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Rocky Mountain Regional Care Model for Bioterrorist Event

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

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Oxygen Supply Options

Oxygen Supply Options Developed by the Developmental Center for Operational Management (DCOM), USAF

Text Version of a PowerPoint® Presentation.


Slide 1

Deployable Oxygen Solutions for FEMA

Slide presents photos of DOGS System, EDOCS System, and NPTLOX System. Select for Images (87 KB).

Slide 2

Briefing Outline

  • Objectives.
  • Assumptions.
  • Basic Systems.
  • Oxygen Generation Process.
  • Components—Comparison Matrix.
  • Options and Comparisons.
  • Additional Considerations.

Slide 3

Objectives

  • To provide information about oxygen systems to FEMA for use in emergency mass casualty operations.
  • To deliver oxygen to converted medical facilities such as hotels which would become hospitals.
  • Provide procurement options.

Slide 4

Assumptions

  • FEMA Region 8 possesses the following equipment:
    • Respirators.
    • Transportation sources.
    • Facilities.
  • FEMA has procedures for:
    • Emergency Response Plans.
    • Memorandum of Understanding with Military Medical Organization.
    • Procurement/Funding.

Slide 5

FEMA Region 8

FEMA Regional Offices: Serving Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming

Slide presents a map of the U.S. with FEMA Region 8 highlighted. Select for Image of Map (21 KB).

Slide 6

Basic Systems

  • Oxygen Generation Systems:
    • Deployable Oxygen Generation System (DOGS).
    • Expeditionary Deployable Oxygen Concentration System (EDOCS).
    • Home Fill Systems.
  • Oxygen Storage Systems:
    • Mobile Oxygen Storage Tank (MOST).
    • New Generation Portable Therapeutic Liquid Oxygen (NPTLOX).
    • Hospital Oxygen Backup System (HOBS).
  • Oxygen Distribution Systems:
    • Portable Oxygen Distribution System (PODS).
    • Surgical Oxygen Distribution System (SODS).

Slide 7

Oxygen Generation Process

Example:

  • On Board Oxygen Generating System (OBOGS).

Slide 8

Simplified OBOGS Operation

Slide presents a graphical representation of the OBOGS oxygen generating process. Select for Image (45 KB).

Slide 9

Components

O2 Generation Systems Oxygen Flow Rate
Liters/Minute
Power Req
KW
Effectiveness
O2 LPM/KW
Cube
Ft3
Cost
K
O2 Purity
Expeditionary Deployable Oxygen Concentration System (EDOCS) 120 120 8 15 108 131 93 +/- 3
Portable Therapeutic Oxygen Concentration System (PTOCS) 45 7 6 75 40 93+
Portable Oxygen Generation System (POGS) 33 12 3 27 35 93-95
Patient Ventilation Oxygen Concentration System (PVOCS) 20/20 4.3 5 73.5 35 93 +/- 3
Invocare HomeFill Oxygen Compressor 3 0.2 15 2.8 2.5 93 +/- 3
*provides oxygen and medical grade air Oxygen/Air          

Slide 10

Generation Systems

  • EDOCS.
  • DOGS.
  • Home Fill System.

Slide presents photos of DOGS System, EDOCS System, and Home Fill System. Select for Images (71 KB).

Slide 11

Deployable Oxygen Generation System (DOGS)

Essex Cryogenics

  • PTOCS Concentrator.
  • P/N 60C-0169-0100.

Slide presents photos of DOGS System. Select for Image (66 KB).

Slide 12

Expeditionary Deployable Oxygen Concentration System (EDOCS)

Slide presents two photos of EDOCS System. Select for Images (84 KB).

Slide 13

EDOCS vs. DOGS

Parameter EDOCS 120 DOGS
Oxygen Purity 90-96% >93% with potential to meet 95%
FDA Approval Yes Yes
Oxygen Outflow Control No information available 0.5-15 LPM at each outlet
System Weight 3800 lbs 870 lbs
Portability Forklift 4-person carry on
Oxygen Flow Rate 120 LPM 45 LPM
Oxygen Outlets 4 Oxygen Fill Ports to fill H-Tanks (comes with M tanks) 3 oxygen outlets with a minimum flow rate of 11 LPM per outlet at 50 ± 5 psig
Cube Size 108 cubic feet. 2 units can fit on a 463L pallet 43 cubic feet. 3 units can fit on a 463L pallet
Dimensions 94" L X 40" W X 50" H Air tank module—23½" W X 43½" L X 27½" H
Compressor—23½" W X 43½" L X 27½" H
Concentrator module—21"W X 30"L X 38" H
HP cylinder refill component—34"W X 27"L X 23¾
Cost $140K $33K (POM) (Boost 66 20K)
$39K surge estimate
Power 8 KW (estimated 2-3KW) 6.8 KW

Slide 14

Home Fill System

  • 3 liters per min @ 14-21 psi.
  • 110V AC and 200 Watts.
  • Light weight: 33 lbs.
  • Approx $2,500.

