The Operating Theatre Journal

Introducing the Allen Shoulder Access System

For more information call: 01244 660 954www.melydmedical.comD-770424-A1 February 12, 2009 © 2009 Allen Medical Systems, Inc. All Rights Reserved

Effortless intraoperative arm positioner that fi ts your budget!

Ease of Use: Effortless Positioning

Sterility:

Unobstructed Access Storage PositionEffortless Positioning External Rotation

March/April 2009 Issue No. 222 ISSN 1747-728X

2 THE OPERATING THEATRE JOURNAL www.otjonline.com

Europe’s top medical suction collection system now available in Britain.

Buy the FLOVAC® range at Unitate.com

The FLOVAC® suction collection system, which is well known and widely used throughout Europe’s hospitals and clinics, is now available to buy in the UK exclusively at Unitate.com. The

FLOVAC® range is designed for the collection of organic fl uids in ‘high fl ow, high vacuum’ applications (EN ISO 10079-3). It is available as either a single use disposable system,

or as rigid re-usable canisters with disposable liners. The re-usable containers have hermetically sealed lids and are fi tted with connectors for lines to the suction system and to the patient. An anti-refl ux hydrophobic and antibacterial fi lter

protects the equipment and/or the vacuum pump and the fi lter also acts as an overfl ow valve, de-activating the vacuum source when the canister is full.

A comprehensive range of accessories and components for the FLOVAC® system is available and can be seen at Unitate.com, together with a fi nely engineered four-container trolley to support the system and an on/off tap with vacuum gauge to enable staff to monitor the operation of the equipment.

The Unitate range, manufactured by Flow-Meter™ of Italy, includes systems for oxygen therapy, anaesthesia and all applications of medical gases. Unitate products have the quality and versatility to be adaptable for a wide variety of situations, such as GP medical centres, emergency vehicles, hospitals, veterinary clinics, community nurses, home-based treatment, and anywhere where oxygen therapy or medical gases are required for patient care. Many of the products provide an affordable disposable or single patient option that reduces cross infection risks and increases safety.

Unitate.com (a trading name of Plan-B Marketing Ltd) is the sole UK distributor for Flow-Meter™ products, and the online source www.unitate.com has been launched to enable medical equipment buyers throughout the UK the opportunity to assess and purchase the complete range on line or place an order on account.

Each product has been expertly designed to ensure safety, versatility, quality and affordability. Sales of Flow-Meter™ medical products are increasing rapidly across Europe. The new resource at www.unitate.com brings UK users of medical gases ready access to the benefi ts of the range.

Visit: www.unitate.com today to view the range, or call 01892 600136 for more information. When responding to articles please quote ‘OTJ’

A work accident leaves a woman blind in one eye. As she copes with the loss, within months the vision in the other, previously uninjured eye begins to blur, and the eye becomes red and infl amed.

The rare eye condition, known as sympathetic ophthalmia, occurs when vision is lost in one eye through injury or multiple surgeries, and the body’s overactive immune system attacks the remaining healthy eye. Left untreated, a person can become completely blind.

However, University of Iowa ophthalmologists and colleagues have tested and are now using a surgical implant called Retisert to prevent complete vision loss and eliminate dependence on systemic, or whole-body, immunosuppression. Before use of the surgical technique, doctors had to “shut down” a person’s entire immune system to stop the attack on the remaining good eye.

“Until recently, the primary treatment option for sympathetic ophthalmia was non-surgical and involved high doses of oral steroids followed by oral immunosuppressive medication to preserve vision in a patient’s remaining eye,” said Vinit Mahajan, M.D., Ph.D., assistant professor of ophthalmology and visual sciences at the University of Iowa Carver College of Medicine and a retinal surgeon with University of Iowa Hospitals and Clinics.

“But this treatment, similar to organ transplantation cases, subjects patients to life-long use of immunosuppressive drugs that have serious side effects such as osteoporosis, weight gain, potentially life-threatening infection and liver or kidney damage,” he added.

The new Retisert treatment involves the surgical implantation into the endangered eye of a small plastic tab that contains a slow-release steroid called fl uocinoloe acetonide. The insert provides immunosuppression only to the endangered eye, not other body parts. It lasts for about two-and-a-half years and then can be replaced.

Along with University of Iowa retinal surgeons James Folk, M.D., professor of ophthalmology, and Karen Gehrs, M.D., clinical associate

New surgical implant tested at U-Iowa prevents total blindnessDevices helps prevent complete vision loss and eliminate dependence on systemic immunosuppression for rare, but potentially devastating, eye condition

professor of ophthalmology, Mahajan published a retrospective paper online in January in the journal Ophthalmology that documents the successful use of Retisert to treat eight patients with sympathetic ophthalmia.

The device previously was studied in approximately 300 individuals who had a different immune system infl ammation of the eye. The UI-led sympathetic ophthalmia study found that with Retisert, the eight patients reduced or eliminated use of systemic medications to control infl ammation. While two patients needed to resume using an oral immunosuppressive, vision improved or remained stable in all eight patients.

“Using Retisert, we are stabilizing vision in patients with sympathetic ophthalmia and getting them off the heavy-duty immunosuppressive medications,” Mahajan said. “Patients had been willing to put up with the serious side effects of systemic immunosuppression because if they lost vision in their remaining good eye, it would be totally life-altering. With Retisert, we can save the eye, and the side effects are limited to treatable risks of high pressure or cataracts in the eye.”

While each implant costs approximately $20,000, their use appears to be less expensive over the long-run compared to systemic immunosuppressive drugs and the required frequent hospital visits.

