'J» A 1 .1. WWl,'..J «UA.J C •**»* MASK TYPE OKYQEH THERAPY OUTFIT, COMPLETE, AND CKYOSN THERAPY OUTFIT, WITH MANIFOLD mmi WAR DEPARTMENT TECHNICAL MANUAL MASK TYPE OXYGEN THERAPY OUTFIT, COMPLETE, AND OXYGEN THERAPY OUTFIT, WITH MANIFOLD WAR DEPARTMENT 14 AUGUST 1944 WA R DEPARTMENT TECHNICAL MANUAL TM 8-617 MASK TYPE OXYGEN THERAPY OUTFIT, COMPLETE, AND OXYGEN THERAPY OUTFIT, WITH MANIFOLD WA R DEPARTMENT 14 AUGUST 1944 United States Government Printing Office Washington ; 1944 WAR DEPARTMENT, Washington 25, D. C, 14 August 1944. TM 8-617, Mask Tvpe Oxygen Therapy Outfit, Complete, and Oxygen Therapy Outfit, with Manifold, is published for the information and guidance of all concerned. [A.G. 300.7 (26 Jun 44).] By order of the Secretary of War: G. C. MARSHALL, Chief of Staff. Official: J. A. ULIO, Major General, The Adjutant General. Distribution: As prescribed in paragraph 9a, FM 21 -6: except ROTC (0) ; ID 8(2) ; IR 8(2) ; IC 8(2) ; Med Tech Sch (2). ID 8: T/O and E 8-550. IR 8: T/O and E 8 - 510, 8 - 560, 8 - 580, 8 - 581. IC 8; T/O and E 8 - 187, 8 - 534, 8-537T, 8 - 667. For explanation of symbols, see FM 21-6. CONTENTS Paragraph Page CHAPTER I. GENERAL Scope 1 1 Description 2 1 Manufacturers 3 1 CHAPTER 2. OXYGEN EQUIPMENT MANUFACTURING COMPANY Section I. Packing and Assembling. Component parts and assembling 4 2 Disassembling and packing 5 8 II. Operation. Connecting and testing regulator 6 8 Adjusting the mask 7 8 Gas concentration . . 8 8 Humidification 9 9 Purpose of Wagensteen button . 10 9 III. Maintenance and Repair. Maintenance 11 9 Repairs and replacements 12 10 Special repair tools 13 15 CHAPTER 3. HEIDBRINK DIVISION OF OHIO CHEMICAL AND MANUFACTURING COMPANY Section I. Packing and Assembling. Component parts and assembling 14 17 Disassembling and packing 15 17 II. Operation. Connecting and testing regulator 16 21 ' Adjusting the mask 17 21 Gas concentration 18 21 Humidification 19 24 Purpose of Wagensteen button 20 24 III. Maintenance and Repair. Maintenance 21 25 Repairs and replacements 22 25 APPENDIX STANDARD NOMENCLATURE LIST OF PARTS Oxygen Equipment Manufacturing Company 1 28 Heidbrink Division of Ohio Chemical and Manufacturing Company 2 30 CHAPTER I GENERAL 1. SCOPE. This manual is published for the information and guidance of all persons charged with the operation and maintenance of Medical Department Items No. 37126, Mask Type Oxygen Therapy Outfit, Complete, and No. 93643, Oxygen Therapy Outfit, With Manifold. The manual is concerned chiefly with the assembly, operation, maintenance, and repair of these units. There are appended standard nomenclature lists of parts with reference to illustrations and quantities of parts. 2. DESCRIPTION. The equipment considered in this manual is used in the administration of oxygen or a mixture of 80 percent helium and 20 percent oxygen. a. Item No. 37126, Mask Type Oxygen Therapy Outfit, Complete, is for the administration of oxygen or a mixture of helium and oxygen to one patient. b. Item No. 93643, Oxygen Therapy Outfit, With Manifold, is for the administration of oxygen or a mixture of helium and oxygen to one or two patients. 3. MANUFACTURERS. The two types of equipment are manufactured by both the Oxygen Equipment Manufacturing Company, 405 East 62nd Street, New York, N. Y., and The Heidbrink Division of The Ohio Chemical and Manufacturing Company, 1177 Marquette Street, N. E., Cleveland, Ohio. CHAPTER 2 OXYGEN EQUIPMENT MANUFACTURING COMPANY Section I. Packing and Assembling 4. COMPONENT PARTS AND ASSEMBLING, a. Item No. 37126, Mask Type Oxygen Therapy Outfit, Complete, is packed in a carton containing one regulator with two gauges, one oxygen concentration meter, one adapter, one nasal mask, one oronasal mask, supply tubing and mask parts. b. To assemble