Are you struggling to determine what NFPA Category your medical air/vacuum project falls under? Follow NFPA 99 2018 gas system requirements to determine by your facilities level of sedation. These levels are classified Category 1, 2 and 3. In order of highest level of sedation to lowest level of sedation. Always have your end-user determine the facilities level of sedation. I recommend having a form letter they sign off on for your records.
The below table from the American Society of Anesthesiologists defines these Categories.
| Type | Category 3 | Category 2 | Category 1 | Category 1 |
|---|---|---|---|---|
| Sedation | Minimal Sedation Anxiolysis | Moderate Sedation/Analgesia ("Conscious Sedation") | Deep Sedation/ Analgesia | General Anesthesia |
| Responsiveness | Normal response to verbal stimulation | Purposeful** response to verbal or tactile stimulation | Purposeful** response following repeated or painful stimulation | Unarousable even with painful stimulation |
| Airway | Unaffected | No intervention required | Intervention may be required | Intervention often required |
| Spontaneous Ventilation | Unaffected | Adequate | May be inadequate | Frequently inadequate |
| Cardiovascular Function | Unaffected | Usually maintained | Usually maintained | May be impaired |
Now that you have your level of sedation you can follow the below chart to meet NFPA 99 2018 minimum requirements. This guide addresses when zone valve boxes and alarm requirements. Whether your vacuum system can be simplex. WAGD ready vacuum requirements. Your testing and verification, and reserve gas requirements.
| Type | Category 3 | Category 2 | Category 1 |
|---|---|---|---|
| Permissible Depth of Anesthesia | Nitrous anxiolysis and minimal sedation | Moderate Sedation | Deep sedation and general anesthesia |
| Zone Valves Required | No | No | Yes |
| Zone Alarms Required | No | Yes | Yes |
| Master Alarm Panel | Yes | Single | Dual |
| Control for Line Pressure | Per Manufacturer | Maintain stable pressure and flow for peak demand | Maintain stable pressure and flow for peak demand |
| Vacuum System | Dental vacuum | Simplex | Duplex, separate from dental vacuum |
| Waste Anesthetic Gas Scavenging | None | Nitrous scavenging may run through dental vacuum system | Separate Waste Anesthesitic Gas Disposal (WAGD) and medical vacuum from dental vacuum |
| Testing and Verification | In dental offices using dental gas systems, follow local code and manufacturer specs | American Society of Sanitary Engineers (ASSE) 6030 3rd Party Verifier | American Society of Sanitary Engineers (ASSE) 6030 3rd Party Verifier |
| Installation | Brazed, soldered, or fitted joints | Brazed with nitrogen purge | Brazed with nitrogen purge |
| Reserve Gas | Minimum not required | One-day reserve supply | One-day reserve supply |
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