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Found 36 results
  1. Event
    Energy-based devices, lasers and diathermy are some of the most commonly used pieces of equipment in operating theatres today. Dangerous emissions can be produced that affect the respiratory systems of everyone in the operating theatre. This study day will look at the occupational hazards of exposure to surgical plume in the operating theatre, as well as the associated risks to the surgical team, patients and visitors. It will also highlight how to assess risk and mitigate against the dangers of surgical plume and how to implement changes. Topics Include: Electrosurgery/diathermy/laser. Anaesthetic airway fires. Laparoscopic surgery aerosolisation. Health and Safety and risk assessment. Surgical plume. Register
  2. News Article
    Some hospitals are suspending supplies of gas and air, after it was found to pose health risks to midwives. What can be done to ensure pregnant women still get the help they need? When Leigh Milner was expecting her first baby, she knew exactly how she wanted her labour to go. Her birth plan included an epidural for the pain and she was hoping, she says ruefully, for “all the drugs”. But that is not how things worked out. Milner, 33, a BBC presenter, ended up giving birth to Theo at Princess Alexandra hospital in Harlow last month with nothing but paracetamol for pain relief, in what she calls a positively “Victorian” experience. “I kept begging over and over again – ‘I need something for pain relief’ – and the only thing they could give me was paracetamol because they didn’t have gas and air. I was quite frightened, I didn’t know what else to do,” says Milner. "Birth is painful, but it shouldn’t be traumatic.” Read full story Source: The Guardian, 16 March 2023
  3. News Article
    NHS trusts are to be told to remove devices linked to more than 120 never events caused by ‘unconscious errors’. A national patient safety alert from NHS England which urges trusts to remove all air flowmeters from wall medical gas outlets. It is likely to be published next month. The alert comes after 121 never events in the last three years involved staff members accidentally connecting patients to air instead of oxygen. This number is close to 10% of all never events recorded during that period. These types of never events have been recorded by 57 NHS organisations during 2018-19, 2019-20 and 2020-21. The incidents took place mostly on medical wards and in emergency departments. They occurred despite NHSE issuing a patient safety alert in 2016, which recommended removing the flowmeters from wall outlets when not in active use. According to NHSE documents - seen by HSJ - the never events often went undetected “for some time”, even when other staff responded to deteriorating patients or took over their care. The regulator concluded this makes it more likely that there have been other unreported incidents. Read full story (paywalled) Source: HSJ, 17 May 2021
  4. Content Article
    Actions Purchase sufficient powered nebuliser devices for use across the organisation; to remove the need for medical air to drive nebulisers via a flowmeter. Remove the need for air flowmeter use in the delivery of humidified air, by purchasing sufficient devices that use ambient air. Review any niche uses of air flowmeters and replace with suitable alternatives. If in exceptional circumstances, an air flowmeter cannot be replaced by an alternative device, ensure the flowmeter is tethered to the equipment. On completion of actions 1,2 and 3, remove and discard all medical air flowmeters except those tethered to equipment for niche use. Reversibly cap off all medical air outlets that are no longer routinely required; secured caps are most appropriate for this. Ensure policies and procedures relating to the prescribing and administration of nebulised medication are updated to reflect this change in practice and that they align with British Thoracic Society (BTS) guidance.