the Mask Type Oxygen Therapy Outfit, as shown in figure 1, proceed as follows: (1) Attach the oxygen concentration meter, 9R10694 (fig. 1), to the regu- lator, 9R10601 (fig. 1), by screwing the union nut, attached to the meter, on the regulator outlet restrictor bushing, 9R10680 (fig. 1), and tighten with a wrench. (2) Slip one end of the supply tubing, 9R10722 (fig. 1), over the outlet on the back of the meter and attach the other end of the tube to the inlet of the inspiratory valve, 9R10716 (fig. 1). (3) Slip the mouth of the oxygen collecting bag, 9R10626 (fig. 1), over the lower end of the inspiratory valve. Make certain that the valve inlet to which the tubing has been attached is pointing downward, as shown in figure 1. (4) Fit the desired type of mask or facepiece over the upper end of the inspiratory valve. (5) When a medical type gas cylinder is to be used, screw the adapter, 9R10616 (fig. 1), into the regulator inlet connector and insert a fiber washer, 9R10682 (fig. 1), into the end of the adapter. When a commercial-type gas cylinder is to be used the adapter is not necessary. c. Item No. 93643, Oxygen Therapy Outfit With Manifold, is packed in a carton which contains one regulator with two gauges, one manifold (either type "A” or type "B-B”), one adapter, two nasal masks, two oronasal masks, supply tubing and mask parts. d. To assemble the Oxygen Therapy Outfit With Manifold, as shown in figure 2, proceed as follows: (1) Attach the manifold to the regulator by screwing the union nut onto the regulator outlet restrictor bushing and tighten with a wrench. (2) Fit the ends of the supply tubes, 9R10624 (fig. 2), over each of the manifold plug-in valves, 9R10742 (figs. 3, 4, and 5), and attach the other ends of the tubes to the inlets of the two air intake valves, 9R10720 (fig. 2). (3) For assembly of collecting bags, masks, and adapter proceed as outlined in paragraph 4b(3), (4), and (5). 2 Med. Dept. No. Nomenclature 1. 9R10701 Facepiece. Nasal, Rubber. 2.9R10620 Valve, Expiratory, Flutter. 3.9R10696 Mask, Nasal, Complete. 4. 9R10680 Bushing, Restrictor, Outlet, Regulator. 5.9R10612 Gauge, Liter Flow. 6.9R10604 Gauge, High Pressure. 7.9R10601 Regulator, Pressure Reducing, Com- plete. 8. 77890 Cylinder, Valve Adapter, High Pres- sure. 9. 9R10622 Strap, Retainer. 10. 9R10712 Button, Retainer Strap, Adjusting, Plastic. Med. Dept. No. Nomenclature 11.9R10702 Facepiece, Oronasal, Rubber, 12.9R10704 Button, Retainer, Strap, Facepiece. 13. 9R10706 Button, Wagensteen. 14. 9R10716 Valve, Inspiratory, Metal. 15. 9R10626 Bag, Rubber, 2/3 Liter. 18. 9R10722 Tubing, Rubber, 1/2 Inch 0. D., 3/8 Inch I. D. x 55 Inch. 17. 9R10694 Meter, Oxgyen, Concentration. 18. 9R10682 Washer, 11/16 Inch 0. D., 1/4 Inch I. D. x 1/8 Inch, Fiber. Figure 1. hem No. 37126 Mask Type Oxygen Therapy Outfit, Complete, manufactured by the Oxygen Equipment Manufacturing Company. 3 Med. Dept. No. Nomenclature 1.9R10628 Valve, Inspiratory, Flutter. 2. 9R10620 Valve, Expiratory, Flutter. 3.9R10720 Valve, Air Intake, Metal. 4. 9R10768 Mask, Oronasal, Complete. 5.9R10610 Manifold, Regulator, Complete 6. 9R10612 Gauge, Liter Flow. 7. 9R10604 Gauge, High Pressure. 8. 9R10601 Regulator, Pressure Reducing, Com- plete. Med. Dept. No. Nomenclature 9. 77890 Cylinder, Valve Adapter, High Pres- sure. 10. 9R10712 Button, Retainer Strap, Adjusting, Plastic. 11. 9R10622 Strap, Retainer. 12.9R10766 Mask, Nasal, Complete. 13. 9R10624 Tubing, Rubber, 3/8 Inch 0. D., 1/8 Inch I.D. x 55 Inch. 14. 9R10626 Bag, Rubber, 2/3 Liter. Figure 2. Item No. 93643 Oxygen Therapy Outfit, with Manifold, manufactured by Oxygen Equipment Manufacturing Company. 4 Med. Dept, No. Nomenclature 1. 9R10738 Connector Hose. 2. 9R10736 Valve, Check, Automatic. 3. 9R10734 Nipple, Pipe, Short. 