“If you add up the total number of patient visits, costs of lab tests and the costs of the immunosuppressive drugs, the $20,000 for the device is cheaper,” Mahajan said.

Mahajan and colleagues are reaching out to retinal surgeons nationwide to make them aware of this new treatment option for patients with sympathetic ophthalmia.

In addition to the University of Iowa and the Wills Eye Institute, the retrospective study involved researchers at the University of Illinois Eye and Ear Infi rmary and Sentro Oftalmogico Jose Rizal at the University of the Philippines.

fi nd out more 020 7100 2867 • e-mail [email protected] Issue 222 MARCH/APRIL 2009 3 l

Africa Mercy, the world’s largest non-governmental hospital ship, has arrived on assignment to the French-speaking West African nation of Benin. Despite the stability of both the country and its economic growth, it is still considered one of the poorest nations in the world, ranking at 163 out of 177 countries according to the United Nations Human Development Index in 2005. In this nation, if you live past your fi fth birthday, you have a life expectancy in the best circumstances of another 50 years.

The Africa Mercy will remain in Benin until November carrying out the programmes of health care and community development. Mercy Ships mission and vision is poignantly refl ected as the ship weighs anchor in the port city of Cotonou - meaning ‘mouth of the river of death’ in the local language, while her crew bring life to those who so desperately need both hope and healing!

Graeme Walls, Director of Mercy Ships New Zealand, says the pay is not good … in fact there is no pay … but the rewards will be very satisfying. “The commitment of each of the 450 volunteers from around the world who will fi nd their own way to Benin and pay crew fees while onboard to help defray the ship’s running costs is inspiring. This kind of determination to put their faith into action, and to use their skills in medical and community development services to provide people in one of the world’s poorest nations is what makes Mercy Ships work.”

“There is a special need for Operating Theatre nurses willing to spend a few weeks or longer during the entire Benin assignment from February to November. Each year more and more New Zealanders are serving with us in West Africa where the Africa Mercy, the world’s largest private hospital ship concentrates efforts to bring hope and healing to the forgotten poor. We would love to hear from anyone interested in serving as a volunteer in any of a wide range of skills,” he says.

For more information in New Zealand visit: www.mercyships.org.nzemail: [email protected] or phone +64 9 950 4303

For more information in the United Kingdom: www.mercyships.org.uk email: [email protected] or phone +44 (0) 1438 727800

The Operating Theatre Journal is published twelve times per year. Available in electronic format from the pages of www.otjonline.comand in hard copy to hospitals throughout the UK. Personal copies are available by nominal subscription.

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Wednesday 25th March 2009All enquiries:Mr. L.A.Evans

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The OTJ Lawrand Ltd PO Box 51 Pontyclun CF72 9YYTel: 020 7100 2867

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Neither the Editor or Directors of Lawrand Ltd are in any way respon-sible for the statements made or views expressed by the contributors. All communications in respect of advertising quotations, obtaining a rate card and supplying all editorial communications and pictures to the Editor at the PO Box address. No part of this journal may be repro-duced without prior permission from Lawrand Ltd.

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Mercy Ships has operated hospital ships in developing nations since 1978. The emphasis is on the needs of the world’s poorest nations in West Africa, where the hospital ship Africa Mercy provides the platform for services extending up to ten months at a time. The ship has 6 operating theatres, a 78-bed hospital and state-of-the art equipment.

Gangway Group : Nick Booth - Ward Nurse, Auckland City; Selina Leggit - Ward Nurse, Palmerston North; Alison Brieseman - Operating Theatre Manager, Tawa; Maria Foxley - Ward Nurse, Palmerston North; Irene George - Ship Finance Offi cer, North Shore City; Glenys Gillingham - Opthalmic Surgical Nurse, Matamata. (Image courtesy of Mercy Ships)

Alison Brieseman of Tawa (NZ),Africa Mercy, Operating Theatre Manager

(Image courtesy of Mercy Ships)

Opportunity For Theatre Nurses

Heart Valve Procedure To Help Patients Who Cannot Have Surgery,

Imperial College Healthcare, EnglandA new procedure to replace the heart valve of patients with aortic stenosis has been introduced at Imperial College Healthcare to help patients who have been turned down for open heart surgery.

The new minimally invasive technique, called TAVI (transcatheter aortic valve implantation), will treat patients who are considered too high risk to have traditional surgery because of their age or other co-morbidities such as lung disease, renal impairment or previous stroke.

The technology offers an alternative treatment for patients with severe aortic stenosis who are considered unsuitable to have open heart surgery and would otherwise have a poor prognosis without a valve replacement.

Aortic stenosis happens when one of the valves in the heart - the aortic valve - narrows, restricting the fl ow of blood through the valve and making the heart pump harder, which can lead to breathlessness, chest pain, dizziness, blackouts and ultimately heart failure.

The new procedure is performed in a cardiology catheter laboratory rather than in an operating theatre and works by making a small incision in the patient’s groin or the apex of the heart, and introducing an artifi cial valve using a catheter. The valve consists of three leafl ets inside a metal cage called a stent, which is mounted on a balloon. Once the new valve is in position, the balloon is infl ated, crushing the old valve against the wall of the aorta and replacing it with the new one.

Traditionally aortic valves are replaced via open heart surgery, involving a bigger incision in the patient’s chest, putting the patient’s heart on bypass and a prolonged period of rehabilitation. Patients having the new minimally invasive procedure could have a shorter recovery period and potentially less time in hospital.

