Consumer medicine information

Air Liquide Healthcare Medical Oxygen 100% v/v Bulk Liquid and Medical Oxygen 100% v/v Gas Medicinal

Oxygen

BRAND INFORMATION

Brand name

Air Liquide Australia Limited Oxygen Bulk Liquid

Active ingredient

Oxygen

Schedule

Unscheduled

What is in this leaflet?

This leaflet answers some common questions about Medicinal Oxygen. It contains only some information, and does not take the place of talking to your doctor or appropriate healthcare professional.

All medicines may assist you, but sometimes there are risks. Your doctor or healthcare professional has weighed up the risks of you using Medicinal Oxygen against the benefits they expect it will have for you.

If you have any questions about using Medicinal Oxygen, ask your doctor.

Keep this leaflet with you as you may want to read it again.

What Medicinal Oxygen is used for?

Medicinal Oxygen is used for breathing, to treat or prevent oxygen deficiency.

It is usually given by a doctor, anaesthetist, dentist, ambulance officer or nurse via a mask or nasal prongs. When directed by a doctor, Medicinal Oxygen can be used in your home.

Medicinal Oxygen works by increasing uptake and concentrating oxygen in your tissues.

Your doctor may prescribe Medicinal Oxygen for another purpose. Ask your doctor if you have any questions about why Medicinal Oxygen has been prescribed for you.

This medicine is available only with a doctor's prescription.

Before you use Medicinal Oxygen

When you must not use it:

WARNING: MEDICINAL OXYGEN WILL BOOST BURNING AND MAY INCREASE THE CHANCE OF FIRE.

DO NOT use Medicinal Oxygen if:

a. You are smoking.

b. You are near open flames.

c. You are cooking.

Do not use Medicinal Oxygen if the cylinder is damaged or has the tamper evident plastic seal removed.

Before you start to use it

You must tell your doctor if:

You are a smoker.
You have had any reaction to Medicinal Oxygen therapy.
You have or have had any other health problems or Medicinal conditions, including:

Severe lung disease such as chronic bronchitis or emphysema.

You are pregnant or intend to become pregnant.
You are breastfeeding or wish to breastfeed.

Care should be taken when using Medicinal Oxygen because it is stored at high pressure in the gas cylinder.

Medicinal Oxygen helps fires to start and burn. You MUST consider your safety in areas where oxygen can concentrate, as this increases the risk of fire.

Please discuss this with your doctor if you have any questions.

Taking other medicines

Advise your doctor if you are being treated with bleomycin or amiodarone (Cordarone X®). You must tell your doctor if you are taking any other medicines, including medicines you buy without a prescription from a pharmacy, supermarket or health food shop.

If you have a dry nose or other problems, please speak to your chemist or doctor. DO NOT use petroleum jelly (Vaseline®) or any other products around your nose, on or near the equipment.

How to use Medicinal Oxygen

Medicinal Oxygen should only be used under the supervision of your doctor or healthcare professional.

How much to use and how to use it

The amount of Medicinal Oxygen you need will be decided by your doctor. It is given by breathing it through a mask or nasal prongs.

If you are elderly or have lung problems, you may need a lesser amount of Medicinal Oxygen. Your doctor will decide this for you.

Follow all directions given to you by your doctor carefully, and do not modify the flow of Medicinal Oxygen.

If you do not understand the instructions, ask your doctor for help.

How long to use it?

Your doctor will decide how long you need to use Medicinal Oxygen.

If you use too much (overdose)

As Medicinal Oxygen is given to you under the supervision of your doctor, anaesthetist, ambulance officer, dentist or nurse, it is very unlikely you will receive an overdose.

If you have any questions, ask your doctor.

After you have used Medicinal Oxygen

Things you must not do

You must not smoke, or be near naked flames such as candles, gas stoves etc or sources of fire such as matches or lighters.

Side effects

Tell your doctor as soon as possible if you do not feel well while you are using Medicinal Oxygen. If you experience being sleepy all the time, you may be suffering from over administration. Contact your doctor for advice.

Tell your doctor if you have any of the following and they worry you:

Soreness in the chest with dry cough or any breathing difficulties.
Problems with eyesight
Dry nose, mouth or sore ears
Nausea

These side effects are usually mild.

Tell your doctor immediately if you have the following:

Breathing problems

These are serious side effects and you may need urgent Medicinal attention. Serious side effects are rare.