4. 9R10732 Casting, “Y” Manifold. 5. 9R10680 Bushing, Restrictor, Outlet, Regulator. 6. 9R10601 Regulator, Pressure Reducing, Com- plete. Med. Dept. No. Nomenclature 7. 9R10612 Gauge, Liter Flow. 8. 9R10604 Gauge, High Pressure. 9. 9R10678 Connector, Inlet, Regulator. 10. 77890 Adapter. Figure 3. Regulator Manifold Complete, Type "A,” 9R10610. 5 Med. Dept. No. Nomenclature 1. 9R10744 Stem, Plug-in Valve. 2. 9R10748 Bonnet, Plug-in Valve. 3. 9R10732 Casting, “Y” Manifold. 4. 9R10680 Bushing, Restrictor, Outlet, Regulator. 5. 9R10601 Regulator, Pressure Reducing, Com- plete. Med. Dept, No. Nomenclature 6. 9R10612 Gauge, Liter Flow. 7. 9R10604 Gauge, High Pressure. 8. 9R10678 Connector, Inlet, Regulator. 9. 77890 Adapter. Figure 4. Regulator Manifold Complete, Type "B-B,” 9R10610. 6 Med. Dept, No. Nomenclature 1. 9R10744 Stem, Plug-in Valve. 2. 9R10746 Pin, Plug-in Valve Stem. 3. 9R10748 Bonnet, Plug-in Valve. 4. 9R10750 Pin, Bonnet, Plug-in Valve. 5. 9R10752 Washer, Plug-in Valve Seat. 6. 9R10754 Seat, Plug-in Valve. Med. Dept. No. Nomenclature 7. 9R10756 Check, Plug-in Valve. 8,9R10758 Washer, Plug-in Valve Bonnet. 9. 9R10760 Spring, Plug-in Valve. 10. 9R10762 Body, 3/4 Inch Hex, Plug-in Valve. 11.9R10764 Screen, Plug-in Valve. Figure 3. Plug-in valve for Type "B-B” Manifold, 9R10742. 5. DISASSEMBLING AND PACKING. To disassemble and pack the equip- ment proceed as follows: a. Disconnect the oxygen concentration meter or manifold from the regulator. b. Disconnect the tube or tubes. c. Disconnect the masks and bags from the inspiratory or air intake valves. d. Pack all the parts of one outfit into a stout box or carton, preferably the original carton if it is in good condition. Pack paper or rags around the regulator for protection and to keep it from moving during transit. Section II. OPERATION 6. CONNECTING AND TESTING REGULATOR, a. Before connecting the regulator to the gas cylinder, open the cylinder valve for a moment to dislodge any dirt which would otherwise be discharged into the regulator and cause interior damage. Connect the regulator to the cylinder, using the adapter if necessary, and tighten with a wrench. b. To prevent the loss of gas make certain that the connections are tight by proceeding as follows: (1) Close the regulator valve by turning the adjusting screw counter- clockwise until it is loose, then open the gas cylinder valve. (2) Apply a thin film of soap suds around all connections with a shaving brush or paint brush. (3) If bubbles occur, a leakage is indicated at that point. Tightening of the connection will often stop the leak, but if not, specific repairs may be required as described in section III. c. Tests for leakage when using a manifold may be made as described above except that the regulator valve is left open and the manifold outlets closed by removing both of the plug-in valves. 7. ADJUSTING THE MASK. The mask, either nasal or oronasal, is placed over the nose or nose and mouth of the patient and adjusted with the head- bands. The headbands should be tightened just enough to make a snug fit so that no leakage occurs between the face and the mask rim. Be sure that the flutter valve is in good condition and functions properly. 8. GAS CONCENTRATION, a. When using item No. 37126 Mask Type Oxygen Therapy Outfit, with the oxygen concentration meter, the percentage of oxygen concentration may be adjusted from 40 percent to 95 or 100 per- cent by turning the top plate of the meter to the desired percentage. The flow of gas should be such that the oxygen collecting bag fills and partially closes while the patient is breathing. To increase the flow turn the regulator adjusting screw in a clockwise direction. To decrease the flow turn in a counterclockwise direction. 