Dr Ghada Mikhail, cardiologist and programme lead for TAVI, said: “As this new technology develops we hope to be able to offer this procedure not only to older and higher risk patients, but also to a wider group of lower risk patients.”


schedule new work orders, which can then be fully uploaded into a large onboard memory.

The compact, lightweight design and long life battery power of the Rigel 288 reduces downtime between tests, making the instrument practical and highly portable for multi-site use.

It features easy-to-follow menu driven instructions for ease of operation and test control of all required electrical safety tests in manual, semi automatic or fully automatic test modes.

Users also have the facility to select from a range of preset test programs or develop their own customised routines.

Point-of-care ultrasound hits the mark for orthopaedics

The latest point-of-care ultrasound technology from SonoSite has been chosen for its easy portability and excellent image quality by consultant orthopaedic surgeon Harry Brownlow, at the Royal Berkshire Hospital in Reading, to help in the diagnosis and treatment of a whole range of shoulder and elbow injuries.

I have used ultrasound for several years and was just bowled over by how good the images from SonoSites M-Turbo system are compared to those from similar systems, explained Mr Brownlow. I routinely work at different hospital sites so it is important for me to have a light, truly portable system that is easy to carry round and is, at the same time, robust enough to withstand any knocks or bumps. With the M-Turbo system I can also export images onto USB which is really important for me. He added: My anaesthetist colleagues frequently borrow the system to guide nerve blocks and they are achieving excellent results.

Patients too are impressed with the images from the M-Turbo system. Mr Brownlow said: If you can show a patient exactly whats going on, it gives them a great deal of confi dence in my abilities and the diagnosis Im giving. It often saves on the need for MRI scans and is also great for guiding needles for injections.

For more information about SonoSite products, please contact:Sonosite, Alexander House, 40A Wilbury Way, Hitchin,Herts SG4 0APTel: +44 (0)1462 444 800Fax: +44 (0)1462 444 801Email: [email protected] Website: www.sonosite.com

Please quote ‘OTJ’

New Rigel fi eld service kit cuts medical device testing times

Service engineers can reduce the time taken to test the electrical safety and operation of a wide range of medical devices and equipment used in hospitals, operating theatres and other facilities using a fi eld service kit now available from Rigel Medical.

The comprehensive kit featuring the Rigel 288 is suitable for engineers requiring a fl exible, easy-to-use and accurate solution for testing devices for electrical safety to IEC 62353 or other appropriate standards and guidelines including IEC/EN60601-1, VDE 0751-1, AS/NZS 3551, AAMI, NFPA-99, MDA DB 9801- 2006.

A state-of-the-art Bluetooth barcode scanner enables devices and equipment to be quickly and easily identifi ed, while test results can be stored within the Rigel 288 safety analyser and printed wirelessly to the rugged battery operated Elite Test n Tag printer.

Traceability is improved as information can be downloaded into Med-eBase - the easy-to-use asset management software. This enables the user to store and manage test results, email html test certifi cates to clients and

A large internal memory facilitates the storage of test results for safety audit and traceability purposes. In addition, as well as storing the results of electrical tests, there is also the ability to record user defi ned inspections and measurements from other equipment such as SpO2, NIBP, ECG and other electro medical patient equipment.

The kit comes in a hard wearing, impact and water resistant Pelican carry case featuring dedicated foam inserts to safely hold the instrumentation in place and provide optimum protection during transportation.

Rigel 288 fi eld service kit forms part of a comprehensive range of high performance specialist biomedical test equipment supplied by Rigel Medical, part of the Seaward Group. More at Rigel Medical is based at Bracken Hill, South West Industrial Estate, Peterlee, County Durham, SR8 2SW.

For more information on the including pricing, contact Jan Rosen at [email protected] or call +44 191 5878701.

When responding to articles please quote ‘OTJ’

NHS medical device training goes online A ground-breaking project is being launched in the UK to create a National Health Service (NHS) e-learning platform for medical devices, including a library of both generic and detailed training.

The NHS Training Hub for Operative Technologies in Healthcare (THOTH) has secured almost half a million pounds over two years from the Department of Health to get the project off the ground and the fi rst online training is scheduled to go live in the Spring.

A number of device types will be selected initially, with the criteria focusing on those which are patient safety-critical, in extensive use throughout the NHS and technically complex. Eventually the categories will be extended and will cover all major devices, from defi brillators and infusion pumps to ECGs, diathermy equipment and pressure-relieving patient beds.

The aim is to ensure staff are trained in new or different medical devices and that

information is easily accessible through a secure NHS network, hosted by e-Learning for Healthcare. Generic information on the device category will be included as well as detailed guidance from the manufacturer and, where appropriate, supported with explanatory graphics or simulations.

The e-learning platform will link up with the electronic staff record and details of training undertaken will be lodged on individual records.

Tim Rubidge, THOTH operations director, said: “Given that a key aim for the NHS is to ensure that the workforce is trained to the highest standards, the medical device e-leaning platform will give easy, 24/7 access to a library of initial training on specifi c medical devices.

“All manufacturers have an interest in high-quality training on their equipment and this initiative provides an opportunity to enhance their partnership with the NHS.

“Staff will be able to call up new devices they are going to be working with and get a ‘look and feel’ for the equipment – how it works, how it’s controlled, specifi c safety features etc, before going on to the ward.

“It’s important to stress that the e-learning library will not be a substitute for hands-on training but will support it, giving staff a good, initial overview. We also have to bear in mind that pressures to keep staff on the wards can mean that current medical device training is patchy or incomplete. The e-learning platform will bring training to the staff.”