If the above happens, tell your doctor immediately or go to casualty at your nearest hospital

Other side effects not listed above may also occur in some patients.

Tell your doctor if you notice anything else that is making you feel unwell.

Ask your doctor if you don’t understand anything in this list.

Do not be alarmed by this list of possible side effects.

You may not experience any of them.

After using Medicinal Oxygen

Storage

Medicinal Oxygen is stored as a compressed gas in cylinders.

For safety, store cylinders in well ventilated areas and not in small enclosed spaces.

Disposal

Do not discard empty or damaged cylinders.

All cylinders are to be returned to the supplier whose details are printed on the product label.

Product Description

What it looks like

Medicinal Oxygen (O₂) is an odourless, colourless gas supplied in all white cylinders (white body with a white shoulder). Cylinder sizes include 0.16, 0.27, 0.46, 0.47, 0.59, 0.76, 1.00, 1.50, 4.10, 4.20, 10.30, 41.20, 41.70, 63.00, 82.40, and 123.60 (m³). Medicinal Liquid Oxygen is stored in in the bulk liquid form and then supplied via a reticulated gas distribution system within healthcare facilities which is available in the gaseous form from the wall outlet.

Ingredients

Active Ingredient:

Oxygen: ≥ 99.5 % v/v min

Excipients:

None

Name and Address of Sponsor & Supplier

Air Liquide Healthcare Pty Ltd
Suite 4
270 Lahrs Road,
Ormeau, QLD, 4208

Australian Registration Number

Oxygen - AUST R 32749 (Compressed)

Oxygen – AUST R 32744 (Liquid)

This leaflet was prepared on November 2024

Version Number: 3

Published by MIMS February 2025

BRAND INFORMATION

Brand name

Air Liquide Australia Limited Oxygen Bulk Liquid

Active ingredient

Oxygen

Schedule

Unscheduled

1 Name of Medicine

Oxygen.

2 Qualitative and Quantitative Composition

Contains ≥ 99.5% v/v oxygen.
There are no excipients in medicinal oxygen.

3 Pharmaceutical Form

Medicinal liquid oxygen is supplied in bulk liquid form and stored in vacuum insulated vessels having a capacity between 1,000 and 65,000 litres water volume. It is subsequently supplied via reticulated gas distribution systems within healthcare facilities and available in gaseous form from the wall outlet.
See Section 6.5 Nature and Contents of Container.

4 Clinical Particulars

4.1 Therapeutic Indications

For respiratory delivery where there is a requirement for medicinal oxygen to treat or prevent hypoxemia.

4.2 Dose and Method of Administration

Medicinal Oxygen is administered by inhalation through the lungs. The major exception is when a metered supply is fed into the oxygenator of an extracorporeal circulation of a cardio-pulmonary bypass system.
Inhaled Medicinal Oxygen must be administered using an appropriate pressure reduction device and equipment such as mask or nasal prongs to deliver the required inspired concentrations of oxygen, between 21% and 100%, as determined by the prescriber after full clinical assessment. Most delivery systems for adults result in an inspired oxygen concentration of 60% or less. Inhaled oxygen may require humidification when treatment duration is longer than an hour.
Standard texts and clinical protocols should be consulted for the oxygen requirements specific to the underlying condition and the clinical status of the individual patient. It is essential to monitor ventilation, arterial oxygen saturation, and the clinical effect of the treatment.
In general, the aim of treatment is to ensure, by adjusting the oxygen fraction in the inhaled air (FiO₂), so that the oxygen partial pressure in arterial blood (PaO₂) does not fall below 60 mmHg or that the oxygen saturation of haemoglobin in arterial blood does not fall below 90%. The dose (FiO₂) must be adjusted according to each patient's individual needs, taking into account the risk of oxygen toxicity. The general recommendation is to use the lowest dose necessary to achieve the desired result of treatment. In cases of pronounced hypoxia, oxygen fractions that can involve a risk of oxygen toxicity may be indicated (see Section 4.9 Overdose).
In short-term treatment with oxygen, the oxygen concentration i.e. the fraction of the inhaled gas mixture (FiO₂; avoid > 0.6 = 60% O₂ in the inhalation gas mixture) should be maintained so as to achieve an arterial oxygen partial pressure (PaO₂) > 60 mmHg.
In patients with chronic respiratory disorders with hypercapnia, there is a risk of reduced respiratory drive with high oxygen concentrations, and low controlled oxygen concentrations (24%-28%) are generally used, with incremental increases based on individual clinical assessment and arterial blood value.
Treatment of neonates with oxygen may be required but must be strictly monitored, so that the oxygen concentration may be reduced when the patient's condition allows. For neonates (full-term and preterm) the appropriate institutional protocols, based on full clinical assessment, should be followed. The lowest effective concentration should be sought in order to achieve an adequate oxygenation appropriate for neonates.
In the emergency/acute setting, the usual dose for adults to treat or prevent acute oxygen deficiency is 3-4 litres per minute when using nasal prongs or 5-15 litres per minute with a mask.
Oxygen treatment must be continuously evaluated and the effect measured by means of PaO₂ or arterial oxygen saturation.
The use of medical oxygen for hyperbaric oxygen treatment is beyond the scope of this registered therapeutic good. See specialist literature.

