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/ / / / M2VA 2014 Volume 18 Issue 2 (July)

Deep Breaths

It doesn’t take any sort of formal medical training to comprehend how crucial oxygen is when treating wounded warriors, whether that treatment needs to takes place right on the battlefield or happens back at a basecamp hospital unit. It’s a cornerstone of life on Earth, after all, and, as Scott Brady said, “Supplemental oxygen is typically provided on the battlefield during hemorrhage, pneumothorax, and for open or penetrating chest wounds.” In other words, oxygen is used for nearly every kind of typical combat-zone injury.

Brady, a biomedical engineer for the U.S. Army Medical Material Agency at Fort Detrick, Md., went on to explain that “the Department of Defense has invested research and development dollars to fulfill the requirement for unlimited oxygen from a small, lightweight device.”

Smaller and lighter, yes, but without sacrificing performance. Increased flow rates, improved reliability, and higher safety standards also are on DoD’s wish list. “Those would all be welcome advancements for providing supplemental oxygen on the battlefield,” Brady added.

The people at On Site Gas Systems have been working on those exact types of advancements for nearly 25 years, and on armed-forces-specific solutions since 2001. “The military came to us years ago with this need,” said Robert Wolff, the company’s vice president of sales. “We had already been making oxygen generators for a long time, but the question was, ‘Okay, can we now take this and make it so that the military can transport it and set it up easily, use it, have it be reliable and withstand getting banged around in the back of a truck, and have it stay operational in the desert when it’s over 100 degrees?’ We took the concept that we had been using for a number of years and brought that to meet the military’s standards.”

That concept is to separate the molecules of existing air. As Wolff said, “It’s not terribly complicated, but it’s not exactly easy.

“The air you breathe is about 21 percent oxygen. What we do is pull out a good amount of the balance, mostly nitrogen, and end up with a concentration of USP93 medical-grade oxygen, which is 93 percent oxygen, plus or minus 3 percent. It’s just a separation of molecules. It’s a physical process, not a chemical one.”

Perhaps then the more complicated process was to imbed that science into a battlefield-ready contraption. “That’s our expertise, though,” said Guy Hatch, chief executive officer at On Site Gas. “Our company is built around finding a solution that meets our customers’ specific needs. In this case, it was to take existing technology and make it small enough and robust enough to operate anywhere in the world.”

Ultimately, location can be one of the biggest challenges. “The extreme environments encountered on the battlefield make sustainment of oxygen generators difficult,” explained Brady. “The Army performs environmental tests before selecting equipment to ensure the devices are not only effective and safe, but also suitable for the environment to which they will be deployed.”

Hatch, Wolff and their colleagues were up to the task. “It took a lot of engineering and design work, and then there was a lot of trial and error and testing that was involved with prototypes,” said Wolff. “These things have to withstand being dropped, withstand the cold and heat. They have to go from storage to being deployed on trucks, planes and helicopters, and then set up in the field—all without heavy equipment to move it.”

The end result of all the brainstorming and blueprints was their Portable Oxygen Generation System (POGS), a self-contained, man-portable, FDA-approved unit that can generate up to 33 liters per minute of medical-grade oxygen.

“That oxygen can then be put either directly into patient care—you can hook a patient directly up to our unit—or into a distribution system for a facility, or you can fill cylinders and have those for transportation and back up,” Wolff said.

Those three options mean that POGS essentially solves one of the military’s biggest oxygen-related problems. “In a medical situation, whether it’s non-critical or critical care, oxygen is required and used everyday,” said Wolff. “The dilemma, especially for the military, is the ability—or lack thereof—to have oxygen when you need it at all times.”

But since POGSs simply make use of the ambient air wherever they’re deployed, they can supply much-needed oxygen 24 hours a day, seven days a week if needed. “It’s an on-demand system,” Wolff explained. “We’re creating oxygen and it’s being used or filling cylinders at the same time. Logistically, we don’t have to rely on anybody else bringing cylinders or tanks in. We just take the air and run it through our generator. You control your oxygen.

“So, with our equipment, as long as it’s provided air—and minor maintenance over the course of time—the oxygen never goes away. You don’t have to replenish anything. It’ll just keep on running for years and years.”

Easy Oxygen on the Go

Oxygen cylinders—a necessity for medical transfers and certain other emergencies—do need replenishing. “That need presents a logistics issue when transporting across a battlefield,” said Brady. “The Army reduces the logistical burden by using large oxygen generators at combat support hospitals.”

Cobham’s Deployable Oxygen Generation System–Medium (DOGS-M) is one of the devices that can help ease that particular burden. It produces 93 percent pure oxygen at the rate of 120 liters per minute, and in addition to “providing medical-grade oxygen directly to patients at field based hospitals, it can fill various sized cylinders,” said the company’s business development manager, Craig Case.

“Our ground-based systems have been qualified to meet the U.S. Air Force medical oxygen generator standards for large volume systems,” added Case. “Still, the Cobham DOGS-M has relatively small physical dimensions (among large-volume generators) so more units can be transported on a single pallet, reducing transportation costs.”

As a matter of fact, each DOGS-M weighs in at about 2,250 pounds, but their slim profile, measuring just 28 by 60 by 76 inches, allows up to four to be loaded on a single standard 463L pallet.

At the other end of the size spectrum, Cobham also manufactures oxygen generators specifically for medical helicopter transport groups. The Advanced Medical Oxygen Generating System (AMOGS) is “designed for the Sikorsky HH-60L/M medical evacuation helicopter,” said Case. “It’s a unique system in that it provides USP93 oxygen directly to patients en route or via an integrated storage bottle.”

