Boc Entonox ed User manual

Best-in-class cylinder packages

BOC Healthcare pioneers the medical gas products and services that will

deliver tomorrow’s patient care today. Our unrivalled commitment to

improving medical gas technology, reduces costs, and optimises patient

treatment. All BOC Healthcare gas cylinders are designed to be robust,

reliable, convenient to use and safe to handle. To provide the highest

quality, all cylinders are tested at every ﬁ ll to ensure patient safety.

Integral valve cylinders

BOC was the ﬁ rst UK company to introduce integral valve cylinders to

the healthcare sector. These simple, ready to use cylinders require no

additional equipment. The lightweight packages in the range are more

convenient to use and hold more gas than conventional cylinders.

The beneﬁ ts and features of these cylinders are:

• constantly live gauge indicates gas levels, even when the

cylinder is not turned on

• higher gas capacity for less cylinder changes

• lightweight small cylinders for less lifting eﬀ ort, ideal for

portable use

• improved manual handling, minimising the risk of injury

• easier to store and handle due to its ﬂ at stable base and

carry handle

• clear product labelling to avoid selecting the wrong gas

• eliminates the costs of buying and maintaining separate regulators

• tamper-evident covers to ensure the gas is kept uncontaminated

and safe for the patient up to the time of use

• no need for a cylinder key

• simple push ﬁ t connection to save time.

With BOC as your provider, you can be sure to beneﬁ t from leading-

edge technology.

ENTONOX® (50% nitrous oxide/50% oxygen).

Integral valve cylinders (ED, EX).

→ BOC: Living healthcare

Cylinder features

Convenient

carry handle

Easy on/oﬀ handwheel

Clear product identity

Flat base

“Live”

contents gauge

Batch label

Clear product identity

Capstan

Schrader outlet

03Cylinder instructions

5.5 Replace the outlet cover by

pulling up the hinged grey cover.

5.1 Remove the demand valve

from the patient. If the treatment

is ﬁ nished safely dispose of the

ﬁ lter and mouthpiece or mask.

4.1 Instruct the patient on how to

use the demand valve correctly

before commencing therapy.

The gas should be inhaled for

at least 2 minutes prior to

starting any procedure for

optimum pain relief.

3.5 Check the demand valve is

operating by pushing the “test

button”. Ensure you can hear the

gas ﬂ owing.

3.1 Ensure the demand valve

is clean and ready for use. You

will need a single patient use

mouthpiece or face mask.

5.3 Vent any residual gas in the

hose by pressing test button on

the demand valve. Wait for the

gas to stop venting.

4.3 Ensure the clinical condition

of the patient remains satisfactory

throughout the therapy.

If the patient experiences

complications ask them to stop

inhaling the gas.

4.4 Check the contents gauge at

regular intervals (as described

in 2.3), to make sure there is

enough gas to continue the

therapy.

3.3 Insert the probe on the hose

connected to the demand valve

into the Schrader outlet. Push

ﬁ rmly to ensure the probe clicks

securely into place.

3.4 Slowly turn on the

cylinder by rotating the hand

wheel anti-clockwise until it

comes to a stop. Do not use

excessive force.

5.6 Check the cylinder gauge, for

content level (refer to nominal

duration chart). Return the

cylinder to a designated ‘in use’

or empty storage area.

5.2 Turn oﬀ the cylinder by

rotating the hand wheel clockwise

until it comes to a stop. Do not

use excessive force.

4.2 Use scavenging equipment

whenever possible, to avoid a

build up of nitrous oxide in the

environment. If scavenging is

not possible, use in a well

ventilated area.

3.6 Check for leaks which maybe

indicated by a hissing sound.(1)

3.2 Fit a new microbial ﬁ lter to the

demand valve. Fit a new ﬁ lter/

mouthpiece for each patient to

prevent cross contamination.

5.4 Disconnect the probe from

the cylinder outlet. Holding the

probe twist the capstan and

withdraw it from the outlet.

5. After use

4. Monitoring during use

Note:

(1) If you suspect that you have a leak, turn oﬀ the cylinder and check

the equipment is properly connected. Turn on the cylinder and re-check

for leaks. If the leak continues, turn oﬀ and quarantine the cylinder and

contact BOC Healthcare.

02 Cylinder instructions

Instructions for use.

1. Initial safety checks

Before handling cylinders ensure your hands are clean. If you have

been using alcohol based gel or liquids to decontaminate your hands

make sure the alcohol has totally evaporated.

2.1 Ensure you have the correct

medical gas by checking the

cylinder label.

2.5 Open the valve outlet cover.

The hinged grey cover is pulled

down. Do not remove the grey

cover and reﬁ t after use.

When selecting the cylinder for use, check that the cylinder is free from

oil and grease, particularly around the Schrader outlet. Check that the

cylinder is not damaged in any way, if it is contact BOC.

