Oxygen was in high demand at the height of the coronavirus pandemic this spring at Mount Sinai South Nassau hospital, and its oxygen system struggled to keep up. In re-sponse, a new, $100,000 system was installed at the hospital earlier this month, in-creasing its oxygen volume by 500 percent.
The hospital receives liquid oxygen in bulk, and it is stored in a 6,000-gallon oxygen farm on the hospital’s south side. When patients need oxygen, liquid oxygen travels through evaporator tubes, which convert it to gas, and it then travels through a series of pipes and feeds underground to the hospital building, where it is delivered through a network of copper pipes to patient units.
Because of the high demand for oxygen at the peak of the pandemic, the evaporator tubes were freezing, and administrators decided it was time to replace them.
“We were able to keep up with the demand during Covid with our engineering staff,” said Andrew Triolo, the hospital’s assistant vice president of design, development and construction and property management. “Now that everything’s been upgraded and we have that additional capacity, we feel there will be no problem to meet the demand that we saw in March, April and May.”
Triolo said the system was more than 20 years old, so the pipes, manifolds and regulators had to be changed, but the storage tank remained untouched. The project took eight days to complete, and while the oxygen system was offline, temporary trailers were brought in to send oxygen to patients. The evaporator pipes are four large bundles of 15 to 20 pipes. For the new pipes, engineers increased their width from an inch to an inch and a half to allow for a higher volume.
Joe Calderone, MSSN’s senior vice president of corporate communications and development, said there were as many as 90 patients on ventilators during the height of the Covid-19 crisis, and 70 to 100 percent of patients were on oxygen at a given time. Extra emergency tanks had to be brought in to ensure that the hospital did not run out of oxygen. The units that were farther away from the oxygen farm on the south side of the hospital were not receiving the proper flow because the system in place had trouble handling the volume.
During flu season, the hospital usually has about 10 patients on ventilators at most, and 30 or 40 using oxygen. The hospital now has 140 ventilators and access to others on an emergency basis if needed. Calderone said staff members are confident the new system can handle a potential second wave, and could serve 200 patients on ventilators, if necessary.
“It’s part of what we’re doing to make sure that the hospital is ready in the event of a second surge, which we hope we don’t see,” he said. “. . . This was never foreseen. This kind of event was just not foreseen when they built this system.”
Calderone called the need for an upgrade a life-and-death situation, and praised the staff for coming together during the surge and the administration and board of directors for approving the replacement.
Dr. Frank Coletta, chief of critical care, said the oxygen issues were alarming for staff members and engineers, but they did not become rattled and were able to adapt to the situation. He added that being able to replace the system offered him a great deal of relief.
“I sleep better at night,” Coletta said. “I know that I have 140 ventilators ready to go, and I know that each and every one of them can be powered with the kind of oxygen that we need because of the new delivery system. On top of that, we have a contingency program so that when and if a surge were to come, it won’t be like the first time where we had to invent everything.”
Along with the oxygen system, the coronavirus pandemic caused staff and administrators to implement many changes. There are now daily conference calls, a contingency program is now in place so that staffers can rotate into different positions if another surge were to happen, and a host of procedures and equipment were implemented and upgraded.
As of Friday, MSSN had 13 Covid-19 patients, three of whom were on ventilators. Coletta said it was a slight uptick from recent months, when Covid-19 patients numbered in the low single digits, none of whom were on ventilators. He added that research and analytics show there will likely be a 30 percent Covid-19 patient surge at the hospital by the end of the year, and he noted staff will be ready should that happen.
“When asked, our unit of people are ready and willing to come forward and put their best foot forward to be sure that our hospital and our patients have the best care available,” he said, “and I’m very proud of that.”