Since onboard medics and crewmembers already have plenty to be thinking about, Cobham made sure that the AMOGS was as plug-and-play as possible. It comes with dedicated system software and a modular design to ease maintenance issues. The valves are simplified and the status panel is particularly straightforward. Furthermore, “Cobham offers training programs for operation and service of all our units,” added Case.

Ease of use also was one of the main considerations when OxySure Systems started the development of their Model 615 Portable Emergency Oxygen System. “It’s an on-demand, emergency-duration device that’s suitable for layperson use,” said Julian Ross, OxySure’s chief executive officer.

Not only is it easy to use, but it’s an entirely different kind of product. “It’s a unique technology,” Ross continued. “Medically pure oxygen is created instantly when needed from two dry, inert powders inside a specially designed dispenser made of lightweight and thermoplastic materials [the Model 615].”

It may seem like something out of a futuristic science fiction movie, but the three-step process really is nearly effortless. All anybody in the immediate vicinity must do to begin oxygen delivery is insert a powder cartridge, turn the Model 615’s obvious knob, and outfit the victim with the mask. That’s it, and then the system will push six liters of medically pure oxygen per minute for at least 15 minutes. If additional oxygen is required, a fresh cartridge can be employed.

Because it is so easy and utterly portable—the dispenser weighs just 11 pounds—it can “greatly improve access to emergency oxygen that positively affects the survival, recovery and safety of individuals in numerous areas, especially military applications,” Ross added.

Liquid Oxygen

Essex Industries supplies the military with yet one more type of product: liquid oxygen (LOX). But they didn’t decide to do it on a whim. “The design and development of the Essex products was driven by customer request,” explained Tim Bannister, vice president of sales and business development, Essex Industries. “The United States Air Force Special Services called on us, with our experience in LOX systems, to solve their problems of medical oxygen delivery. We were able to devise a system of products [the Battlefield Oxygen Sustainment System, or BOSS] for battlefield applications.”

Put simply, BOSS is a complete collection of products that were designed specifically to generate, liquefy, store, fill and deploy liquid oxygen. The system currently features four products (which are also available separately): the Oxygen Generator and Liquefier (OGL), Backpack Medical Oxygen System Filling Station (BMOS-FS), Mounted Medical Oxygen System (MMOS), and Backpack Medical Oxygen System (BMOS).

As impressive as this range of products is, it’s Essex Industries’ fundamental difference from other companies in the same industry that remains their standout quality. “LOX systems inherently provide several advantages over gaseous systems in medevac applications,” explained Bannister.

“Liquid oxygen increases in volume 860 times as it converts from a liquid to a gas. That means a smaller amount of LOX will produce a large volume of gas, eliminating heavy storage cylinders. This reduces both the weight and space required, resulting in portable units that are easier to carry without sacrificing capability. Fill time also is much faster: It takes only 10 percent of the time to refill these units than comparable high pressure gaseous systems.”

As Brady indicated, logistics is one of the greatest challenges associated with field-based oxygen generation and delivery. But inconvenient emergencies happen all the time, and the oxygen absolutely must arrive where it’s needed. “Our OGL helps solve this issue by providing a more compact, mobile means to generate LOX in the field, and thereby provide a practical method for refilling field and medevac equipment,” Bannister said.

These are truly portable solutions, too. The BMOS is a lightweight LOX storage and gaseous delivery system that can be carried or worn by parachutists and ground support personal to administer oxygen to a patient in the field. The BMOS-FS, a portable LOX storage device that is designed to fill multiple BMOS or MMOS systems, can be carried by two ground-support personal or mounted in an aircraft, helicopter, or ground vehicle.

“In addition, our products feature several benefits that overcome obstacles or challenges found in the field,” Bannister continued. The BMOS, MMOS, BMOS-FS and Next Generation Portable Therapeutic Liquid Oxygen System do not require a power source for operation. They are more reliable, with no moving parts and no requirements for periodic testing, and also provide versatility. For example, medics can use the BMOS to run a ventilator.”

The bottom line is that “our system enables the military to provide and generate medical oxygen wherever it is needed,” Bannister said. And sometimes it’s needed in places beyond the battlefield. “These products have been well received by all branches of the military. Their deployment has brought life-saving medical oxygen to soldiers on the battlefield and in medevac transport. But their usage has extended to civilian medevac and disaster response applications, too. The generators and filling stations enable all emergency personnel to keep the equipment ready for any crisis situation.”

Guy Hatch also emphasized non-military applications. “Disaster management requires medical oxygen,” he agreed. “We sent a bunch of POGS down to New Orleans after Katrina because the infrastructure for this particular need was unusable for about two weeks. Our machines were essentially set up as an oxygen filling station for the cylinders that went out to the airport and other places where they had taken folks. POGS were used in Haiti after the earthquake, too; in the field hospitals and make-shift clinics.”

Indeed, whether it’s in the field or in a helicopter—and supplied by separating molecules from the air or taking advantage of the liquid form—oxygen isn’t only a cornerstone of life, it’s a cornerstone of medical treatment and disaster management. Fortunately, these companies and others like them are making it easier than ever for this essential gas to get where it needs to be, when it needs to be there. ♦

Last modified on Monday, 18 August 2014 10:27

Additional Info

  • Issue: 2
  • Volume: 18
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