AANA journal course: update for nurse anesthetists--medical gases, hospital pipelines, and medical gas cylinders: how safe are they?

Medical gases which hospital personnel are familiar with include oxygen, nitrous oxide, medical air, carbon dioxide, and nitrogen. Their composition and packaging is defined by the Code of Federal Regulations and the United States Pharmacopeia/National Formulary. Unfortunately, numerous safety issues and even cases of death occur each year that relate to the use of these gases in medical settings. This review documents incidents of near hits and deaths of patients from pipeline and gas cylinder use and describes the key role that anesthesia and healthcare personnel play in verifying the integrity of gases used and the systems which deliver them.