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Welcome to MGPHO

The Medical Gas Professional Healthcare Organization (MGPHO) was founded in 1998 as an organization that is dedicated to advancing the safe design, manufacture, installation, maintenance and inspection/verification of medical gas and vacuum systems through education. The organization is actively involved in identifying, understanding, and maintaining state and federal standards as well as improving the techniques used in testing and verification.

Board of Directors Election Results

MGPHO is pleased to announce the 2023 changes to our Board of Directors!


Ross Williams, Vice President, Legal

Al Moon, Vice President, Finance


Latest Educational Webinar

"Medical Gas Piping Systems in Dentistry" was presented by MGPHO Special Expert, Daniel Shoemaker, Product Manager for Air Techniques and Mathis Carlson, Technical Sales Engineer for MediTrac.


During the webinar, they discuss some of the differences in dental medical systems in the 2005 - 2021 NFPA 99 editions. 


As part of the 21st Annual Educational Conference in Indianapolis, Daniel and Mathis will also have a Q & A session as a follow-up to the webinar. The webinar access will be open to all up until the annual conference. After the conference, the webinar and associated Q & A session will be stored in the Members Only section of educational presentations for future use and reference by our membership.


To access the webinar, follow this link and use MGPHO2022 as the password: .


  • Monday, May 06, 2019 7:13 AM | Anonymous

    Question: "Is there a medical indication that the oxygen 99% provision would make a difference in the prognosis of a severely hypoxemic patient in relation to oxygen 93% provision through oxygen generators?"


    Dr. Wong's Response: "No, as long as we focus simply on the clinical factors here. However, before we go into the discussion, it is very important that we discuss two terms that are often erroneously used interchangeably. Those terms are hypoxemia and hypoxia. Hypoxia is the actual shortage of oxygen being delivered to the tissues by the blood. Hypoxia causes oxygen starvation of the tissue during cellular respiration. Hypoexemia, on the other hand, is a decrease in the amount of dissolved oxygen in the arterial blood, as measured by the partial pressure of oxygen on arterial blood gas. This distinction is important because the primary carrier or transporter of oxygen to the tissues is the hemoglobin in the red blood cell. This is why blood looks red when exposed to oxygen and air. It is also why a hypoxic patient turns blue.


    Because of hemoglobin in the red blood cells, the critically ill patient does not simply rely on a diffusion gradient to oxygenate their blood. Instead, hemoglobin has a high affinity for oxygen and picks up this oxygen across the capillary membranes of the alveoli (air sacks) in the lungs. This is, in effect, what a pulse oximeter measures - the percentage of red blood cells that are oxygenated. This is also the major determinant of hypoxia. 


    In addition, there is some "left over" oxygen that diffuses via a concentration gradient into the blood plasma. Think of plasma as the fluid that all the blood cells are immersed in. Some of this oxygen gets dissolved in the plasma, exhibiting a partial pressure that can be measured in the lab. The oxygen contributed by this dissolved oxygen is negligible for cellular respiration because it must first dissolve into the plasma across a concentration gradient, and second then diffuse out of the blood plasma into the cells.


    Now, if we change our focus toward pulmonary (lung) respiration, we find that the difference between 93% oxygen and 99% oxygen is insignificant for several reasons. First, room air is 21% oxygen. Therefore, there is very little difference in the competitive effect of 93% or 99% comparatively speaking. Secondly, it is very rare to actually deliver oxygen directly, instead it is often given by nasal cannula or mask. Even when oxygen is given, varying amounts are actually received by the patient because of dilution by ambient air or exhalation. For example, a nasal cannula delivers about 24% - 28% inspired oxygen. The closest thing to an exception is the intubated patient (although there still is some dilution via exhalation at the so called T of the breathing circuit). Finally, we each have physiologic dead space, meaning the conductive parts of the airway that are not involved in gas exchange (gases mixing between the alveoli and the blood) such as the nose, mouth, pharynx, larynx, trachea, bronchi. The gas in these dead spaces warm, moisturize, and dilute out the oxygen being delivered.


    Therefore, the clinical effect of oxygen 99 vs. oxygen 93 is negligible. Outside the U.S., oxygen 93 is widely used with no clinical issues. The U.S. military has also used and approved oxygen 93. One of the biggest issues even with home concentrators, is the fact that practitioners are not aware that there are differences between the two. However, we don't find an issue with oxygen therapy when practitioners don't adjust their prescription for said therapy when the type of oxygen changes.


    Final thought here is that we are becoming much more aware of the oxidative injury that occurs with use of high oxygen concentrations. In the hypoxic patient, we now strive to use the minimal amount of oxygen possible to maintain appropriate oxygenation of the tissues. Perhaps the biggest clinical concern of oxygen 93 from oxygen concentrators is the theoretical concern of concentrating argon and patients receiving higher than normal amounts of argon gas."


    Jonathan Wong, DMD

The Clinical Importance of Appropriately Designed Medical Gas Systems for Dental Offices

Be sure to read the June 2018 issue of The Anesthesia Patient Safety Foundation newsletter (pages 17 - 19) for the article titled "Safe Gas Systems and Office-Based Anesthesia" written by Jonathan L. Wong, DMD and Gerhard Gschwandtner, PEng. This article explains why dental offices are not exempt from following NFPA 99, and why routine maintenance/certification of office-based gas systems is recommended.

 

Dr. Wong presented "The Rise of Sedation and General Anesthesia in the Dental Office and the Clinical Importance of Appropriately Designed Gas Systems" at our annual conference this year in Atlanta, Georgia.   

Not a member? Join today!

Our membership includes professional technicians, manufacturers, equipment suppliers, medical professionals and others interested in maintaining the integrity of medical gas systems. Membership in the organization will ensure that you are up-to-date on the latest changes in standards and verification practices. 

 

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Upcoming Events

Tuesday, October 08, 2024 8:00 AM (EDT) • Tampa, Florida

The MGPHO Minute

Read the February issue of our newsletter!

Corky Bishop Scholarship

This scholarship is named in honor of Corky Bishop, a charter member of MGPHO, a member of the Board of Governors, and a mentor to many in the medical gas industry. Click here for the scholarship application packet.


Donate to the Corky Bishop Scholarship fund here

Join our discussion!

Monday, March 04, 2024 7:45 AM • Robert Sutter
Tuesday, February 06, 2024 5:23 PM • Al Moon

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Meet Our Special Expert


Jim Lucas

V.P., Sales & Marketing

Tri-Tech Medical, Inc.



"
Why am I a Special Expert for MGPHO? I’m not really sure, I think I’m ‘just one of the guys’. I believe that at one point in the day each of us has a moment of genius and at another point each of us has a moment of oops. To answer your question, probably my knowledge of manifolds, regulators, alarms and fittings are my greatest strengths and perhaps the reason that MGPHO bestowed me with this honor."

    16339 Kranker Drive, Stilwell, KS 66085

    mgpho@me.com