8 b. For use with helium-oxygen mixture (80 percent to 20 percent) set the meter disc at 95 plus percent, and use a flow of 7 to 10 liters per minute. c. When using the Oxygen Therapy Outfit, With Manifold, item No. 93643, approximate oxygen concentrations may be obtained by the use of the following table: Flow in Liters Percentage Per Minute of Oxygen 2 35-44 3 - 4 50 - 60 8-10 90 - 100 The rate of flow may be adjusted with the regulator adjusting screw as described in paragraph 8a. d. When using an 80 percent helium and 20 percent oxygen mixture the rate of flow should be approximately 7 to 10 liters per minute. e. When treatment is momentarily finished, first turn off the cylinder valve allowing the gas to escape from the regulator and facepiece. When all oxygen is released close the regulator valve by turning counterclockwise until it turns freely. 9. HUMIDIFICATION. Enough moisture usually remains in the mask from the patient’s previously expired air to provide sufficiently high and comfortable humidity. When using the oxygen concentration meter the moisture content may be increased by introducing water into the meter up to the top of the transparent window which is just below the meter outlet. 10. PURPOSE OF WAGENSTEEN BUTTON. The Wagensteen Button, 9R10706 (fig. 1), is used to plug the hole near the bottom of the facepiece. The button should be removed only when it is desired to use a Wagensteen tube while oxygen is being administered to the patient. Section III. MAINTENANCE AND REPAIR II. MAINTENANCE, a. All the rubber parts should be cleaned, after each use, by washing with soap and water or an aqueous sterilizing solution at room temperature, then rinse and dry thoroughly. Do not sterilize the rubber parts by boiling or autoclaving. The metal inspiratory valve should be washed and rinsed, then wrapped in gauze and boiled for three minutes. Clean other metal parts with a nonflammable cleaning fluid. b. The following precautions should be taken to lengthen the life of the equipment: (1) Never use any oil or substance containing oil on any part of the oxygen control equipment. (2) Keep the equipment clean and dry. 9 (3) Clean the regulator inlet and the gas cylinder valve before connecting the regulator. (4) Do not tamper with regulator parts. (5) When starting to administer gas open the gas cylinder valve slowly. 12. REPAIRS AND REPLACEMENTS, a. Masks. Minor leaks in masks may often be repaired with rubber patches but when a mask develops a bad leak or becomes worn, it should be replaced with a new mask. The expiratory flutter valve may be replaced by merely snapping out the old valve and metal holder and inserting a new one. An extra flutter valve is packed with each mask. b. Air intake valve. To replace the square flutter valve, 9R10628 (fig. 2), in the air intake valve, 9R10720 (fig. 2), push out the metal flutter valve holder with a screw driver or similar tool. To insert the new square flutter valve place it on the ball of the finger and insert it in the air intake valve over the sleeve in which it fits, then force in until it snaps into place. c. How to replace regulator seat. Refer to figures 6 and 7 and proceed as follows: (1) Turn adjusting screw, 9R10642, to the right to lift the seat, 9R10602, off the nozzle, 9R10666. This step is important. (2) Place the back cap, 9R10672, in a vise and tap the outlet lug of the regulator body with a small hammer to loosen the body to the left. When it is loose, use a wrench and keep turning to the left until the back cap is removed. Note. If available, use the regulator body holder, 9R10692 (fig. 8) and the hexag- onal bonnet wrench, 9R10690 (fig. 8), instead of the vise and wrench mentioned above. (3) Remove the four yoke screws, 9R10676, in seat retainer centerpiece, 9R10668. (4) Remove the seat