  5. News Article
    Hospital trusts must only remove gas and air on maternity wards as a “last resort”, NHS England has said. Several hospitals temporarily suspended the use of gas and air following concerns that midwives and staff are being exposed to too-high levels of gas over prolonged periods of time. Some pregnant women have posted on social media, saying the decisions have left them feeling anxious and worried about their pain relief options. Some NHS trusts have also come under fire for the way they communicated the message that gas and air would be suspended. In new guidance to trusts, NHS England said it had looked at the health impacts for staff of levels of nitrous oxide exceeding prescribed levels, “drawing upon relevant legislation and existing guidance on the safe management of gas and air in healthcare settings”. It said trusts must ensure they are compliant with legislation and national guidance on the use of gas, but must only remove it for women as a last resort and must tell them about other pain relief. “Where, following the meeting of the (medical gas) committee, there is concern that the trust is not compliant, then this should be formally reported by the trust to the NHS England regional operations centre for the attention of the regional chief midwife,” the guidance said. Read full story Source: The Independent, 3 March 2023
  6. News Article
    Scotland has become the first country in the world to stop its hospitals using the anaesthetic desflurane because of the threat it poses to the environment. NHS data suggests the gas, used to keep people unconscious during surgery, has a global warming potential 2,500 times greater than carbon dioxide. Banning it in Scotland - from its peak use in 2017 - would cut emissions equal to powering 1,700 homes a year. In the last few years, more than 40 hospital trusts in England and a number of hospitals in Wales have stopped using it. Dr Kenneth Barker, anaesthetist and clinical lead for Scotland's national green theatres programme, said he was shocked to find the anaesthetic drug he had used for more than a decade for many major and routine operations was so harmful to the environment. "I realised in 2017 that the amount of desflurane we used in a typical day's work as an anaesthetist resulted in emissions equivalent to me driving 670 miles that day," he said. "I decided to stop using it straight away and many fellow anaesthetists have got on board. "When you are faced with something as obvious as this and with the significance it has to the environment - I am very glad we have got to this stage." Read full story Source: BBC News, 3 March 2023
  7. News Article
    Nitrous oxide levels on Watford General Hospital's maternity suite far exceeded legal limits during peak periods, a BBC investigation has found. In February 2022, air monitoring showed levels of almost 5,000 parts per million (ppm) - 50 times what is safe. The hospital's trust said it had since installed machines to remove the gas. It was one of a number of nitrous oxide incidents reported by NHS trusts to the Health and Safety Executive (HSE), Freedom of Information data has shown. The HSE disclosed the details following a request for its notifications under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR). There were 11 notifications to the HSE between August 2018 and December 2022 from seven NHS trusts and one private hospital in relation to nitrous oxide - almost all relating to maternity units. Monitoring has led to a string of NHS trusts suspending the use of Entonox - a mixture of nitrous oxide and air used to assist women in labour with pain relief. NHS bosses acknowledge there is "limited research on the occupational exposure to Entonox, and the long-term health risks this may pose", though at least one expert has played down the risk. But staff working in maternity units face uncertainty due to prolonged periods of time spent in affected areas, with particular concerns over Vitamin B deficiency due to exposure. Read full story Source: BBC News, 13 February 2023
  8. News Article
    A hospital has stopped using gas and air in its maternity unit to "protect our midwifery and medical team". The Princess Alexandra Hospital in Harlow, Essex, said the decision followed tests on nitrous oxide levels. It said it would temporarily suspend the use of Entonox while additional safety equipment was installed. Giuseppe Labriola, director of midwifery, said: "There is no risk to mothers, birthing people, their partners and babies." Other hospitals have previously temporarily suspended the use of gas and air in recent months including Basildon and Ipswich. Read full story Source: BBC News, 22 January 2023
  9. News Article