THOTH will be working closely with staff, particularly medical device trainers, manufacturers and the Royal colleges, to compile the e-library. It will set up a panel of experts to review specifi c information before it is launched on the site, and staff will be required to complete an assessment of their knowledge of a device as part of the online learning.

Source MTB Europe


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New production line tester for medical electronics Comprehensive 60601 testing

Electronic medical equipment manufacturers can take advantage of a new test unit from Clare Instruments, which improves the electrical safety and compliance testing of equipment in accordance with the 60601 set of standards.

SafeMedic enables manufacturers to undertake the electrical testing of a wide range of Class I and Class II powered medical equipment in their own test laboratory for either fi nal prototype type tests or during the development process.

SafeMedic can also be used by electrical safety laboratories and certifi cation bodies for the type test certifi cation of manufacturers’ fi nal products. It is also suitable for end-of-line safety testing during the manufacturing process.

The instrument features the latest digital technology, enabling complete traceability of results, and is suitable for applications in overseas production markets.

Two versions are available with one featuring a unique in-built defi brillation test capability.

This makes SafeMedic a benefi cial choice for a manufacturer requiring a single instrument that’s not only de-fi b approved but also capable of carrying out the full range of required tests. Both versions include a comprehensive suite of test functions enabling the user to safely complete type testing in accordance with the requirements of IEC 60601 - the international technical standard for the manufacture and testing of medical electrical equipment.

These include all the required leakage tests completed within the six standard tests, automatically switching through the applied parts test regime detailed within the standard.

SafeMedic includes connection for 12 x applied parts and also applies earth bonding to 40A, while AC/DC high potential (HIPOT) with ramping, insulation resistance and a load test are all easily programmable by the user.

SafeMedic can be operated remotely by a PC so that test programmes can be specifi cally

designed to meet individual customer requirements in bespoke testing cells thus providing fl exibility and maximum ease-of-use.

Available in a standard 480mm rack and case, the product is fl exible enough to be used as an easily transportable, stand alone unit or integrated as part of a wider application specifi c test station incorporating industrial PC and other equipment fi xtures.

Load testing can be carried out for 50 and 60 Hz units, power 0.1KVA to 4KVA, current 0.0A to 16A.

The test unit comes with an earth bond probe, applied parts/patient connection probe system, powerful software and a comprehensive, easy-to-follow user manual.

A barcode scanner, printer and a full range of EN 50191 peripherals are available as optional extras.

Clare Instruments, part of the Seaward Group, is a market leading supplier of electrical safety testing instrumentation and systems for manufacturers serving international markets. More at: www.clareinstruments.com

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Tristel’s ultrasound decontamination system meets need for speed, ease and reliability

Half of the respondents in a recent Tristel survey of ultrasound professionals indicated that they felt there was room for improvement in ultrasound equipment decontamination and disinfection protocols [1]. A frequently-cited requirement was for a quick, easy and reliable method.

The Tristel for Ultrasound range is designed exactly to meet those needs, and provides a variety of disinfectant formats all based on the company’s proprietary chlorine dioxide chemistry. The combination of products and packaging formats – wipes, foam, and liquid solutions - can be tailored to the specifi c disinfection needs of individual departments. The system is designed specifi cally for the decontamination of both non-invasive and invasive ultrasound equipment.

Duo for Ultrasound and Solo for Ultrasound can be used for cleaning and disinfection of all equipment, including skin surface transducers, probe holders, keyboards, monitor cases, control panels, cables and all ultrasound accessories.

For the disinfection of transoesophageal echo (TOE) probes, the Tristel Trio Wipes provide a controlled manual process. It provides full traceability and offers a decontamination process to the standards of endoscope disinfection within two minutes.

Stella 5 provides an immersion disinfection technique for transoesophageal echo (TOE) probes with the ability to record all steps of the disinfection process.

Audit trail data is downloadable by blue tooth or USB port. The portable unit both protects instruments from damage and prevents cross-contamination during transport.

For more details visit www.tristel.com [1] Questionnaire results on fi le at Tristel.

For further information contact Tristel Solutions Limited: Polly Oates, DirectorTristel Solutions LimitedLynx Business Park, Fordham Road, SnailwellCambridgeshire, UK CB8 7NYTel: +44 (0) 1638 721500 Fax: +44 (0) 1638 721911Email: [email protected] Website: www.tristel.com


Test spots contaminated equipment Scientists have perfected a highly sensitive test to detect vCJD-causing proteins on surgical instruments.

The test, which picks up the presence of prions on metal surfaces quickly and accurately, could help show whether decontamination processes are working.

Although there is no recorded case of a patient developing vCJD after surgery, experts say it is possible.

The test has been developed by the Medical Research Council Prion Unit at University College London.

Details are featured in Proceedings of the National Academy of Sciences.

As well as causing vCJD, prions are also responsible for a disease called kuru in humans, BSE in cattle and scrapie in sheep.

They are known to be able to survive conventional hospital sterilisation methods.

Professor John Collinge, director of the MRC Prion Unit, said: ‘’The presence of prions in blood and body tissues beyond the brain make many surgical and dental procedures a potential risk factor for transmission of prion diseases.

“Research has found that prions can withstand many sterilisation techniques, are very sticky and, when attached to a metal surface like a surgical instrument, are even more resistant to both chemical and heat treatments.’’

Better than animal tests The new test is much faster, and 100 times more sensitive than the existing test which involves injecting samples of suspect tissue into the brain of a mouse or hamster, and waiting for the animal to develop symptoms of disease.

It also makes it possible to test many samples at once at a relatively low cost.