4.3 Contraindications

There is no formal contraindication to oxygen therapy.
Due to increased risk of fire, patients should not smoke during oxygen therapy. See Section 4.4 Special Warnings and Precautions for Use.

4.4 Special Warnings and Precautions for Use

Domiciliary oxygen therapy is not indicated for adult patients with severe airflow limitation whose main complaint is dyspnoea but who maintain a PaO₂ > 60 mmHg and who show no secondary effects of chronic hypoxia, or who have not received adequate therapy of other kinds (e.g. bronchodilators and corticosteroids, treatment for right ventricular failure or have any respiratory infection). See Section 4.2 Dose and Method of Administration.
Oxygen therapy may affect the level of consciousness in a patient with hypercapnia and reduced respiratory drive. See Section 4.2 Dose and Method of Administration.
Patients with bleomycin lung injury: the pulmonary toxicity of high-dose oxygen therapy can potentiate lung injury, even if given several years after the initial lung injury by bleomycin and the target oxygen saturation to be achieved may be lower than in other patients. See Section 4.5 Interactions with Other Medicines and Other Forms of Interactions.

General.

Warning: oxygen aids and increases combustion.
Oxygen strongly supports combustion. Smoking is prohibited and no naked flame is allowed.
Oxygen in contact with oils, greases and tarry substances creates a highly dangerous environment due to the risk of spontaneous combustion.
Electrical equipment capable of sparking or generating extreme heat should not be used in the vicinity of patients receiving oxygen.

Check the following before use.

Oxygen cylinders must be fitted with an appropriate and lawfully supplied pressure-reducing device dedicated to use with medicinal oxygen and complying with Australian Standards (see Section 4.2 Dose and Method of Administration; Section 4.4 Special Warnings and Precautions for Use, Handling and instructions for use). Where this device is separate, it must match the cylinder valve pin index outlet. Where the dispensing equipment connection is separate, this must be connected by an oxygen-specific coupling.
See Section 4.2 Dose and Method of Administration; Section 6.4 Special Precautions for Storage.
Additional information is contained in the Safety Data Sheet for Medicinal Oxygen from the Sponsor.
Oxygen toxicity may occur with prolonged exposure to high inspired oxygen levels. High oxygen concentrations should be given for the shortest possible time required to achieve the required clinical outcome and reduced as soon as possible to the lowest concentrations needed to prevent or treat hypoxia.
Premature infants are at higher risk of complications of oxygen toxicity, such as retinopathy of prematurity.
The use of oxygen for the management of hypoxaemia requires appropriate prescription, monitoring and review. (Also see Section 4.2 Dose and Method of Administration).
Furthermore, up to date clinical guidelines, local and institutional protocols and recommendations from the relevant professional bodies should be consulted for detailed and current information. The response to oxygen varies depending on the underlying disorder, cause of hypoxia, and clinical status of the individual patient. The clinician should consider all relevant factors in selecting the inspired oxygen concentration, flow rate, and duration of therapy, taking into account the risk of oxygen toxicity. The general recommendation is that the lowest dose - FiO₂ - to achieve the desired result of therapy, a safe PaO₂ must be the aim. Careful monitoring of oxygen therapy is required, with repeated clinical assessment and monitoring of inhaled oxygen concentration (FiO₂) and checks of arterial oxygenation e.g. by arterial blood gas measurements (PaO₂), or arterial oxygen saturations (SaO₂) via pulse oximetry, as clinically appropriate.
If oxygen is mixed with other gases, its concentration in the gas mixture inhaled (FiO₂) must be maintained at least at 21% in the inhaled gas. Oxygen inhaled fraction can be increased up to 100%.

