Supplemental oxygen therapy provides increased concentrations of gas to individuals with respiratory conditions who cannot extract sufficient amounts from room air. The delivery of this concentrated gas from a high-pressure cylinder requires a specialized component to safely control the flow. This device reduces the extremely high pressure inside the storage container to a safe, usable level for the patient. Attaching this component correctly is a precise procedure that directly impacts the safety and efficacy of the prescribed treatment. A secure, leak-free connection ensures the patient receives the proper therapeutic dose.
Required Equipment and Preparation Steps
Before beginning the attachment process, gather the required equipment: the oxygen cylinder, the pressure-reducing flow control device, and the specialized wrench or key if the cylinder valve lacks a handwheel. A small, non-metallic washer or gasket, often called a Bodok seal, is necessary, as it creates the high-pressure seal between the two metal surfaces. Inspect the connection point on the flow control device to ensure this sealing washer is present, undamaged, and correctly seated.
The first preparatory step involves ensuring the cylinder valve outlet is free of dust or debris. This is accomplished by a process known as “cracking the tank,” where the valve is opened slightly and then immediately closed. This quick, gentle burst of gas clears any foreign particles from the outlet before the flow control device is attached, which is essential for maintaining oxygen purity and preventing potential combustion risks. Ensure the cylinder is secured in an upright position and that all materials, including hands and tools, are free of oil or grease, which can react violently with concentrated oxygen.
Step-by-Step Regulator Connection
The most common connection for portable oxygen containers uses a yoke-style assembly, standardized as the CGA 870 connection. This design relies on the Pin Index Safety System, which ensures only the correct flow control device can be attached to the oxygen cylinder. The two alignment pins on the yoke must be matched and inserted into the corresponding holes on the cylinder valve.
Hold the flow control device steady and slide the yoke fitting over the cylinder valve post. The pins should seat fully into the valve holes, and the device should sit level and flush against the valve face. If the device appears crooked or does not sit flat, the pins are likely misaligned, and the fitting must be removed and repositioned.
Once the device is correctly aligned, the T-handle or tightening screw is turned clockwise to secure the connection. This T-handle drives the yoke against the cylinder valve, compressing the sealing washer to create an airtight connection. Hand-tighten this handle until it is snug; tools should not be used, as this can easily lead to overtightening and damage the sealing washer or the yoke assembly. The goal is a firm, secure connection where the device is held tightly against the cylinder valve face. Confirm the flow selector on the device is set to the “off” or “zero” position before proceeding.
Verifying the Connection and Setting the Flow Rate
With the flow control device securely attached, open the cylinder valve slowly by turning it counterclockwise using the specialized key or handwheel. Opening the valve gradually allows the high-pressure gas to enter the device slowly, preventing a sudden surge that could damage internal components. Once fully opened, the contents gauge should display the remaining pressure within the cylinder, typically around 2,000 pounds per square inch (psi) for a full tank.
Immediately listen closely for any audible hiss or escaping gas, which indicates a leak at the connection point. If a leak is suspected, close the cylinder valve immediately by turning it clockwise, and inspect the connection for a damaged or missing sealing washer. Using a soapy water solution to check for leaks is generally not recommended for medical oxygen equipment, as residues can pose a fire hazard when exposed to high-pressure oxygen.
After verifying a leak-free connection, connect the prescribed oxygen delivery device, such as a nasal cannula, to the outlet fitting. Set the flow rate by turning the flow selector dial until the indicator aligns precisely with the prescribed liters per minute (LPM). When the cylinder is not in use, the main valve must be closed completely to conserve gas. After closing the cylinder valve, the line must be “bled” by momentarily turning the flow selector on until the pressure gauge needle drops to zero, safely releasing the residual pressure trapped inside the flow control device.
Critical Safety Rules for Oxygen Use
The use of supplemental oxygen introduces specific environmental hazards because concentrated gas significantly accelerates combustion. Although oxygen itself does not burn, it causes surrounding materials to become oxygen-enriched, meaning they will ignite much more easily and burn hotter and faster than normal. The most important safety rule is to establish a strict no-smoking policy in any area where oxygen is being used or stored.
All oxygen equipment, including cylinders and tubing, must be kept a minimum distance of six to ten feet away from any heat source or open flame. This includes gas stoves, candles, fireplaces, electric heaters, and items that generate heat like electric blankets or hair dryers. Petroleum-based products, such as certain creams, ointments, or lip balms, must be avoided entirely, as these materials can ignite spontaneously in an oxygen-rich atmosphere.
For safety and stability, oxygen cylinders must always be stored and used in an upright position and secured with a stand or strap to prevent them from falling over. A falling cylinder can damage the valve, potentially causing a rapid, uncontrolled release of gas. If a cylinder or flow control device appears damaged or a leak cannot be resolved by reseating the connection, the oxygen supplier should be contacted immediately for assistance.