The new test uses steel wires to enhance the sensitivity of a standard cell-based prion detection test called SCEPA (scrapie cell endpoint assay).

The prions present even in a very dilute sample bind tightly to the surface of the steel wires.

The wires are then covered with special cells that are very susceptible to prion infection.

After three days the prion-infected cells are harvested and prion concentration is measured using the standard cell-culture technique.

Professor Collinge said: “’That prions bind so readily to surgical steel is concerning but we have exploited this natural propensity of prions to develop a test that is so sensitive it can detect extremely low concentrations of prions in body tissues.’

“Finding a way to decontaminate delicate surgical tools to ensure they are free of prions is a public health priority.”

Professor Collinge said the test had helped scientists to assess the effectiveness of new methods being developed to ensure surgical instruments are free from prions.

Using it had proved that enzyme solutions developed at the MRC unit were very effective sterilisation agents.

Professor Chris Higgins, chairman of the Spongiform Encephalopathy Advisory Committee (SEAC), said: “This test is a much more sensitive, cheaper and practical alternative to using mouse bioassays to detect prions.”

He said the study would be considered at the next SEAC meeting.

Source: BBC

Scientists have overestimated the risks

from epidurals and spinal anaesthetics

The risks of severe complications linked with epidurals and spinal anaesthetics are “exaggerated”, according to a study.

The study, led by Dr Tim Cook of the Royal United Hospital, Bath, suggests that the procedures are safer than previously thought.

It showed that the risk of permanent harm linked with spinal anaesthetic or epidural was about one in 23,000 to one in 50,000.

Permanent injury in the study was defi ned as symptoms lasting more than six months.

The risk of being paralysed was two to three times less than of suffering any permanent harm.

Besides, the risk for women requiring pain relief for labour or Caesarean section was still lower, and the most pessimistic estimate of permanent harm was one in 80,000.

It was found, the risk of harm associated with epidural use during surgery was considerably higher than during childbirth, between one in 6,000 and one in 12,000.

However, even that was lower than previous estimates.

Cook said that the reason behind higher risk could be that many patients were elderly with medical problems, ‘and that the surgery itself increases risks,” reports The Independent.

The study was published in the British Journal of Anaesthesia. (ANI)


ENT specialist celebrate 130 years of quality Downs Surgical – the UK’s premier surgical instrument manufacturer and Ear Nose and Throat (ENT) specialists - are this year celebrating their 130th anniversary and their global reputation for quality, excellence and outstanding service.

Founded in 1879 by an instrument maker Milikin, Downs Surgical quickly established itself as a market leader and today operates in over 70 countries worldwide.

During this time they have developed new products, solutions and safer procedures that benefi t both patients and surgical staff throughout the world and today their comprehensive product range includes over 5,000 surgical instruments including Ear Nose and Throat (ENT) surgery, cardiovascular, obstetrics and gynaecology.

Priding themselves on staying at the forefront of innovation, Downs Surgical are much more than a supplier of high precision surgical instruments; they are a trusted and fully committed partner for the whole surgical process in hospitals around the world.

It is this wealth of experience and wide ranging knowledge base that has led to Downs Surgical instruments being respected by surgeons all over the world

and is the reason why much of the medical professionals ‘Insist on Downs’.

Speaking about Downs products Mr Ghassan Alusi PhD FRCS (ORL-HNS) from the Royal College of Surgeons of England, said: “Over the years I have worked closely with Downs and have found that not only are their products of the quality one would expect, but they are also committed, as a company, to product and surgical innovation as well as the development of genuine long term partnerships with the surgical profession to promote education, skill developments and clinical excellence.

This is a rare quality in the industry and I value the relationship we have built.”

Ensuring that surgeons have instruments they can rely on, Downs place much emphasis on the design of all of their products to ensure they not only meet, but exceed customers’ expectations.

From design, right through to product fi nishing and packing, the highest standards are adhered to and state-of-the-art equipment is used.

Steve Spurgin, International Business Manager at Downs Surgical, said:

“We listen to people’s requirements, understand their needs and endeavour to develop new and unique solutions that satisfy them at every level. Our focus is not what is possible technologically, but what makes sense medically.

After all, our key objective is to develop instruments that have positive outcomes on the course of a surgical procedure.”

For more information about Downs Surgical or their extensive product range of products please visit: www.downs-surgical.co.uk

When responding please quote ‘OTJ’


Point-of-care ultrasound compliments radiology servicesAn ever-increasing number of radiologists are looking closely at point-of-care ultrasound and at the considerable advantages it offers to compliment traditional radiology services. Used for certain applications and in certain situations, point-of-care scanning allows routine scanning to be carried out throughout the hospital by trained non-radiology staff, while freeing up time for sonographers to focus on specialist services.

Dr Simon Elliott, consultant radiologist and clinical lead in ultrasound at the Freeman Hospital in Newcastle, explained how his own radiology department is making use of hand-carried ultrasound systems: We have been using portable ultrasound since we evaluated the UKs fi rst SonoSite 180PLUS® point-of-care system in 1999. We were very happy with the versatility and image quality of that system for the vast majority of our portable workload and, since then, use of point-of-care ultrasound has dramatically expanded in the hospital. We have now used a full range of systems, simpler ones used on the wards for vascular access and abdominal scans, and some of the more sophisticated and up-to-date models, like SonoSites MicroMaxx® system, in specialist areas such as critical care and the transplant units. We recently reviewed the newest M-Turbo system; it has very good colour sensitivity and you really can just open it up and start scanning straight away. It was universally very well received.