Handling and instructions for use.

Warning: Medicinal Oxygen increases burning and the risk of fire.
Do not use medicinal oxygen if:
a. User and/or patient is smoking;
b. User and/or patient is near open flames.
All personnel handling medicinal oxygen should have adequate knowledge of:
Properties of the gas.
Correct operating procedures for the cylinder.
Precautions and actions to be taken in the event of an emergency.
Under no circumstances should oils or grease be used to lubricate any part of the compressed gas medicinal oxygen cylinder or the associated equipment used to deliver the gas to the patient. Always ensure hands are clean and free from any oils or grease.
Where moisturising preparations are required for use with a facemask or in nasal passages etc., avoid using oil based creams. If in doubt, check with the manufacturer to ensure that the product of choice is suitable for use with oxygen.
Avoid flammable areas if wearing oxygen-saturated clothes.
Always use appropriate protective gloves and glasses when handling or using medical liquid oxygen equipment.
Never touch the cold or iced up parts of the equipment.
Medicinal Liquid Oxygen can lead to severe "cold burns" or destruction of tissue.
In case of frostbite, wash affected area with copious amounts of water for 15 minutes, apply a sterile dressing and seek medical assistance.

Use in the elderly.

Use in the elderly is determined by clinical assessment and course of the illness. Some elderly patients with chronic severe obstructive airways disease may rely on hypoxic drive for respiration and required relatively low inspired oxygen concentrations. See Section 4.2 Dose and Method of Administration.

Paediatric use.

Special care must be observed when administering oxygen to neonates. Preterm infants are more susceptible to the direct and indirect potentially toxic effects of oxygen exposure, including retinopathy of prematurity. Clinical protocols appropriate to the condition and age of the infant should be followed, including advice for appropriate arterial oxygen saturation monitoring. Ongoing monitoring is required to achieve the targeted arterial saturation using the lowest possible inspired oxygen levels. See Section 4.2 Dose and Method of Administration.

Effects on laboratory tests.

Not applicable.

4.5 Interactions with Other Medicines and Other Forms of Interactions

High oxygen fraction may further impair the damages caused by lung toxic agents. The pulmonary toxicity associated with drugs such as bleomycin (even if given several years after the initial lung injury by bleomycin), amiodarone, nitrofurantoin and similar antibiotics and with paraquat intoxication may be exacerbated by inhalation of an increased concentration of oxygen.

Bleomycin.

Potentially fatal pulmonary toxicity can develop in patients treated with bleomycin who are exposed to conventional oxygen concentrations during anaesthesia. It is recommended that oxygen concentration in bleomycin-treated patients should where possible be limited to less than 30% (FiO₂ < 0.3), with use of low concentrations (25%, FiO₂ 0.25) during surgery and post-operative recovery, and avoidance of pulmonary interstitial oedema by careful choice and monitoring of fluid replacement. See Section 4.4 Special Warnings and Precautions for Use.

Amiodarone.

High dose oxygen may increase the risks of amiodarone-induced post-operative adult respiratory distress syndrome.

Nitric oxide (NO).

In the presence of oxygen, nitric oxide is rapidly oxidized to form superior nitrated derivatives that are irritant for the bronchial epithelium and the alveolocapillary membrane. Nitrogen dioxide (NO₂) is the principal compound formed. The oxidation rate is proportional to the initial concentrations of nitric oxide and oxygen in the inhaled air, and to the duration of contact between nitric oxide and oxygen.

4.6 Fertility, Pregnancy and Lactation

Effects on fertility.

Medicinal oxygen has not been shown to adversely affect fertility when used as clinically required.
(Category A)
When oxygen is used in pregnancy as clinically required, treating intercurrent illness and avoiding hypoxemia, at the lowest concentration for the shortest possible time.
Category A does not relate to hyperbaric oxygen treatment and specialist literature should be consulted. It is noted that hyperbaric oxygen treatment during gestation in mice, rats, hamsters and rabbits let to increased resorptions and foetal abnormalities and decreased foetal body weights.
Pregnant women should not be exposed to hyperbaric oxygen.
Oxygen can be used during breast-feeding as clinically required, to treat intercurrent illness and avoid hypoxemia, at the lowest concentrations for the shortest possible time.