Slide 15

Storage Units

  • MOST.
  • NPTLOX.
  • HOBS.

Slide presents photos of MOST System, NPTLOX System, and HOBS System. Select for Images (100 KB).

Slide 16

Mobile Oxygen Storage System (MOST)

  • Capacity 11,320 liters @ 2015 psi.
  • 150 lbs.
  • Non-standard Connections.
  • Not FDA Certified.
  • Aluminum Lined.

Slide 17

Next Generation Therapeutic Liquid Oxygen (NPTLOX)

  • Delivers gaseous oxygen at a rate of 66 LPM at 50 ± 5 psig.
  • Liquid oxygen storage capacity of 20 liters.
  • Has 6 oxygen outlets for patient use, supplies 11 lpm maintaining pressures of 50 ± 5 psig.
  • Weight: 150 lbs when filled to capacity.
  • Accessory kit for O2 delivery devices.
  • Includes a fast-fill interface similar to the current PTLOX.

Slide 18

Hospital Oxygen Backup System (HOBS)

  • Configured bank of eight steel cylinders with manifold connection for large storage needs.
  • 55,000L capacity.

Slide 19

Storage Units

Criteria PTLOX NPTLOX Cylinders MOST
Weight (lbs) 103 lbs 150 lbs Variable by type 150 lbs
Maturity (yes/no) Yes Yes Yes Yes
Proven In use by AFMS Not fielded yet, IOC pending $ In use by AFMS Proven technology, new application & configuration
Power Requirements 9 volt battery 9 volt battery None None
Cube (Ft3) 3.75 7.3 Variable by type and size 9
Availability In use Jun-Jul 03 In use 12-13 weeks
Cost ($) $14K ~$25K ~$190-250 ~$13K

Slide 20

Distribution Systems

PODS—Patient Oxygen Distribution System

  • Mimics hospital system.
  • Off the floor—no tripping hazard.

SODS—Surgical Oxygen Distribution System

  • Operating room equivalent to PODS.

Slide presents photos of PODS and SODS Systems. Select for Images (65 KB).

Slide 21

Pressure Drop

  • Pressure drops over the length of distribution system.
    • Keep hoses as short as possible.
  • With the storage capacity limitation the distributions will not be too long.

Slide 22

Option I

  • Expeditionary Deployable Oxygen Concentration System (EDOCS).
  • HOBS (8-cylinder manifold system).
  • Mobile Oxygen Storage Tank (MOST).

Slide 23

Emergency Oxygen Generation and Distribution System

Slide presents photos of Emergency Oxygen Generation and Distribution System. Select for Images (52 KB).

Slide 24

Requirements and Limitations

EDOCS

  • Supplies 10 patients at 11.0 lpm (respirator) or 55 patients at 2.0 lpm (nasal cannula).
  • Designed to operate 24 hrs/day.
  • Takes 7 hrs to fill 1 HOBS.

MOST

  • Unique hoses and regulators.
  • Less supportable than the standard H Cylinder.

Slide 25

Option II

  • Deployable Oxygen Gas System (DOGS).
    • Requires a Boost 66.
  • HOBS (8-cylinder manifold system).
  • Mobile Oxygen Storage Tank (MOST).

Slide 26

Emergency Oxygen Generation and Distribution System

Slide depicts Emergency Oxygen Generation and Distribution System. Select for Image (19 KB).

Slide 27

Requirements and Limitations

  • DOGS
    • 3 patient outlets.
    • 1 additional fill port.
  • Requires Boost 66.
  • 1 HOBS stores 55,000 liters of O2.
  • Takes 130 hrs to fill up HOBS to full pressure (without patient use).
  • 10 patients per 1 HOBS.
  • Capable of Operating 24 hrs straight.

Slide 28

Option III

  • LOX Storage.
  • Filling Tank with NPTLOX.

Slide 29

Emergency Oxygen Generation and Distribution System

Slide depicts process of Emergency Oxygen Generation and Distribution System using LOX Storage/Filling Tank and LOX Storage System (NPTLOX). Select for Image (39 KB).

Slide 30

Requirements and Limitations

  • Availability of LOX.
  • Extensive Training is Required.

Slide 31

Option IV EMEDS

Slide presents photo of an emergency medical facility. Select for Image (80 KB).

Slide 32

Requirements and Limitations

  • Max 25 Patients per EMED layout.
  • Extensive activation procedures.
  • Surgical Capabilities.
  • Experienced Personnel.