We began by training consultants on the wards to conduct scans within their area of expertise, and this soon cascaded to a range of ward staff, creating a large skill base for basic scanning procedures, Dr Elliott added. There are governance rules and audit procedures in place to ensure that patients receive the best possible service, and new guidelines on the use of ultrasound will help to strengthen this process. Transferring routine work out of the radiology department is a rational use of resources, and releases sonographers and equipment for more specialised scanning. Sonographers can also often make use of the point-of-care systems on the wards for performing complex procedures, such as transplant Doppler or DVT scans, and this further eases the workload within the radiology department.

In recent years, the focus of point-of-care ultrasound has been moving away from radiology as a primary market, however, I believe this is now gradually changing. More radiologists are seeing a role for hand-carried systems in their patient care strategies. The instruments themselves are very robust, which is important in a hospital environment where reliability is crucial, and you can quickly move around the hospital, without having to wait for lifts or move patients. Most importantly, patients are getting a more effi cient service, and being able to provide almost instantaneous diagnosis at the bedside is an important way of streamlining hospital resources.

For more information about SonoSite products, please contact:Sonosite, Alexander House, 40A Wilbury Way, Hitchin SG4 0APTel +44 (0)1462 444 800, Fax+44 (0)1462 444 801Email: [email protected] Website www.sonosite.com

Dr Simon Elliott using a SonoSite M-Turbo system


Virtual Teaching Hospital System (VTHS) Project aims to

transform medical trainingA computer system which enables medical students to practise diagnosing and managing patients in simulations using real patient data is being developed in an interdepartmental collaborative project between Leicester Medical School and the Computer Science Department at the University of Leicester.

The software development, led by Professor Reiko Heckel in collaboration with Dr. John Barry Omara, will improve supervision of medical students during their clinical placements and provide feedback on their diagnoses and treatment choices through a web-based medical decision support system.

The way it is designed to work is that in simulated context, medical students will talk to patients and put the clinical symptoms signs and laboratory or radiological data into the system, which then makes suggestions as to possible diagnoses. As a Teaching-Learning support tool, the students then have to interpret these suggestions and give reasons for their conclusions.

It grew out of an idea from Dr John Omara, part-time lecturer at the School of Medicine, to improve health care in rural areas of Africa, and has evolved through a number of past and on-going projects by Computer Science students. In its present form as a training tool for medical students, it will not be used to treat hospital patients.

The Virtual Teaching Hospital System project, demonstrated to Her Majesty the Queen on her recent visit to the University, is carried out in cooperation with Dr Omara and in consultation with the Department of Medical and Social Care Education.

Those who met the Queen included the group of Computer Science students who won the BEA Systems Award for the best second year project, namely Mayur Bapodra, Jung-Ming Chong, John Pickering, and Dumisani Papaya, as well as postgraduate student Adwoa Donyina, who continued this work in her MSc project and is now doing her PhD at the Department.

Adwoa Donyina commented: The teaching system will assist medical students in rehearsing the problem solving process and help decide what patient information is needed to determine a possible diagnosis and management, while combing the knowledge of the patients history. This expert system will provide guidance and direction with the evolving notion of what might support or refute the diagnosis.

Professor Heckel added: This is an on-going series of group projects for second-year Computer Science students. Five groups of 6-8 students each work on the project for one term. We are about to begin another round of group projects this winter to extend and improve the system and we will carry on offering it as an option to our students as long as there is a signifi cant amount of work to do on it.

All the groups work on the same project and at the end of the term we choose the best solution. That way, there is a good chance of getting results of a high quality.

Dr. John Omara said: The project, when implemented, will make it easier to explain and teach the complex process involved in making clinical diagnosis (The Clinical Thinking Process).

Dr Jonathan Hales, Department of Medical and Social Care Education, added: The value of the system lies in the way the VTHS can be used by medical students to explore what if scenarios i.e. what if this same patient presented with the same symptoms and signs but also with a temperature (or, but without the abdominal pain)? . The value of the system does not therefore lie solely in its ability to come up with useful differential diagnoses, but in its educational capacity, when used by a thoughtful, questioning, exploratory student.


Allen Shoulder Access System from Melyd Medical

Melyd Medical, specialists in Operating Theatre patient positioning, are pleased to announce the launch of the Allen Shoulder Access System, the smallest and most lightweight arm positioner on the market – for any shoulder procedure in the Beach Chair position. It attaches over the drape and provides effortless positioning of the arm intra-operatively - at a fraction of the price of other devices. Additionally, the disposable is more intuitive and competitively priced.

The Allen Shoulder Access System delivers nearly effortless arm positioning for shoulder surgery in the Beach Chair position. By pivoting at the elbow, the device is able to gain complete positioning control of the shoulder joint. The revolutionary patent-pending design allows the entire device to be steam sterilized, and provides an unprecedented level of access to the surgical site. The device also has the capability

state, allowing the surgeon tosimply move the arm without having to adjust the tension, making it ideal for Capsular release, Rotator cuff, SLAPLesion and Bankart repairs.

For more information or free product trial please callMelyd Medical on 01244 660 954 or visit www.allenmedical.com When responding please quote ‘OTJ’

Will They Respect My Body After I Am Dead?

NHSBT online survey reveals current barriers to registration on the NHS Organ Donor Register

Concern about the level of respect given to a deceased persons body and whether doctors would make every possible effort to help a patient if they were identifi ed as a potential organ donor top the list of reasons given for not joining the NHS Organ Donor Register (ODR). These are among the fi ndings of an online survey conducted through NHS Blood and Transplants (NHSBT) websites.