2.3 Make sure the contents gauge

is in the green zone. This indicates

that the cylinder is FULL.

2.2 Check the expiry date on the

batch label. Use cylinders with

the nearest expiry date.

2.4 Remove the tamper evident

handwheel cover by pulling the

tear ring. Discard the cover into

the recycle bin. If the cylinder

has been used before this cover

will not be present.

2. Preparing a new cylinder for use

3. Connecting a demand valve to the Schrader outlet

If the cylinder has been used before make sure you have suﬃ cient gas for treatment by inspecting the

contents gauge. If the needle is in the red zone there is limited capacity and you may need to change

the cylinder (see nominal duration chart overleaf).

In the event of an emergency,

or if you suspect your cylinder

is leaking, contact BOC

Healthcare on 0800 111 333.

2.6 Place the cylinder in a

safe location, preferably in an

appropriately designed cylinder

holder ﬁ tted to the patient‘s bed.

Note:

Ideally the cylinder should not be placed on the bed next to the patient.

If there is no alternative; before placing on the patient‘s bed make

sure that:

• the equipment is connected

• the cylinder is turned on and not leaking (see 3.1 to 3.6)

• check there is a gas ﬂ ow by pressing the test button.

04 Cylinder instructions

Cylinder range and speciﬁ cations

Cylinder code ED EX

Cylinder order code 211-ED 211-EX

Nominal contents (litres) 700 3500

Nominal cylinder pressure (bar) 217 217

Nominal outlet pressure (bar) 4 4

Valve outlet pressure connection ENTONOX BS 5682 Schrader ENTONOX BS 5682 Schrader

Valve operation Handwheel Handwheel

Maximum ﬂ ow-rate (litres/min) Schrader: 40 (nominal) Schrader: 40 (nominal)

Dimensions (inc. valve) L x D (mm) 520 x 100 940 x 140

Water capacity (litres) 2.0 10.0

Nominal weight full (kg) 4.5 19.8

Nominal cylinder duration

Estimated usage time, based on an average 6 litres per minute consumption rate for an adult person.

Gauge contents

Full (100%) Half (50%) Low (25%)

Size (hrs. min) (mins) (hrs. min) (mins) (hrs. min) (mins)

ED ENTONOX (700 ltrs) 1.56 116 0.58 58 0.29 29

EX ENTONOX (3500 ltrs) 9.43 583 4.51 292 2.25 146

HLC/504365/UKS/BAMC/0513

The stripe symbol and the letters BOC are registered trade marks of The BOC Group Limited. Both BOC Limited and The BOC Group Limited are members of The Linde Group,

BOC Healthcare

Customer Service Centre, Priestley Road, Worsley, Manchester M28 2UT

Phone 0800 111 333, Fax 0800 111 555, Email bochealthcare-uk@boc.com, www.bochealthcare.co.uk

Safety information and precautions

• ENTONOX is a non-ﬂ ammable gas, but strongly supports combustion.

• Do not store or use medical gas cylinders near naked ﬂ ames,

sources of ignition or combustible materials.

• Ensure the ENTONOX cylinders are stored in a safe and secure area

where they cannot fall over and cause injury.

• Clearly identify the storage areas with appropriate signage. Ensure

separation of full and empty cylinders.

• Store medical gas cylinders separately from industrial and other non

medical cylinders in a well-ventilated area that is clean and dry,

preferably inside.

• Smoking should not be permitted in the vicinity where cylinders are

used or stored.

• Ensure labels remain clearly visible at all times and not removed or

covered. Unauthorised labels/tags must not be ﬁ tted.

• Use a suitable trolley to transport large cylinders. Any stationary

cylinder trolley in a ward area should be ﬁ xed in place to prevent it

falling over.

• Where available, always use an appropriately designed cylinder

support to hold the cylinder whilst in use adjacent to the patient.

• Ensure the cylinder is set up and tested before placing near the

patient.

• Do not place the cylinder on the patient‘s bed unless there is no

suitable alternative for retaining the cylinder.

• Do not use oil or grease (or any oil-based products which includes

hand creams) in the vicinity of an ENTONOX cylinder.

• If you need to clean the cylinder do not use any materials which

contain ammonium or chlorine compounds.

• Do not refill or tamper with the cylinder package.

Storage and use

If ENTONOX cylinders are allowed to get too cold (below -6ºC) the nitrous oxide component of the gas will start to separate out of the gas mixture,

changing the concentration of the gas delivered to the patient. To prevent this it is recommended that cylinders should be stored above 10ºC for at

least 24 hours before use.

If a cylinder is allowed to get too cold, it will automatically be remixed for use by storing it above 10ºC for at least 24 hours. Alternatively, for small