    Staff at a maternity unit were exposed to almost 30 times the legal workplace exposure limit for nitrous oxide, documents have shown. Testing at Basildon Hospital revealed the levels more than 16 months before colleagues were informed. The Royal College of Midwives said its members there were considering legal action. Routine testing of the maternity suite in June 2021 revealed nine staff members had been exposed to excess nitrous oxide levels during the course of their shifts. Three had readings of more than 1,000 parts per million (ppm) of the gas, while a fourth recorded almost 3,000. The Workplace Exposure Limit is set at 100ppm. Trust management apologised after failing to notify staff at the unit until October 2022. A briefing seen by the BBC stated the issue was logged on the risk register, but "there has not been proper oversight of the problem and staff have not been informed". One person familiar with the situation, who did not want to be identified, said: "We had an email sent out that said 'emergency maternity staff briefing' and there was a Teams meeting. "The Teams meeting was very, very difficult to listen to. It was very emotive. People were angry understandably, but I feel like the executive who were on the call didn't handle it very well." Read full story Source: BBC News, 16 January 2023
  10. Content Article
  11. News Article
    One of the mysteries of COVID-19 is why oxygen levels in the blood can drop to dangerously low levels without the patient noticing. It is known as "silent hypoxia" and as a result, patients have been arriving in hospital in far worse health than they realised and, in some cases, too late to treat effectively. But a potentially life-saving solution, in the form of a pulse oximeter, allows patients to monitor their oxygen levels at home, and costs about £20. They are being rolled out for high-risk Covid patients in the UK, and the doctor leading the scheme thinks everyone should consider buying one. A normal oxygen level in the blood is between 95% and 100%. "With Covid, we were admitting patients with oxygen levels in the 70s or low-or-middle 80s," said Dr Matt Inada-Kim, a consultant in acute medicine at Hampshire Hospitals. He told BBC Radio 4's Inside Health: "It was a really curious and scary presentation and really made us rethink what we were doing." Read full story Source: BBC News, 21 January 2021 See hub resource on the 'Covid Oximetry @home' project
  12. News Article
    Hospitals should ramp up their treatment of COVID-19 patients at home to free up more beds during the peak of the pandemic, under plans announced by NHS England/Improvement. All NHS trusts will receive up to 300 oximeters, which measure oxygen saturation levels and can be used to monitor COVID-19 patients in their own homes, rather than in hospital beds. NHSE has “recommended” that all areas of England “pursue immediate roll-out” given the “intense pressure on hospital beds right now”, according to a letter from medical director Steve Powis and two other national directors. Currently, nearly 60 trusts have COVID-19 patients in at least a third or more of their beds, and the total number of COVID-19 patients is peaking at around 37,000. There have been particular strains on hospital discharge, particularly of covid patients, whom many care homes are unable or unwilling to receive. The scheme, dubbed “covid virtual wards”, has been used at some trusts since the pandemic’s first wave. Read full story (paywalled) Source: HSJ, 19 January 2021
  13. News Article
    The Healthcare Safety Investigation Branch (HSIB) have launched a national investigation into the provision of piped oxygen gas supplies to hospitals. During the COVID-19 pandemic there has been an increased demand for oxygen gas on hospital wards, with more patients needing oxygen therapy. Insufficient oxygen supply to seriously ill patients can have very severe consequences, including death. The investigation is examining a major incident that took place at an acute hospital. Demands on their oxygen supply led to patients being diverted to other hospitals. In addition, patients were also transferred between clinical environments. As part of HSIB's final investigation report, they will make safety recommendations to the appropriate national bodies in order to improve patient safety. Read full story Source: HSIB, 15 January 2021
  14. News Article
    A hospital's oxygen supply has "reached a critical situation" due to rising numbers of COVID-19 infections. A document shared with the BBC showed Southend Hospital has had to reduce the amount it uses to treat patients. It said the target range for oxygen levels that should be in patients' blood had been cut from 92% to a baseline of 88-92%. Hospital managing director, Yvonne Blucher, said it was "working to manage" the situation. "We are experiencing high demand for oxygen because of rising numbers of inpatients with Covid-19 and we are working to manage this," she said. Read full story Source: BBC News, 11 January 2021
  15. News Article