4.7 Effects on Ability to Drive and Use Machines

Under normal conditions, oxygen does not interfere with consciousness, however patients who required continuous oxygen support will require individual assessment, taking their entire medical situation into account for evaluating their ability to drive or operate machinery. See Section 4.4 Special Warnings and Precautions for Use.

4.8 Adverse Effects (Undesirable Effects)

Oxygen toxicity depends upon both inspired partial pressure of oxygen (a function of concentration and barometric pressure) and duration of exposure, the safe duration decreasing as the pressure increases. With 100% normobaric oxygen, symptoms of pulmonary toxicity are cough, substernal chest pain, mild dyspnoea, malaise, nausea, or transient paresthesia after 6-24 hours, substernal distress, atelectasis, decrease in vital capacity (after 18 hours) and acute respiratory distress syndrome (after 24-48 hours).
Adverse effects of oxygen exposure as described in standard texts include:

Eye disorders.

Retinopathy of prematurity, retrolental fibroplasia in neonates.

ENT.

Mucosal dryness and irritation, mucosal inflammation.

CNS disorders.

Drowsiness/carbon dioxide narcosis if given in high concentrations to patients with reduced sensitivity to carbon dioxide tension in arterial blood.

Respiratory.

Chest tightness, dry cough, pain on inspiration, interstitial oedema and pulmonary fibrosis; decreased vital capacity; pneumonitis; atelectasis bronchopulmonary dysplasia in neonates; carbon dioxide retention when given in high concentrations to patients with reduced sensitivity to arterial CO₂ tension.
Worsening of hypercapnia in patients with chronic hypoxia: hypoventilation, respiratory acidosis, respiratory arrest.

Gastrointestinal.

Nausea.

General.

Haemolysis of red blood cells; lipid peroxidation and cell membrane damage due to chemical toxicity in any metabolising cells.

Reporting suspected adverse effects.

Reporting suspected adverse reactions after registration of the medicinal product is important. It allows continued monitoring of the benefit-risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions at www.tga.gov.au/reporting-problems.

4.9 Overdose

In oxygen intoxication there may be pulmonary symptoms of chest tightness, dry cough, and pain on inspiration. Care must be taken where symptoms cannot present (e.g. intensive care) since the onset of objective evidence for pulmonary oxygen toxicity occurs late in its development (see Section 4.8 Adverse Effects (Undesirable Effects)).
The oxygen therapy should be reduced or, if possible, stopped, and symptomatic treatment should be started in order to maintain vital functions (e.g. artificial ventilation/assisted ventilation should be given if the patient shows signs of failing respiration).
For information on the management of overdose, contact the Poison Information Centre on 131126 (Australia).

5 Pharmacological Properties

5.1 Pharmacodynamic Properties

Mechanism of action.

Pharmacotherapeutic group: GASMED, Gas, Medical. ATC Code: V03AN01.
The basal oxygen consumption in humans is approximately 250 mL/min for a body surface area of 1.8 m². It is reduced by about 10% during anaesthesia and natural sleep and by about 50% for a 10°C fall in body temperature. Under normal conditions, alveolar air contains about 14% oxygen (105 mmHg) and the arterial blood has an oxygen tension of 97 mmHg. The difference, known as the alveolar-arterial oxygen tension gradient, increases with age and may be as great as 30 mmHg in a healthy elderly individual. Oxygen in the blood is primarily bound to haemoglobin. The oxygen saturation of haemoglobin in arterial blood is approximately 97%. Each gram of haemoglobin binds approximately 1.34 mL of oxygen, giving maximum capacity of about 20 mL per 100 mL of blood. A small amount, 0.3 mL, exists in solution in the same volume of blood.
The concept of "oxygen availability" can be used to quantify the amount available to the body. It can be expressed as product of cardiac output and the oxygen content of the blood. This is estimated by (cardiac output) x (Hb concentration) x (amount of oxygen carried by one gram of haemoglobin) x (% saturation of haemoglobin), plus the amount in solution.
The average healthy individual with basal oxygen consumption has no more than four minutes supply of oxygen circulating in the blood.
Oxygen is present in the atmosphere at 21% and is essential for cellular metabolism. The therapeutic use of oxygen is intended to improve, or prevent a reduction in, the oxygen content of blood leaving the lungs (or the oxygenator of a heart-lung machine).

