Assessment of Cheater Fittings for Compressed Nitrogen Gas in the Operating Theatres at the Health Sciences Centre Winnipeg

Abstract

Following the completion of a new operating room (OR) facility at the Health Sciences Centre Winnipeg (HSC), a cheater fitting was installed on the nitrogen gas outlets to convert the newer nitrogen Diameter Index Safety System (DISS) outlets to medical-air Schraeder (quick connect) fittings found on most existing surgical tools. These cheaters violate the CSA Z7396.1-06 Medical Gas Pipeline Systems1 standard because they eliminate the gas-specificity of the outlets and thus introduce the possibility of misconnections, potentially resulting in injuries and/or damages. This assessment found that replacement of these cheater fittings is not feasible, due to the double- sheathed hoses and fittings that are used with most surgical tools. In the short term, it is recommended that the OR at HSC mitigate the present risk by installing warning signs near the existing nitrogen outlets and educate staff about the risks of the current cheaters. Following an anticipated shift in the industry, resulting from a revision of the National Fire Protection Agency (NFPA) Standard for Healthcare Facilities, the feasibility of eliminating the cheater fittings will need to be reconsidered.