    Hospitals across England could see oxygen supplies at worse levels this winter than at the peak of the first coronavirus wave – when some sites were forced to close to new admissions. An alert to NHS hospitals this week warned that because of the rise in admissions of COVID-19 patients, there is a risk of oxygen shortages. Trusts have been ordered to carry out daily checks on the amount of oxygen in the air on wards to reduce the risk of catastrophic fires or explosions. The problem is not because of a lack of oxygen but because pipes delivering the gas to wards will not be able to deliver the volume of gas needed by all patients. This can trigger a cut-off in supply and a catastrophic drop in pressure, meaning patients would be denied the oxygen they need to breathe. Read full story Source: The Independent, 20 November 2020
  16. News Article
    Devices which measure blood oxygen levels could be giving “seriously misleading” results for Black and minority ethnic people, possibly contributing to increased Covid-19 mortality, experts have warned. Pulse oximeters attach a clip-like device to a person’s finger, toe or earlobe and send a beam of infrared light to measure oxygen levels in the blood. The resulting reading can be used to monitor oxygen levels of people with a variety of conditions, including by people at home with coronavirus, and to assess patients in hospital. At the moment, coronavirus patients who call an ambulance but are not yet deemed sick enough to go to hospital are being given new home oxygen monitoring kits to help spot those who may deteriorate earlier, and over 300,000 oximeters have been sent out by NHS England. But a new paper cites a “growing body of evidence” that pulse oximetry is less accurate in darker skinned patients. This could be contributing to health inequalities such as the increased COVID-19 mortality rates of ethnic minority patients, according to a review conducted for the NHS Race and Health Observatory. It is now calling for the Medicines and Healthcare products Regulatory Agency (MHRA) to urgently review pulse oximetry products for ethnic minority people used in hospitals and by the wider public. Read full story Source: The Independent, 27 March 2021
  17. News Article
    Doctors and nurses were absent from crucial meetings about oxygen supplies to hospital wards in the run up to the coronavirus crisis, a safety watchdog has warned. At one hospital trust, which was forced to declare a major incident during the second wave of the crisis, doctors had not attended the hospital’s medical gas committee (MGC) since 2014. The Healthcare Safety Investigation Branch (HSIB) said it had discovered a similar lack of input at other NHS trusts and also warned that none of the urgent alerts and guidance from NHS England ahead of the Covid surge had been discussed at the committee. HSIB has launched an investigation into the failure of oxygen piping systems during the Covid surge after a number of hospitals were forced to declare major incidents and divert patients to other hospitals. Read full story Source: The Independent, 24 March 2021
  18. News Article
    There was a "gross failure in basic care" which led to a baby being starved of oxygen during birth, a coroner said. Zak Ezra Carter died at the Royal Gwent Hospital, Newport, two days after being born in July 2018 at Ystrad Fawr Hospital in Caerphilly county. Gwent coroner Caroline Saunders said the monitoring of Zak and his mother Adele Thomas fell "well below the standards expected". She said she was reassured the health board had taken steps to improve care. Ms Thomas told the Newport hearing she felt "scared" and staff "didn't care" when she arrived to give birth on 20 July 2018. In a statement to the inquest she described being turned away from the centre after going into labour on three occasions, before being admitted on the fourth. Ms Thomas said she was initially offered paracetamol as pain relief at the midwife-led centre. She described "a lot of arguing between nurses", one of whom was "bolshie and rude and rough handled me", adding the midwives "did not appear to be in any rush". When Zak was born, he was described as being "white and pale" and without a heartbeat. He did not cry and was taken away to a room for resuscitation. Zak was transferred to the Royal Gwent Hospital where he died two days later. During the first stage of labour, Prof Sanders said "everything was progressing at a normal healthy rate and the fetal heart rate was recorded as completely normal". But she said it was "highly unusual" for the heart rate to not be documented contemporaneously, and the midwives had not been able to explain why they had not done so. Recording a narrative conclusion, Ms Saunders said the monitoring of Ms Thomas and her baby had "fallen well below the standards expected", leading to a "gross failure in basic care" of them in the later stages of labour. Read full story Source: BBC News, 18 March 2021
  19. News Article
    Shortages of oxygen are endangering the lives of more than half a million COVID-19 patients every day in the world’s poorest nations, new research has shown. Despite being vital for the effective treatment of people admitted to hospital with coronavirus, sustained access to oxygen has proven difficult in low- and middle-income countries (LMICs) due to cost, infrastructure and logistical barriers. According to Unitaid, a global health agency, more than half a million people in LMICs currently need 1.1 million cylinders of oxygen per day, with 25 countries currently reporting surges in demand, the majority in Africa. Supplies of oxygen were already constrained prior to COVID-19 and have been exacerbated by the pandemic, Unitaid says. Read full story Source: The Independent, 25 February 2021
