RMGA Emergency Procedures 4 — Questions and Answers
Question 1: A fire occurs in the medical gas storage room. Which action should the RMGA take regarding cylinder valves?
- Open all cylinder valves to release pressure before firefighters arrive
- Evacuate the area and allow the fire department to manage the cylinders (Correct answer)
- Attempt to remove cylinders from the room to prevent explosion
- Close all cylinder valves to prevent gas from feeding the fire
Correct answer: Evacuate the area and allow the fire department to manage the cylinders
Cylinders in a fire are a job for the fire department; the RMGA should evacuate personnel and ensure the fire department is informed of the hazardous materials present.
Question 2: During an emergency shutdown drill, the RMGA closes a zone valve serving the operating rooms. How should clinical staff be notified before this action in a real emergency?
- Notification is not required if the shutdown will last less than 5 minutes
- Notification must be given to all affected clinical staff prior to interrupting supply (Correct answer)
- Only the charge nurse needs to be informed in advance
- A public address announcement is the only required notification method
Correct answer: Notification must be given to all affected clinical staff prior to interrupting supply
NFPA 99 and JCAHO standards require notifying all affected clinical areas before any planned interruption to medical gas supply.
Question 3: The RMGA discovers that a medical gas outlet in an OR has been cross-connected, supplying nitrogen instead of oxygen. What is the immediate action?
- Reduce nitrogen pressure to match oxygen pressure and continue use
- Immediately shut down the affected outlet, notify clinical staff, and initiate a full verification before restoring service (Correct answer)
- Swap the DISS fittings at the wall outlet to correct the connection
- Label the outlet as nitrogen and use it for instrument air instead
Correct answer: Immediately shut down the affected outlet, notify clinical staff, and initiate a full verification before restoring service
A cross-connection is a life-threatening error requiring immediate shutdown, clinical notification, and complete system verification before the outlet is returned to service.
Question 4: A liquid oxygen bulk system experiences a pressure relief valve lift during unusually high demand. What does this event signify?
- The system is operating normally during peak demand periods
- System pressure exceeded the relief valve set point, requiring investigation of demand or regulator function (Correct answer)
- The liquid oxygen is of insufficient purity
- The storage vessel requires immediate replacement
Correct answer: System pressure exceeded the relief valve set point, requiring investigation of demand or regulator function
A relief valve lift indicates pressure exceeded the set point, which may signal excessive demand, a malfunctioning vaporizer, or a regulator issue that must be investigated.
Question 5: When a medical gas pipeline is contaminated with particulate matter after a construction repair, what must occur before returning the line to service?
- A visual inspection of the nearest outlet is sufficient
- The line must be purged, tested for purity, and verified per NFPA 99 before clinical use (Correct answer)
- Increasing flow velocity through the line will flush out contaminants adequately
- The line may be returned to service after 24 hours of standby
Correct answer: The line must be purged, tested for purity, and verified per NFPA 99 before clinical use
NFPA 99 requires purging, purity testing, and verification procedures before a repaired or contaminated line is returned to patient care service.
Question 6: A carbon dioxide alarm activates in the endoscopy suite indicating low CO2 pressure. Which clinical procedure is most immediately impacted?
- Patient warming blankets
- Laparoscopic and endoscopic insufflation procedures (Correct answer)
- Pneumatic tube transport systems
- Surgical instrument sterilization
Correct answer: Laparoscopic and endoscopic insufflation procedures
Carbon dioxide is used for insufflation during endoscopic and laparoscopic procedures; low CO2 pressure directly impacts the ability to perform these procedures safely.
Question 7: An RMGA is notified that a patient suffered harm potentially related to a medical gas error. What regulatory body notification may be required in addition to internal reporting?
- The Environmental Protection Agency (EPA)
- The FDA MedWatch program and applicable state health department (Correct answer)
- The Department of Transportation (DOT)
- The Occupational Safety and Health Administration (OSHA) only
Correct answer: The FDA MedWatch program and applicable state health department
Medical gas errors resulting in patient harm may require FDA MedWatch adverse event reporting and notification to the state health department, in addition to internal incident reporting.
RMGA Emergency Procedures 4
A fire occurs in the medical gas storage room.
Which action should the RMGA take regarding cylinder valves?