retaining ring, 9R10608, with the regulator screw driver, 9R10684 (fig. 9), or a similar one. Push the old seat, 9R10602, out of the seat retaining ring. (5) Insert a new seat by pushing or tapping it snugly in place with a block of wood taking care not to scratch the seating surface. The seat is tapered so that only one face will go into the retaining ring. (6) Replace the parts using a new back cap washer, 9RIO6O6. Dip the new washer in water to lubricate and insure against tearing it. Tighten all parts so that there will be no leakage. (7) Back off the adjusting screw by turning to the left. (8) To make the seat gas tight, attach the regulator to a gas cylinder and, while holding a finger tight over the outlet bushing, turn the adjusting screw all the way in (right), then all the way out (left). d. How to replace regulator diaphragm. Refer to figures 6 and 7, and proceed as follows: (1) Remove back cap and seat retainer centerpiece as outlined in paragraph 12c (1), (2), and (3). (2) Place two flat faces of the hex bonnet, 9R10644, in a vise. 10 Med. Dept. No, Nomenclature 1.9R10642 Screw, Adjusting, Regulator. 2. 9R10644 Bonnet, Regulator. 3. 9R10648 Button, Spring, Regulator. 4.9R10650 Spring, Light, Regulator. 5. 9R10652 Spring, Heavy, Regulator. 6.9R10654 Plate, Diaphragm, Regulator. 7.9R10662 Washer, Regulator Yoke. 8. 9R10656 Diaphragm, Regulator. 9. 9R10658 Washer, Regulator Diaphragm. 10. 9R10660 Yoke, Regulator. Med. Dept. No. Nomenclature 11.9R10664 Casting, Body, Regulator. 12. 9R10666 Nozzle, Regulator. 13. 9R10G08 Ring, Seat Retaining. 14.9R10668 Centerpiece, Seat Retainer, Regulator. 15.9R10606 Washer, Back Cap. 16. 9R10676 Screw, Regulator Yoke. 17.9R10670 Guide, Centerpiece, Regulator. 18. 9R10672 Back Cap, Regulator. 19. 9R10674 Spring, Regulator Back Cap. 20. 9R10602 Seat, Regulator. Figure 6. Pressure Reducing Regulator, 9R10601, Oxygen Equipment Manufacturing Company. Med. Dept, No, Nomenclature I. 9R10658 Washer, Regulator Diaphragm. 2.9R10660 Yoke, Regulator. 3.9R10662 Washer, Regulator Yoke. 4. 9R10656 Diaphragm, Regulator. 5. 9R10654 Plate, Diaphragm, Regulator. 6. 9R10652 Spring, Heavy, Regulator. 7. 9R10650 Spring, Light, Regulator. 8. 9R10648 Button, Spring, Regulator. 9. 9R10644 Bonnet, Regulator. 10. 9R10642 Screw, Adjusting, Regulator. II. 9R10664 Casting, Body, Regulator. Med. Dept. No. Nomenclature 12.9R10680 Bushing, Restrictor, Outlet, Regulator. 13.9R10678 Connector, Inlet, Regulator. 14.9R10666 Nozzle, Regulator. 15. 9R10608 Ring, Seat Retaining. 16. 9R10602 Seat, Regulator. 17. 9R10668 Centerpiece, Seat Retainer, Regulator. 18.9R10676 Screw, Regulator Yoke. 19.9R10674 Spring, Regulator Back Cap. 20. 9R10606 Washer, Back Cap. 21. 9R10672 Back Cap, Regulator. Figure 7. Parts for Pressure Reducing Regulator. 12 HEXAGONAL BONNET WRENCH REGULATOR BODY HOLDER Figure 8. Flexagonal bonnet wrench, 9R10690, and Regulator body holder, 9R10692. 13 REGULATOR SCREW DRIVER HEAD REGULATOR NOZZLE WRENCH REGULATOR CENTER PIECE HOLDER Figure 9. Screw Driver Head, 9R10684, Regulator Centerpiece Holder, 9R10686, and Regulator Nozzle Wrench, 9R10688. (3) Using a wrench turn the regulator body, 9R10664, to the left and unscrew the bonnet, 9R10644. (4) Remove the old diaphragm, 9R10656, diaphragm plate, 9R10654, and yoke, 9R10660, by prying under the edge of the diaphragm with a screw driver. (5) Disassemble the diaphragm plate from the yoke with a screw driver and pliers. (6) Put a new diphragm on the yoke using a new alloy yoke washer, 9R10662, (dipped in water) between the yoke and the bottom of the diaphragm. Install the diaphragm plate to the yoke and tighten snugly with pliers and screw driver. Dip a new diaphragm washer in water and install it between the bottom of the diaphragm and the body. (7) Replace