How to Transport Oxygen Cylinders Safely in a Hospital

To move an oxygen cylinder safely in a hospital, secure it upright on a cart or rack so it cannot fall, slide or roll, keep the valve cap on until the cylinder is connected, and move at walking speed on a clear route. Most handling rules come back to one fact. A full cylinder holds gas at high pressure, and the valve is the weak point.

If a cylinder tips and the valve shears off against a hard surface, the escaping gas can drive the cylinder across a room. That is why a loose cylinder is never acceptable in transit. Every safe method does three things. It holds the cylinder upright, protects the valve and keeps the move under control.

Which rules apply

In a US hospital, cylinder handling falls under OSHA 29 CFR 1910.101 for compressed gases, OSHA 29 CFR 1910.253 for keeping oxygen apart from fuel gases in storage, NFPA 99 for medical gas in health care facilities, and the Compressed Gas Association handling guidance that OSHA references. The Joint Commission checks that the hospital enforces them through written policy and staff training.

Read together they say the same thing. Keep cylinders upright and secured, protect the valve, keep oxidizers away from fuel gases, keep full and empty cylinders apart, and move cylinders on equipment built for the job. Your facility policy is what staff are held to, and it can be stricter than the codes.

Step by step

1. Close the valve fully and bleed the pressure out of the regulator before you disconnect anything.
2. Fit the valve protection cap on any cylinder made for one.
3. Check the cylinder for dents, corrosion or a leak, check that the cart brake holds, and make sure no oil or grease is on the fittings.
4. Load the cylinder upright and restrain it with a chain, a strap or a fitted rack.
5. Move at walking speed. Slow down at ramps, door thresholds and elevator gaps, and never leave a loaded cart alone on an incline.
6. At the destination, set the brake and check the cylinder is still secured before you connect it.

Moving a single cylinder

Most oxygen moves in a hospital are one cylinder, often an E size going to a patient room, a test or a discharge. Keep it upright and secured and protect the valve, the same as on a full rack. Close the valve when nobody is using the oxygen. If the patient is breathing from that cylinder, leave the flow as ordered for the whole trip.

Use a single cylinder cart or a wheeled cylinder stand, with the cylinder strapped or chained in before you move. Do not carry a cylinder by the valve or the regulator, do not tuck it under an arm, and do not drag it, slide it or roll it on its base.

When the cylinder travels with a patient, keep it upright in the holder on the wheelchair, stretcher or bed frame. Never lay a cylinder on the bed or in the patient’s lap. It can roll off or knock the valve against a rail. Stay with the cylinder until it is in a holder or back in storage, including in the elevator, and never leave it in a corridor.

For an MRI, do not take the cylinder, regulator, cart or holder into the magnet room unless the MRI staff have cleared that exact equipment. A steel cylinder near the magnet can be pulled across the room.

At the bedside, keep the cylinder in a stand or holder and never leave it standing loose against a wall. Take empties back to the marked empty area instead of leaving them in the room, so nobody picks one up by mistake.

Oxygen is an oxidizer

Oxygen does not burn by itself. It makes other materials catch fire more easily and burn hotter. Keep oil and grease off oxygen valves, regulators and fittings, keep combustibles such as paper and linen off the cart, and keep the route clear of heat and open flame.

When a powered cart makes sense

A wheeled cart takes the lifting out of the job. A powered cart also takes out the pushing and pulling, which is where back, shoulder and hand strain comes from when staff move full racks over long routes or up ramps. For one cylinder on a short, flat trip, a secured manual cart is enough. For full racks, see the motorized gas cylinder carts.

Our MGC medical gas cylinder carts hold 24 to 48 M7, M9, C, D or E cylinders upright on a powered base rated for 6 degree inclines, with a brake that stops roll back when the operator stops. The coated racks keep cylinders off bare metal, which also keeps the cart quiet in the halls. For liquid cylinders, the Pony Express 2010 carries one liquid cylinder or up to four K size cylinders, and the Pony Express 2100 loads and unloads a liquid cylinder up to 850 lb by itself.

Size the rack to the number of cylinders one person moves on a normal trip, not the largest number the cart could hold. Then check the steepest ramp on the route against the cart rating.

A powered cart is a handling aid. It does not meet NFPA 99, OSHA or your facility policy by itself. Staff still close and cap valves, secure each cylinder and keep gases apart. The cart makes the safe method easier to follow.

Questions

Can an oxygen cylinder be moved lying down?

No. Move medical oxygen cylinders upright and secured. A cylinder on its side can roll or slide off a cart and let the valve strike a hard surface.

Does the valve cap go on before the move?

Yes, on any cylinder made for one. Close the valve and bleed the regulator first, then fit the cap, then load the cylinder upright and secure it.

How far apart must oxygen and fuel gas cylinders be kept?

Oxygen must be kept apart from fuel gases in storage by a set distance or a fire rated barrier. Use the figure in the code your facility has adopted, from OSHA 29 CFR 1910.253 and NFPA 99, for any sign or label.

Who can move medical gas cylinders?

Staff the hospital has trained and authorized under its written handling policy, such as porters, respiratory therapists, nurses and facilities technicians. The codes set the handling requirements, and the hospital decides who is trained to follow them.

Can one person carry an E cylinder by hand?

Only for a few steps, such as lifting it into a holder. Hold the body of the cylinder and never lift it by the valve, a removable cap or the regulator. For any real distance, put it on a cart or in a holder.

Can an oxygen cylinder ride on the patient’s bed?

Only upright in a holder made for that bed or stretcher. A loose cylinder on the mattress can roll off. The fall can hurt the patient, and a broken valve can send the cylinder flying.

How do you move an oxygen cylinder in a car?

Close the valve unless the patient is using the oxygen. Keep the cylinder upright and secured so it cannot tip, and do not lay it on the seat or the floor. Nobody smokes in the vehicle. Keep a window open a little so a leak cannot build up oxygen in the car. Do not leave the cylinder in a closed parked car, because Compressed Gas Association guidance says a cylinder should not get hotter than 125°F and a car in the sun can pass that.