Clinical trials.

No data available.

5.2 Pharmacokinetic Properties

Absorption.

Inhaled oxygen is transported via the airways to the lungs with the inspired air. Oxygen is absorbed in the alveoli by gas exchange resulting from the difference in partial pressure from the inspired air/gas mixture to the capillary blood. Increasing the inhaled oxygen concentration (i.e. inspired gas oxygen fraction, FiO₂), is intended to compensate for problems of ventilation, diffusion and ventilation/perfusion mismatch, by increasing the alveolar partial pressure of oxygen.

Distribution.

Oxygen is transported mainly bound to haemoglobin. A small amount though is free and dissolved into plasma.

Metabolism.

The uptake of oxygen by the blood in the lungs and discharge to the tissues is determined by the oxygen dissociation curve. The characteristic sigmoid curve ensure that, at tensions between 40 and 15 mmHg, the oxygen carried in the blood from the lungs can be readily given up to the tissues. See Figure 1.

The update from the lungs is rapid, because blood flow through the capillaries, where exchange takes place, occurs in about 0.5 seconds. At rest, mixed venous blood returning to the lungs contains 13-14 mL of oxygen per 100 mL, but with severe exercise, the oxygen content may fall to 3-4 mL. In very active tissue, there is almost complete extraction of oxygen.

Excretion.

The uptake of oxygen is favoured by simultaneous loss of carbon dioxide which is excreted in the expired air. Conversely, the entry of carbon dioxide into the blood from the tissues facilitates oxygen transfer to the cells.

5.3 Preclinical Safety Data

Genotoxicity.

No data available.

Carcinogenicity.

No data available.

6 Pharmaceutical Particulars

6.1 List of Excipients

There are no excipients in Medicinal Liquid Oxygen.

6.2 Incompatibilities

See Section 4.4 Special Warnings and Precautions for Use.

6.3 Shelf Life

In Australia, information on the shelf life can be found on the public summary of the Australian Register of Therapeutic Goods (ARTG).

6.4 Special Precautions for Storage

Due to the nature of the storage vessel it can be stored under any ambient conditions and still keep the liquid oxygen at below -180 degree C.
Storage and shelf life according to appropriate Australian Standard.
Storage vessels and vessel compounds must be maintained according to relevant Australian Standards, customer agreements and other relevant legislation.
A water tap must be provided for ice removal from the valve.
Warning notices prohibiting smoking and naked flames must be clearly posted around the storage vessel.
The vessel compound must be made of concrete and not bitumen.
Emergency Services should be advised of the location of the storage vessels.

6.5 Nature and Contents of Container

Medicinal liquid oxygen is supplied:
In bulk liquid form and stored in vacuum insulated vessels having a capacity between 1,000 and 65,000 litres water volume.
It is subsequently supplied via reticulated gas distribution systems within healthcare facilities and available in gaseous form from the wall outlet. Oxygen is identified via a label on the wall and/or on specified outlets.
Bulk vessels are identified by the following:
Painted all white;
Include "Air Liquide" signage containing the product name, UN number and Hazchem Code.

6.6 Special Precautions for Disposal

Not applicable.

6.7 Physicochemical Properties

Chemical structure.

C = O.
Composition complies with the current European Pharmacopoeia specification for Oxygen.
Purity: greater than or equal to 99.5% v/v.
Carbon dioxide: not more than 300 ppm v/v.
Carbon monoxide: not more than 5 ppm v/v.
Water: not more than 67 ppm v/v.
Appearance: odourless, colourless gas.
Molecular weight: 32.
Boiling point: -183.1°C (at 1 bar).
Density: 1.335 kg/m (at 15°C).
Combustion: non-flammable, strongly supports combustion.

CAS number.

77282-44-7.

7 Medicine Schedule (Poisons Standard)

Prescription Medicine Only - Not scheduled.

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Consumer medicine information

Air Liquide Healthcare Medical Oxygen 100% v/v Bulk Liquid and Medical Oxygen 100% v/v Gas Medicinal

Oxygen

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