the assembly of yoke and diaphragm using care to place the yoke so that it is centered about the bridge and does not touch it at any point. The legs of the yoke should be concentrically parallel to the edges of the bridge. The regulator centerpiece holder, 9R10686 (fig. 9), should be used if it is available. (8) Replace both springs, 9R10650 and 9R10652, and the spring button, 9R10648, on top of the diaphragm plate. (9) Screw on the bonnet, 9R10644, and tighten with a wrench. (10) Reassemble seat retainer centerpiece and back cap as described in paragraph 12c (6). e. How to replace a gauge. To remove either the high pressure gauge or the liter flow gauge, it is necessary to tap the gauge boss on the regulator body all the way around with a hammer. This cracks the litharge which has been used to form a hard cement. Do not attempt to remove the gauge before breaking the litharge as it might result in a fracture of the nipple. After the litharge is cracked unscrew the gauge with a wrench. When putting on a new gauge use a very thick compound of litharge and glycerin on the first several threads of the gauge connection. Turn the gauge into the body several turns by hand and rotate back and forth several times to be certain that the compound thoroughly covers the threads. Do not employ too much force when tightening the gauge. Allow the cement to dry for at least thirty minutes before testing or using the gauge. Caution: Do not use ordinary luting compounds as they are highly com- bustible in contact with oxygen. Such products as white lead, linseed oil, etc., must never be used. 13. SPECIAL REPAIR TOOLS. In the repairs described above certain tools are mentioned which are made especially for the regulator. These tools include a hexagonal bonnet wrench, 9R10690, a regulator body holder, 9R10692 (see fig. 8), a special screw driver, 9R10684, regulator centerpiece holder, 9RIO686, and regulator nozzle wrench, 9R10688 (see fig. 9). 15 Med. Dept. No, Nomenclature 1. 9R10820 Plug, Oxygen Bag. 2. 9R03136 Washer, Regulator, 23/36 Inch 0. D., 3/16 Inch 1. D„ 1/16 Inch Thick, Fiber. 3. 9R10426 Bag, Rubber, 2/3 Liter. 4. 9R10424 Tubing, Rubber, 3/8 Inch O. D., 3/16 Inch I. D., 55 Inch Long. 5. 9R10428 Tube, Rubber, Perforated, 5 Inch. 6.9R10814 Connector, Bag to Mask, Plastic. 7. 9R10420 Disc, Valve, Sponge Rubber. 8. 9R10422 Strap, Retainer. 9. 9R10810 Slide, Adjusting, Retainer Strap. Med. Dept. No. Nomenclature 10.9R10808 Hook, Retainer Strap. 11.9R10804 Button, Wagensteen. 12. 9R10800 Facepiece, Nasal, Rubber. 13. 9R10490 Outlet, Flowmeter. 14.9R10472 Flowmeter, Oxygen, Helium-Oxygen, Complete. 15. 9R10414 Gauge, 3,000 Lb., High Pressure. 16. 9R10430 Tube, Inlet, Tapered. 17. 9R11492 Regulator, Tank, Complete. 18.9R10506 Stem, Needle Valve. 19. 9R10802 Facepiece, Oronasal, Rubber. Figure 10. Item 37126, Mask Type Oxygen Therapy Outfit, Complete, manufactured by the Ohio Chemical and Manufacturing Company. 16 CHAPTER 3 HEIDBRINK DIVISION OF OHIO CHEMICAL AND MANUFACTURING COMPANY Section I. PACKING AND ASSEMBLING 14. COMPONENT PARTS AND ASSEMBLING, a. Item No. 37126, Mask Type Oxygen Therapy Outfit, Complete, is packed in a carton containing one regulator with a high pressure gauge and a flowmeter attached, one adapter, one nasal mask, one oronasal mask, supply tubing and mask parts. b. To assemble the Mask Type Oxygen Therapy Outfit, as shown in fig. 10, proceed as follows: (1) Slip one end of the rubber supply tubing, 9R10424, over the flow- meter outlet, 9R10490, and attach the other end of the tube to the inlet of the plastic, bag to mask connector, 9R10814. (2) Insert the lower end of the plastic connector, the end with the perfor- ated rubber tube, 9R10428, into the mouth of the rubber bag, 9R10426. (3) Fit the desired type