Bulk oxygen and nitrous oxide delivery systems: design and dangers.
(1/11)
A survey of hospitals with anesthesia residency training programs was undertaken to determine the frequency and types of complications encountered with the use of bulk supplies of oxygen and nitrous oxide. Of the responding hospitals, 98 per cent dispense oxygen from a central source and 80 per cent dispense nitrous oxide from a central source. Nearly a third of the hospitals responding reported the occurrence of serious or potentially serious accidents related to their bulk gas delivery systems. In three instances accidents resulted in patient deaths. More than half of the reported incidents were decreases in oxygen pipeline pressure, often resulting in insufficient delivery of oxygen for clinical use. Most complications related to pipeline accidents could have been prevented by observance of National Fire Protection Association regulations. Anesthesiologists should be familiar with these regulations and should understand the designs of gas delivery systems in their institutions. (+info)
SURVEY ON PREVACUUM HIGH-PRESSURE STEAM STERILIZERS.
(2/11)
None of the 10 prevacuum high-pressure sterilizers of different makes tested was able to produce and maintain the conditions advocated by the Medical Research Council working party on high-pressure steam sterilizers (1959) or by Knox and Penikett (1958) with the result that steam did not penetrate adequately the single challenge load and it was not sterilized. The sterilization of ;group drums' of various sizes and contents was erratic and tended to give operators a false sense of security. An alarming number of minor engineering faults were present in seven out of 10 machines tested and they require very much more skilled maintenance than is being given at the moment. The possibility of centralizing sterilizers to central sterile supply departments and placing them under the care of a regional engineer cannot be too highly recommended. The presence of undetected ;leaks' and a failure to draw a prevacuum of 20 mm. even with a steam burst interferes with sterilization of a challenge load. A leak test should be performed twice daily and should not exceed more than 1 mm. in one minute at 20 mm. absolute. The centre of the load should be monitored by crossed tapes or Brownes tubes in each sterilizing cycle. Although the challenge load was sterilized when the chamber was filled to capacity, a more reliable cycle consisting of a double prevacuum of 20 mm. or more with intermediate steam burst to 10 lb. ensured the sterilizing of a single challenge load, which could be adequately controlled by the chamber drain temperature. (+info)
Hospital-acquired legionnaires disease in a university hospital: impact of the copper-silver ionization system.
(3/11)
We evaluated the impact of the copper-silver ionization system in a hospital where hyperendemic nosocomial legionellosis and was present and all previous disinfection measures had failed. After implementation of the copper-silver ionization system, environmental colonization with Legionella species decreased significantly, and the incidence of nosocomial legionellosis decreased dramatically, from 2.45 to 0.18 cases per 1000 patient discharges. (+info)
Powering the future: how Hamilton Health Sciences put cogeneration to work for healthcare.
(4/11)
The absolute necessity of a stable and uninterrupted power supply within hospitals makes many of these facilities uniquely suited to cogeneration plants. Hamilton Health Sciences recently completed the largest hospital cogeneration project ever undertaken in the country. Spanning three acute care hospitals and generating a combined total of 22.75 megawatts of electricity, Hamilton Health Sciences' cogeneration plants address energy supply issues by offering a clean and reliable power source completely within the hospital's control, and provide the organization with the potential to generate its own revenue into the future by selling excess electricity back to the province. The following article highlights Hamilton Health Sciences' approach to the project, including some important lessons learned, and may serve as an example for other publicly funded institutions interested in implementing similar projects. (+info)
Synthesis of trigeneration systems: sensitivity analyses and resilience.
(5/11)
Legionella pneumophila in a hospital water system following a nosocomial outbreak: prevalence, monoclonal antibody subgrouping and effect of control measures.
(6/11)
Swabs and water samples from a hospital water system were cultured for legionellae over an extended period. Legionella pneumophila serogroup 1, including outbreak associated strains, were isolated in small numbers from approximately 5% of these samples despite implementation of the current DHSS/Welsh Office regulations. No cases of nosocomial legionnaires' disease were proven during the study. Physical cleaning and chemical sterilization of taps, and replacement of washers with 'approved' brands did not eradicate the organisms. Eradication of legionellae in hospital water supplies appears to be unnecessary in preventing nosocomial legionnaires' disease provided the current DHSS/Welsh Office recommendations are implemented. (+info)
Role of stagnation and obstruction of water flow in isolation of Legionella pneumophila from hospital plumbing.
(7/11)
The stagnation of water in two of four hospital hot-water storage tanks found to contain Legionella pneumophila was reduced by keeping the two tanks continually on-line for 1 year. L. pneumophila colony counts in these two tanks fell quickly to low levels, whereas the organisms persisted in the two tanks that were not in use. L. pneumophila continued to be isolated from 50 to 100% of the hospital showerheads which were sampled during this period. We also examined aerators and other hospital faucet fixtures which obstruct water flow. L. pneumophila was isolated from 22 of 30 faucet aerators and 2 of 16 vacuum breakers but not from 26 nonobstructed faucets or 6 backflow preventers. Over a 7-month period, after nine faucet aerators were sterilized, 10 of 60 surveillance cultures revealed L. pneumophila, despite the inability to isolate the organism from the potable-water tanks in use. These data suggest that prevention of stagnation in hot-water tanks may be effective in reducing L. pneumophila concentrations in potable-water systems serving high-risk populations. We have also shown that faucet aerators, by providing a surface for L. pneumophila to colonize, can become secondary reservoirs for the organism in hospital plumbing. (+info)
Hazards of hospital bulk oxygen delivery systems.
(8/11)
Numerous problems can occur with liquid oxygen delivery systems, in part because of the complexities of such systems. These systems must comply with guidelines of the Joint Commission on Accreditation of Hospitals. During the past year, 18 major problems with the liquid oxygen delivery system have occurred at the authors' hospital. Five times, false alarms have resulted from calibration drift in line pressure sensors. Thrice, excessive depletion of the reverse supply has occurred because of pressure imbalance between the main and reserve systems. Twice, excessive depletion of the reserve supply occurred owing to failure of the vacuum seal on the reserve supply vessel. Eight other potentially serious mishaps have also been reported. These problems, which are inherent in liquid oxygen delivery systems, are for the most part preventable. (+info)