Over 5,000 people responded to the survey, with 90% supporting organ donation and transplantation. Of those who said they were undecided or against joining the ODR, more than half said they were worried about how their body would be treated after death.

Dr Paul Murphy, an Intensive Care Consultant in Leeds and NHSBT’s National Clinical Lead for Organ Donation, said: This survey shows that there may be questions playing on peoples minds to which they need answers and reassurance.

I cannot tell you just how much respect and honour my staff have for patients who donate organs after their death. Donors, and their families, are very special to us, and we do everything that we can to maintain an individuals dignity throughout - why would we do any less when you consider the tremendous gift that they are making?

As a society, we need to discuss issues about death and donation more openly. It is only through public debate that we can resolve some of these concerns and give people the confi dence to join the Organ Donor Register.

The survey also found that: - More than half (against or undecided) want more information about what happens to the body after death. - Half want more reassurance that doctors will give best possible care/every effort to save the lives of donors. - 60% of those undecided/against organ donation are unsure (rather than against) about registering. - The most common reason for not wanting to register is to avoid thinking about dying. - Amongst those undecided or against, more than 50% are unsure whether doctors give donors the same level of care, or believe they do not.

Dr Murphy added: As an intensive care doctor, I can give the public my absolute assurance that we always have - and we always will - do everything we can to save the lives of our patients, and that we have particular safeguards in place to ensure that staff who may be subsequently involved in transplantation have no involvement in the care of a patient who might become a donor when they die. Donation only becomes an option that we consider when death is inevitable, but it does need to become accepted as a normal part of end of life care if life is to go on for others when people die.

More than a quarter - 26% of the UK population - have joined the NHS ODR pledging their organs for transplant after their death, but the number waiting for the call telling them that a life-saving organ has been found for them has risen to almost 8,000 and continues to steadily increase.

Around 3,000 organ transplants take place in this country every year, but during the same period approximately 1,000 people - 3 a day - die while waiting because of the shortage of donated organs.

Joining the Register is easy, call the Organ Donor Line on 0845 60 60 400, go online www.organdonation.nhs.uk or text GIVE to 84118. Alternatively, write to NHSBT, Fox Den Road, Stoke Gifford, Bristol, BS34 8RR

Chronic Use of Metoclopramide Linked to Tardive Dyskinesia

The FDA is requiring manufacturers of metoclopramide to add a boxed warning to their drug labels about the risk of tardive dyskinesia from its long-term or high-dose use.

More at www.docguide.com


Use of suction in arthroscopic knee washoutA.Ardolino, T.B.Crook, J.T.K.Melton, Department of Orthopaedics and Trauma, Poole Hospital, Dorset.

Background

Arthroscopic knee washout is a common procedure employed to help clear infection either in the native joint or following arthroplasty. Common practice involves the use of two ports, one to introduce fl uid into the knee and the other to allow free fl uid drainage from the knee.

This can be time consuming, may not ensure adequate removal of debris and can potentially contaminate the operating theatre. We describe a technique of knee washout aimed at avoiding these problems.

Technique

The patient is prepared in the usual way, supine with a tourniquet, prepped and draped. An antero-lateral portal is established in standard fasion, the blunt trocar is removed and the saline tubing is connected (Figure 1).

A second portal is established in the antero-medial position. A Yankauer sucker is inserted into this outfl ow port and is attached to suction (Fig 2). The saline is then run through into the joint and out through the suction tubing. Gentle massage of the popliteal fossa, the medial and lateral gutters and supra-patella pouch may also help ensure thorough irrigation of the joint.

Discussion

Replacing the outfl ow port with a Yankauer sucker on suction creates a closed circuit resulting in less mess and contamination of the operating theatre. It also allows for removal of infected fi binous debris and blood clots which may otherwise remain within the joint.

It is quicker than free drainage which has benefi ts for unwell patients.

Correspondence to: A.Ardolino Department of Orthopaedics and Trauma, Poole Hospital NHS Foundation Trust, Dorset. [email protected]

Figure 1:Knee set up ready for washout with fi rst port in situ

Figure 2:Yankauer sucker inserted into second port

Weight-loss stomach surgery on obese people increases 40 per cent in a year

The amount of bariatric surgery the NHS carries out on obese people to help them lose weight increased 40 per cent in 2007/08, according to a report from The NHS Information Centre recently.

Overall hospital admissions for obesity also increased, reaching 5,018 in 2007/08, a 30 per cent increase on 2006/07 and almost a seven-fold increase on 1996/97.

In 2007/08, people with a primary diagnosis of obesity had 2,724 hospital episodes involving bariatric surgery (a range of procedures carried out on the stomach which can help weight-loss and which include stomach stapling, gastric bypasses and sleeve gastrectomy). This was 40 per cent up on 2006/07 when 1,951 such episodes involving people with a primary diagnosis of obesity took place. The number of episodes is of course small in the context of the proportion of obese people in the population.

The number of NHS prescription items dispensed to treat obesity increased to 1.23 million in 2007 a rise of 16 per cent from 2006.

The two drugs most commonly prescribed for weight-loss purposes in the NHS are Sibutramine and Orlistat. Sibutramine alters chemical messages to the brain that control feelings and thoughts about food, while the other, Orlistat, prevents some fat absorption in the intestine.

Statistics on obesity, physical activity and diet: England, February 2009 highlights the prevalence of obesity among adults and children and the demands this is placing on NHS services. The report also charts changing patterns of physical activity and diet.