of mask over the upper end of the plastic connector. (4) When a commercial type gas cylinder is to be used screw the adapter, 77890, into the regular inlet connector and tighten with a wrench. When a medical type gas cylinder is to be used the adapter is not necessary. c. Item No. 93643 Oxygen Therapy Outfit, With Manifold is packed in a carton containing one regulator with a high pressure gauge, a flowmeter, and a manifold with two outlet valves attached, one adapter, two nasal masks, two oronasal masks, supply tubing and mask parts as shown in figures 11 and 12. d. To assemble the Oxygen Therapy Outfit, With Manifold, as shown in figure 11, proceed as follows: (1) One tube must always be fitted over the flowmeter outlet, 9R10490, and another tube is then attached to either one of the outlet valves on the manifold, 9R10532, by means of the plug-in coupling, 9R10550 (fig. 13). The other ends of the two tubes are attached to the inlets of two plastic bag to mask connectors. (2) For assembly of the collecting bags, masks and adapter, proceed as outlined in paragraph 14b (2), (3), and (4). 15. DISASSEMBLING AND PACKING. To disassemble and pack the equip- ment proceed as follows: a. Disconnect the tube or tubes. b. Disconnect the mask or masks from the bag to mask connector. 17 Med. Dept. No. Nomenclature 17. 9R10424 Tubing, Rubber, 3/8 Inch O. D., 3/16 Inch I. D„ 55 Inch Long. 18. 9R03136 Washer, Regulator, 23/36 Inch 0. D., 3/16 inch I. D., 1/16 Inch Thick Fiber. 19.9R10802 Facepiece, Oronasal, Rubber. 20.9R10430 Tube, Inlet, Tapered. 21.9R10532 Manifold, Complete. 22. 9R10534 Valve, Outlet, Manifold, Complete. 23. 9R10550 Coupling, Plug-in, Complete. Figure 11. Item 93643, Oxygen Therapy Outfit, with Manifold as manufactured by the Ohio Chemical and Manufacturing Company. Med. Dept. No. Nomenclature 11.9R10472 Flowmeter, Oxygen, Helium-Oxygen, Complete. 12.9R10528 Screw, Adjusting, Handwheel, Regu- lator. 13. 9R10414 Gauge, 3,000 !b., High Pressure. 14.9R10526 Regulator, Tank, Complete. 15. 77890 Cylinder, Valve Adapter, High Pressure. 16. 9R10422 Strap, Retainer. Med. Dept. No. Nomenclature 1. 9R10820 Plug, Oxygen Bag. 2. 9R1C426 Bag, Rubber, 2/3 Liter. 3.9R10428 Tube, Rubber, Perforated, 5 Inch. 4.9R10814 Connector, Bag to Mask Plastic. 5.9R10810 Slide, Adjusting, Retainer Strap. 6. 9R10804 Button, Wagensteen. 7.9R10420 Disc, Valve, Sponge Rubber. 8. 9R10800 Facepiece, Nasal, Rubber. 9. 9R10808 Hook, Retainer Strap. 10. 9R10424 Tubing, Rubber, 3/8 Inch O.D., 3/16 Inch I. D., 55 Inch Long. 18 Med. Dept. No. Nomenclature 1. 9R10424 Tubing, Rubber, 3/8 Inch 0. D„ 3/16 Inch I. D., 55 Inch Long. 2. 9R10800 Facepiece, Nasal, Rubber. 3. 9R10550 Coupling, Plug-in, Complete. 4. 9R10534 Valve, Outlet, Manifold, Complete. 5. 9R10552 Screw, Cap, Manifold, Flowport. S. 9R10532 Manifold, Complete. Med. Dept. No. Nomenclature 7. 9R10472 Flowmeter, Oxygen, Helium-Oxygen, Complete. 8. 9R10414 Gauge, 3000 Lb., High Pressure. 9. 9R10526 Regulator, Tank, Complete: With handwheel adjusting screw. 10.9R10802 Facepiece, Oronasal, Rubber. 11. 9R10426 Bag, Rubber, 2/3 Liter. Figu ° 12. Item 93643, Complete Assembly of Oxygen Therapy Outfit, with Manifold, as manufactured by the Ohio Chemical and Manufacturing Company. 19 MANIFOLD PLUG-IN COUPLING Med. Dept. No. Nomenclature 1. 9R10552 Screw, Cap, Manifold, Flowport. 2. 9R10554 Gasket, Fiber, Manifold, Flowport. 3.9R10474 Ring, Retaining, Flowmeter. 4.9R10524 Screen Copper, Flowmeter Union Nut, 5. 9R10556 Flowport, Manifold. 6.9R10558 Gasket, Flowport. 7.9R10560 Gasket, Limit Port, Manifold. 8. 9R10546 Ring, Retainer, Outlet Manifold. Aled. Dept. No, Nomenclature 9. 9R10548 Screen, Outlet Manifold. 10. 9R10544 Port, Limit, Outlet Manifold. 11. 9R10538 Spring, Outlet Manifold Valve. 