

Buku Sistem Mekanikal MOH v3.indd 2 29/08/2019 10:28 AM

2.1. Oxygen System

2.2. Nitrous Oxide (N₂O) And Entonox (N₂O + O₂)

2.3. Medical Air (Ma4) And Surgical Air (Sa7)

2.4. Vacuum System

Buku Sistem Mekanikal MOH v3.indd 3 29/08/2019 10:28 AM

2.5. Aneastethic Gas Scaveging System (AGSS)

3. Operation And Maintenance

3.1. Rules And Responsibility 44

Buku Sistem Mekanikal MOH v3.indd 4 29/08/2019 10:28 AM

FRAME WORK FOR MANUAL BOOK

1.1 STANDARD & REGULATIONS

• Factory and Machinery Act (FMA) 1967

• MS 2675-1:2017 Medical Gas Systems – Part 1 : Code of Practice For The

• MS 2675-2:2017 Medical Gas Systems – Part 2 : Code of Practice For Operation

• Health Technical Memorandum 02-01 : Medical Gas Pipeline Systems, Part A :

• Health Technical Memorandum 02-01 : Medical Gas Pipeline Systems, Part B :

• Health Technical Memorandum 2022 : Medical Gas Pipeline Systems, Part A :

• Health Technical Memorandum 2022 : Medical Gas Pipeline Systems, Part B :

Buku Sistem Mekanikal MOH v3.indd 5 29/08/2019 10:28 AM

There are seven

N Nitrus Oxide (N2O)

7 Surgical Air (SA7)

Figure 2: Type of Medical Gas

Buku Sistem Mekanikal MOH v3.indd 6 29/08/2019 10:28 AM

OLOUR CODING AND ORIENTATION

Manual Book of Mechanical System

Buku Sistem Mekanikal MOH v3.indd 8 29/08/2019 10:28 AM

Buku Sistem Mekanikal MOH v3.indd 9 29/08/2019 10:28 AM

2.1.2 VIE TANK

Figure 6: VIE tank and accessories

Buku Sistem Mekanikal MOH v3.indd 10 29/08/2019 10:28 AM

Buku Sistem Mekanikal MOH v3.indd 11 29/08/2019 10:28 AM

Work Parties Rules

Request Concession To inform hospital pharmacy for ordering liquid oxygen

Ordering Hospital Hospital pharmacy contact supplier/gas provider for

Concession • Unlock the plant and escort gas provider during

Supplier/ Gas • Contact concession when reach to VIE plant.

Record Hospital • To verify the receipt of filled amount complete with

Buku Sistem Mekanikal MOH v3.indd 12 29/08/2019 10:28 AM

Basic Vessel Construction & Pressure Relief

Figure 8: VIE Tank Vessel

Buku Sistem Mekanikal MOH v3.indd 13 29/08/2019 10:28 AM

Figure 10: Cylinder Manifold System

Buku Sistem Mekanikal MOH v3.indd 14 29/08/2019 10:28 AM

Figure 12: Flow for Oxygen System

Buku Sistem Mekanikal MOH v3.indd 15 29/08/2019 10:28 AM

2.1.4 MAIN PARAMETER

Automatic Manifolds and Emergency Reserve (Manual) Manifolds

Gas Terminal Units (GTUs)

Area / Local Alarm Panel at User Departments

*Note: 1.0 bar = ~100kPa = 14.7 psi

Buku Sistem Mekanikal MOH v3.indd 16 29/08/2019 10:28 AM

2.1.5 ALARM INDICATION