War-game a medgas alarm rule by proving each zone lane has a named owner, a measured age-out, and a reverse path before draft alarms start governing every zone lane.
Medgas alarm rules fail when "ready for acknowledge" means a status without a decision artifact, when teams dual-count a draft alarm as both aspirational and live, and when critical zone families still pin to one thin plant desk because the lane inventory is incomplete. The review needs one written inventory of zone lanes, one owner who can deny a risky shortcut, and a documented consequence when a failed alarm ages past the deadline.
| Zone lane | Owner | Age-out | Reverse path |
|---|---|---|---|
| Primary O2 alarm path | Named plant charge | Measured minutes | Documented hold |
| Vacuum dual path | Plant ops | Measured minutes | Documented restore |
| OR medgas bridge | Perioperative lead | Measured minutes | Documented re-route |
Fill the table from stored exports, not from memory. Empty cells are blockers, not notes for later.
Lock one alarm family before scale
State which medgas classes the rule covers, the effective date, which alarm lanes change, how versions are stored, and what happens to zones already in flight. Name the units that feel it first and the safety promises that depend on coherent medgas handling. If the memo mixes a medgas alarm rule with an oxygen bulk outage and a chiller failure drill, split them.
Write the decision you will make if the war game finds nothing new. Also write the reverse criteria: the missed lane, pressure gap, or case deadline that would force a medgas alarm rule rollback within a stated window.
Medgas break points
- A critical zone class stays soft while the aggregate medgas dashboard stays green.
- Two teams claim the same lane ownership and neither can force a freeze at week end.
- A restore has already left a zone without a trusted alarm state.
- The primary medgas export lags beyond the planned observation window.
- An operator skips an alarm gate because an OR cutoff is near.
For each break point, require detection time, unit impact, containment, and the authority to force a medgas alarm rule rollback. Commands and export links belong in the runbook.
Hostile seats on the alarm rules
Feed Pingpong the rule memo, the lane exhibits, and seating briefs for plant, perioperative, respiratory, and facilities. First pass steelmans the rule. Later passes attack from those seats. Final pass turns surviving objections into phased lane rules, mitigations, or a changed recommendation. Agreement across passes is not proof. Keep the objections that still have evidence gaps.
Pair with an oxygen bulk-outage stress test, the plant ops lead seat, the facilities ops lead seat, and a chiller failure drill. More operating decisions live in the war-game decisions hub.
Ship the rule only when approved and blocked alarm labels can be reproduced from stored medgas exports without a verbal override.