12.9R10542 Seal, Gasket, Moulded, Outlet Mani fold. 13. 9R10536 Body, Outlet Manifold Valve. 14.9R10540 Valve, Disc, Outlet Manifold. 15. 9R10534 Valve, Outlet, Manifold, Complete. Figure 13. Details of manifold, 9R10532, and plug-in coupling, 9R10350 20 c. Pack all the component parts of one outfit in a stout box or carton, preferably the original carton if it is in good condition. Pack paper or rags around the regulator, gauge and flowmeter for protection and to keep the parts from moving during transit. Section II. OPERATION 16. CONNECTING AND TESTING REGULATOR, a. Proceed as described in paragraph 6a. b. To test for gas leakage when not using a manifold proceed as outlined in paragraph 6b. c. To test for gas leakage when using a manifold proceed as follows: (1) Remove the plug-in coupling from the manifold outlet valve and remove the supply tubing from the flowmeter outlet. (2) Apply a thin film of soap suds around all connections and on the ends of the manifold outlet valves. (3) Open the regulator until the flowmeter registers one liter per minute, then close the flowmeter outlet with a thumb or finger and watch for bubbles which indicate a leak. 17. ADJUSTING THE MASK. The mask, either nasal, 9R10800 (figs. 12 and 14) or oronasal, 9R10802 (figs. 12 and 14) is placed over the nose or nose and mouth of the patient and adjusted with the headbands. Pull the headbands just tight enough to make a snug fit and to prevent leakage between the face and the rim of the mask. 18. GAS CONCENTRATION, a. The following rates of flow will provide the approximate percentages of oxygen in the inspired air and may be used for either one or two patients: Percentage of oxygen Liters Small Medium size Large per minute person person person 3 45 - 60 40 - 55 35 - 50 4 60 - 75 55 - 70 50 - 65 5 75 - 90 70 - 80 65 - 75 6 90 - 100 80 - 90 75 - 85 7 90 - 100 85 - 92 8 92 - 100 b. The rate of flow is adjusted with the needle valve, 9R10506 (fig. 10) when using item No. 37126 Mask Type Oxygen Therapy Outfit, or the regulator handwheel adjusting screw, 9R10328 (fig. 11) when using item No. 93643 Oxygen Therapy Outfit With Manifold c. When administering a mixture of 80 percent helium and 20 percent oxygen the flow should be adjusted to the respiratory volume of the patient 21 NASAL MASK ORONASAL MASK Med. Dept. No, Nomenclature 1. 9R10424 Tubing, Rubber, 3/8 Inch 0. D., 3/16 Inch I. D., 55 Inch Long. 2. 9R10810 Slide, Adjusting, Retainer Strap. 3. 9R10422 Strap, Retainer. 4. 9R10804 Button, Wagensteen. 5. 9R10808 Hook, Retainer Strap. 6. 9R10800 Facepiece, Nasal, Rubber. Med. Dept. No. Nomenclature 7. 9R10802 Facepiece, Oronasal, Rubber. 8. 9R10420 Disc, Valve, Sponge Rubber. 9. 9R10814 Connector, Bag to Mask, Plastic. 10. 9R10428 Tube, Rubber, Perforated, 5 Inch. 11. 9R10426 Bag, Rubber, 2/3 Liter. 12. 9R10820 Plug, Oxygen Bag. Figure 14. Items 37127, Mask Type Oxygen Therapy Outfit, Mask Nasal, and 37128 Mask Type Oxygen Therapy Outfit, Mask Oronasal, as manufactured by the Ohio Chemical and Manufacturing Company. 22 oc. LU t— Cl. < Q < !*N K St u St « 8 o' 00 IV « 3. SI I0 ao -S 5 "1 8 o § ■* o\ » C . s -V * £ ®0 b> «-> V a, |j -i M „■ E . g c Ie -=2 J? O * > . S,St/, -520 “ .j-S SSS">>> -S . ■& = -S #° w S .= ai = « ns •£: — 1-'2Mto• O-QC .i°“#2isl|>1 * Wisest*I = H*“1*^*1I •S -KV.--S >;f S-=~ o gfoc £>“ g , =00 g) O -n g,T5 W) . 3,.= J2 Q= oSa: «.S *-- = « S“ ® S|=K| i~-“£ |,£ 5 S-g E =-|iZ 1 |ri =?>_? = s= o-.E £ . . - ® “ * = jt , u "tli CO k. TO 3 w « (CJ I- u Q. ~*~* D. Q, m -D JJJ Ci/lT** (/) q. U ,2 CD O. O gj _ <0 O ■—— q, {j co 3 CO CO V 3 CO CO d. ra MZv)V)fflM(LUZQl/lliOUZUUI^Uh>UM(9u *5- °2S,^i^tf£SS^IOOMTfU)OOOCMC£)»)-aCSOO • *3’Ty^^,raoo^-Tr^y^-^^-Tr^r^r^r CT> O) 05 cn CD OO GT> CO CO CO O) CO O) C7> CD CD CD r- CN CO CD N CO C> O CN CO Tf tf>