Pin Index Safety System The Pin Index Safety System, or PISS, is a means of connecting high pressure cylinders containing medical gases to a regulator or other utilization equipment. It uses geometric features on the valve and yoke to prevent mistaken use of the wrong gas. This system is widely used worldwide for anesthesia machines, portable oxygen administration sets, and inflation gases used in surgery .Concept The pin index safety system uses a face seal between the cylinder valve and the associated yoke clamp. There are two holes in specific positions on the cylinder valve body below the outlet port, in positions associated with the gas mixture, which prevent connection of the cylinder to a yoke or pressure regulator with a mis-matched set of pins. The holes accept pins 4 mm diameter by 6 mm long which are correctly aligned with the holes.Pin index configurations Each gas cylinder has a pin configuration to fit its respective gas yoke. Refer to the diagram for pin numbers; dimensions are in millimeters. O2 : 2,5 N2 O: 3,5 Mixture of O2 and N2 O, commonly called Entonox: 7 Air: 1,5 Mixtures of CO2 and O2 with more than 7% CO2 : 1,6 Mixtures of CO2 and O2 with less than 7% CO2 : 2,6 He: No pin Mixtures of O2 and He with less than 80% He, commonly called Heliox: 2,4 Mixtures of O2 and He with more than 80% He: 4-6 Cyclopropane: 3,6 Ethylene: 1,3 Nitrogen: 1,4 International Standards The pin index system is a safety system designed to ensure the correct gas is filled into the correct cylinder, and that the cylinder will only connect to the correct equipment. The positions of the holes on the cylinder valve correspond with the pins fitted to the yoke attached to the equipment. The pin positions for each medical gas are unique. If an attempt is made to fit the wrong gas cylinder to the yoke a tight seal will not be made, as the pins cannot locate.The system requires a seal between the yoke and valve to prevent leakage. This is called a Bodok seal , and is a moulded rubber washer supported by a metal rim .Limitations It is possible to bypass the pin-index system if the pins are removed , damaged or corroded, if extra washers are used, or on some valves with a short face above the orifice, by inverting the gas cylinder. There is one report of the cylinder being painted the wrong colour leading to error.Alternative systems Medical gas cylinders larger than size E are more likely to be fitted with threaded connectors. The connections used for larger cylinders vary widely among jurisdictions. One such system are the American CGA fittings . In Europe there are British Standard , German Standard and French connections, and Japan has the Japanese Standard.Blanking Plugs Blanking plugs can be inserted into empty yokes to ensure that there is no leak out of the yoke when not in use.
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