RMGA Safety Protocols & Risk Management 3 — Questions and Answers
Question 1: Under NFPA 99, which entity is responsible for authorizing interruption of a medical gas system in an occupied healthcare facility?
- The gas contractor performing the work
- The Infection Control Officer
- The Designated Person (DP) in coordination with clinical leadership (Correct answer)
- The local fire marshal
Correct answer: The Designated Person (DP) in coordination with clinical leadership
The Designated Person must coordinate system interruptions with clinical staff to ensure patient safety before any shutdown occurs.
Question 2: A Failure Mode and Effects Analysis (FMEA) for a medical gas system is used to:
- Document past equipment failures for insurance purposes
- Proactively identify potential failure points and their impact on patients (Correct answer)
- Calculate the cost of replacing aging pipeline components
- Track gas consumption by department
Correct answer: Proactively identify potential failure points and their impact on patients
FMEA is a proactive risk management tool that identifies how each component might fail and assesses the consequences before failures occur.
Question 3: When a new medical gas system installation is complete, the required sequence of testing before patient use is:
- Visual inspection only, then pressure test
- Pressure/leak test, then purity/concentration test, then labeling verification (Correct answer)
- Purity test, then a 24-hour observation period
- Labeling check, then flow test, then visual inspection
Correct answer: Pressure/leak test, then purity/concentration test, then labeling verification
NFPA 99 mandates pressure/leak testing followed by gas concentration verification and outlet labeling checks before any system is placed in service.
Question 4: What is the correct color code for a medical-grade Nitrous Oxide cylinder in the United States?
- Green
- Yellow
- Blue (Correct answer)
- Gray
Correct answer: Blue
In the US, nitrous oxide cylinders are coded blue, which helps prevent misconnection with other medical gases.
Question 5: A safety relief valve on a medical gas bulk storage system is designed to open when:
- Daily inspection is overdue
- System pressure exceeds the maximum allowable working pressure (MAWP) (Correct answer)
- Ambient temperature drops below freezing
- Gas purity falls below specification
Correct answer: System pressure exceeds the maximum allowable working pressure (MAWP)
Relief valves are pressure-actuated safety devices that open to vent gas when system pressure exceeds the MAWP, preventing vessel rupture.
Question 6: In a Root Cause Analysis (RCA) following a medical gas incident, the team should focus primarily on:
- Identifying and disciplining the responsible employee
- Discovering underlying systemic failures that allowed the event to occur (Correct answer)
- Calculating financial losses caused by the event
- Determining whether the gas supplier was at fault
Correct answer: Discovering underlying systemic failures that allowed the event to occur
RCA seeks systemic causes—process gaps, equipment design, training deficits—rather than individual blame, enabling lasting safety improvements.
Question 7: Which NFPA 99 requirement applies to the segregation of full and empty medical gas cylinders in storage?
- They may be stored together if clearly labeled
- Full and empty cylinders must be stored in separate, clearly marked areas (Correct answer)
- Only cylinders over 200 cubic feet need to be segregated
- Segregation is only required for flammable gases
Correct answer: Full and empty cylinders must be stored in separate, clearly marked areas
NFPA 99 requires full and empty cylinders to be stored separately and clearly marked to prevent accidental use of an empty cylinder in an emergency.
RMGA Safety Protocols & Risk Management 3
Under NFPA 99, which entity is responsible for authorizing interruption of a medical gas system in an occupied healthcare facility?