  20. News Article
    Coronavirus patients who call an ambulance but are not yet sick enough to go to hospital are being given new home oxygen monitoring kits to help spot those who may deteriorate earlier. Across the Thames Valley region, thousands of patients will be given the kits which include a pulse oximeter device to monitor blood oxygen levels, a diary to track their symptoms and advice on what to do if they become sicker. South Central Ambulance Service Trust (SCAS) has become the first ambulance service in the country to launch the scheme after research showed a small drop in oxygen levels among some patients could be an early warning sign of serious complications. Patients with pneumonia and non-Covid lung conditions often experience shortness of breath before a drop in oxygen levels. But with coronavirus, patients can suffer what has been called ‘silent hypoxia’ where their oxygen levels can fall before the patient becomes breathless and calls for help. Read full story Source: The Independent, 2 February 2021
  21. News Article
    Demand for oxygen from COVID-19 patients recovering at home is set to place the NHS under strain, the health service has warned. NHS England has issued guidance to out-of-hospital health providers on the extra demands likely to be placed on them given the number of people recovering after a hospital stay with the coronavirus. It warns that the provision from its home oxygen services and community respiratory teams across the NHS is expected to be an issue as the scale of demand increases. Andrew Whittamore, a practising GP and clinical lead for the Asthma UK and British Lung Foundation partnership, said concerns about the potential for hospitals to be overwhelmed in the early part of the pandemic had led to community oxygen teams being primed to take on more patients – but he described that ramping up as “a short-term fix”. “We don’t know how long people are going to need oxygen or other services for,” he said. “There are definitely going to be extra patients added on to our community teams’ workloads.” The Taskforce for Lung Health – of which the British Lung Foundation is a member – has raised particular concerns about access to pulmonary rehabilitation. An education- and exercise-based treatment, which is proven to be more effective for lung patients than many drug-based treatments, and face-to-face classes have been suspended during the pandemic. It may be that such treatment would also be helpful for some patients recovering from COVID-19. Jackie Eagleton, policy officer at the British Lung Foundation, said there had been issues with access to pulmonary rehabilitation for a long time, but the need to offer this form of support to people with lung conditions “has never been more pressing than it is now”. Read full story Source: The Independent, 16 June 2020
  22. News Article
    A new review by a Healthcare Safety Investigation Branch (HSIB) found outdated systems used to provide oxygen around hospitals struggled to cope with demand, particularly during the winter months during the Covid surge. HSIB was created to investigate safety issues in England, and have said the problems with oxygen was not isolated to just one hospital. Read full story. Source: BBC News, 24 June 2021
  23. Content Article
  24. Content Article
  25. Content Article
    The pandemic has placed massive pressure on the healthcare system, particularly when providing patients with enough oxygen to help treat the symptoms of COVID-19. HSIB's investigation so far indicates that trusts experiencing issues with oxygen demand have plenty of oxygen reserves [liquid oxygen]. However, the issue lies with a combination of the pipework/system used to deliver the oxygen and where patients needing the most oxygen are cared for along the oxygen supply network. HSIB therefore suggesting estates, pharmacy services and clinicians work closely together to map out the capabilities of their piped systems. They should consider spreading out patients with the highest need for oxygen more evenly, to help inform decisions about where patients may be safely cared for. The current pandemic has forced hospitals to reconfigure wards, and in so doing this has unbalanced the oxygen supply. Many hospitals work on a radial system, so the gas is pumped along the pipe network in one direction. When the system is balanced, anticipated levels of oxygen can be piped to everyone around the hospital. But, with increased and uneven demand on the pipe network - due to a group of COVID-19 patients, for example - oxygen supply levels may be reduced to other patient areas.
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