Slide 33

Option V

Home Fill Oxygen Compressors

  • Low flow oxygen requirements.
  • One per patient (3 lpm) enough for nasal cannula.
  • Combinations of 2 or more units increase capabilities.

Slide 34

Comparison

Choices Method Advantages Disadvantages
Option I
(EDOCS)
10 patients each
Gas
  • H Tanks readily available.
  • High yield capability.
  • Large Unit.
  • Requires additional distribution network.
Option II
(DOGS)
3 patients each
Gas
  • H Tanks readily available.
  • Man Portable.
  • Higher power consumption.
Option III
(NPTLOX)
6 patients each
LOX
  • High volume capacity.
  • Availability of liquid oxygen.
  • Training.
Option IV
(EMEDS/DEPMEDS)
25 patients max
EMEDS
  • Experience and Practice.
  • Activation Procedures.
Option V
(Home Fill Unit)
1 patient each
Gas
  • Small/Portable.
  • Low power consumption.
  • Low oxygen yield patients.
  • Long Shelf-life.
  • Only for non critical patients (3 lpm).

Slide 35

Oxygen Equipment Vendors

Product Vendor POC Web site Phone
PTOCS
NPTLOX
Essex Cryogenics Timothy Bannister
www.essexind.com
(314) 832-8077
EDOCS
MOST
HOBS
Pacific Consolidated Industries Lee Smith
www.pci-intl.com
(714) 979-9200
Home Oxygen Systems OxLife None
www.oxlifeinc.com
1-800-780-2616
Home Oxygen Systems Preferred Healthcare None
www.phc-online.com
1-866-553-5319
POGS Onsite Gas None
www.onsitegas.com
(860) 667-8888

Slide 36

Additional Considerations

  • Storage.
  • Transportation.
  • Maintenance.
  • Power Demands.

Slide 37

Storage Concepts

  • Preposition major Oxygen system components within the key cities in Region 8.
  • Acquire items and use in a mobile medical assemblage to supply remote locations.

Slide 38

Transportation

  • Components should be palletized for storage and immediate transport.
  • Systems could be transported from storage site to emergency location via ground transportation.

Slide 39

Maintenance

Contract Logistics support should include:

  • Training.
  • Support annual reviews.
  • Spares.
  • Repairs and replacement parts.
  • Warranty.

Slide 40

Power & Oxygen Requirements

  Basic +10 +25
Max Power Draw 181 KW 146.4 KW 205.1 KW
Available Power 100 KW 200 KW 200 KW
EST 02 Usage 89 LPM 162 LPM 281 LPM
EDOCS 120 LPM 8 KW (2) 16 KW (3) 24 KW
(EST) Boost 66 2-3 KW (2) 4-6 KW (3) 6-9 KW
02 Flow 120 LPM 240 LPM 360 LPM
EDOCS Cost 140K 280K 420K
w/ Boost 66 Cost 160K 320K 480K
DOGS 45 LPM (2) 13.4 KW (4) 27.2 KW (7) 47.7 KW
02 Flow 90 LPM 180 LPM 315 LPM
Reg. Cost 66K 132K 321K
Surge Cost 72K 144K 252K

Slide 41

Max Power Requirements

  Basic +10 +25
EMEDS 64.2 KW 122.7 KW 174.5 KW
CP-EMEDS 10.5 KW 17.4 KW 24.3 KW
Water Tent 4 KW 4 KW 4 KW
CP-Water Tent 2.3 KW 2.3 KW 2.3 KW
Max Power Draw 81 KW 146.4 KW 205.1 KW
Available Power 100 KW 200 KW 200 KW
EDOCS 120 LPM 8 KW (2) 16 KW (3) 24 KW
(EST) Boost 66 2-3 KW (2) 4-6 KW (3) 6-9 KW

Slide 42

Questions

  • Oxygen Plants in Region 8.
  • Hotels in contract with FEMA (floor plans/layout).
  • Oxygen Equipment in FEMA's inventory (i.e. ventilators, anaesthesia machines, etc).
  • Medical Support/Capability of remote Hospital (Concept of Operation).
  • What is the O2 Equipment in a CDC Push Pack and how much does it consume?

Slide 43

Credits

  • Col. Daniel K. Berry, 311 HSW/YAM.
  • Lt.Col. Lloyd S. Shackelford, 311 HSW/YAMA.
  • 2d Lt. Clifford A. Hewitt II, 311 HSW/YAMA.
  • MSgt. Ernesto V. Lozares Jr, 311 HSW/YASA.
  • SSgt. Marc C. Paradis, USAFSAM/ATR.
  • Mr. Gregory J. Iltis, Contractor, 311 HSW/YAMA.

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