The report also shows that in England in 2007:

• 24 per cent of adults were classed as obese BMI of 30 kg/m² or over.

• Men and women were equally likely to be obese, with the percentage of women classed as obese increasing from 16 per cent in 1993 and of men from 13 per cent in 1993.

• 17 per cent of boys and 16 per cent of girls aged two to 15 were classed as obese, increasing from 11 per cent and 12 per cent respectively in 1995.

Chief executive of The NHS Information Centre Tim Straughan said: The report highlights the scale of the countrys obesity problem and shows increasing NHS treatment using weight-loss surgery and medications.

Obesity can pose major health risks by potentially increasing the likelihood of such diseases as diabetes, high blood pressure, heart disease, strokes, and a range of other, often life-threatening, conditions.

The report shows that since 1997 a greater proportion of adults are meeting Government guidelines for the amount of physical activity they should be doing to stay healthy and since 2001 a greater proportion of both adults and children are eating fi ve portions of fruit and vegetables a day.

Obesity increases the risk of health problems for many millions of people and our report shows measures such as weight-loss surgery and medication are being used increasingly.

The report is at: www.ic.nhs.uk/pubs/opad08

Hospitals adopt ‘aircrew checks’

Safety checks styled on those carried out by aircrews before take-off have been rolled out at NHS Highland hospital theatres.

Called the surgical pause, it is a fi nal checklist that nurses and doctors make before performing an operation to reduce any risk of error.

Questions include: is this the right patient?

NHS Highland said the checks had proved successful and were similar to those used by other health boards.

The checklist is used by theatre staff at Caithness General in Wick, Raigmore Hospital in Inverness, Lorn and Isles in Oban and Belford Hospital in Fort William.

Other key questions asked include: are we going to operate on the right part of the body, are we doing the right procedure, are we aware of allergies, do we need blood and is it available?

While safety checks have always been made, health chiefs said the surgical pause provided one that was rigid and uniform.

Raigmore theatre manager Gavin Hookway said he was impressed with how staff had taken up the challenge of introducing the system.

He said: “It might sound simple but of course it takes time to perfect a system and it can’t be rolled out until we know that it is working to the patients’ advantage.

“We’re now at the stage where it has been introduced into all nine of our main operating theatres and it’s being used for every patient, every time.

“It only takes a minute to do the checks and it gives us confi dence that we are increasing the safety of our surgery.”

Source: BBC


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Fukuda Denshi exhibits expanding range of IC monitors at ISICEM in Brussels

Fukuda Denshi is a leading supplier of advanced patient monitoring and user-confi gurable clinical information management systems. The company plans to showcase a comprehensive range of its highly acclaimed patient bedside and central station monitors at the forthcoming 29th ISICEM symposium, which is held in the Brussels Convention Centre from 24th – 27th March 2009.

Among the products on display is the DS7600W wide-screen central station monitor which features a 19” colour multifunctional LCD to display waveforms and measurement for up to 16 patients. These monitors effectively review the vital signs parameters to reduce the burden on nursing staff in locations as varied as the ICU through to the general wards.

Demonstrations will also be shown on the Metavision Suite Clinical Information System. Designed for the ICU, it is a fully customisable MVICUTM.

This features a clinical fl ow sheet plus drug, fl uid and task management activities, along with diagnosis tools and confi gurable printed reports.

Also displayed will be the high performance DS-7300 system with its facility to monitor 12 lead ECG, IBP, NIBP, CO2, Temp, Resp, SpO2, Pulse and EtCO2. In addition, the latest member of the bedside monitor range, the DS 7200 series, will be on display, featuring hardwire and telemetry connectivity. These monitors are designed for ICU/HDU, cardiology and A&E departments.

Completing the line up will be the popular DS-7100 series of compact powerful monitors with multi-parameter facility and an 8.4” high resolution colour LCD, which can display up to six waveforms and all measured values. The Fukuda Denshi sales and technical teams will be available to give delegates a warm welcome and provide all the information they might require.

Fukuda Denshi: Healthcare bound by technology.When responding please quote ‘OTJ’

Hopkins Surgeons Remove Donor Kidney Through Vagina

Surgeons at Johns Hopkins University have removed a kidney from a donor for transplant. The vaginal removal of the kidney was performed using a minimally invasive procedure that surgeons say may increase the willingness of others to donate their kidney.

Robert Montgomery, M.D., Ph.D., chief of the transplant division at Johns Hopkins University School of Medicine led the kidney transplant team in performing one of the fi rst surgeries ever to remove a kidney by way of the vagina.

The kidney from the donor was removed through a small incision in the back of the vagina from a 48-year-old female, on January 29.

The procedure, called a transvaginal kidney extraction, has been performed in the past to remove damaged and diseased kidneys, but never for kidney transplant, and never on a healthy kidney. The operation performed by the Hopkins transplant team eliminated the usual abdominal incision required for kidney donors.

Dr. Montgomery says, “Since the fi rst laparoscopic donor nephrectomy [kidney removal] was performed at Johns Hopkins in 1995, surgeons have been troubled by the need to make a relatively large incision in the patient’s abdomen after completing the nephrectomy to extract the donor kidney. That incision is thought to signifi cantly add to the patient’s pain, hospitalization and convalescence. Removing the kidney through a natural opening should hasten the patient’s recovery and provide a better cosmetic result.”

The donor has a small incision hidden in her naval, a lot less pain, and a shorter recovery time. Dr. Montgomery believes the success using vaginal removal of a kidney for transplant might increase the willingness of others to donate a kidney.

A traditional procedure, known as laparoscopy, guided the vaginal kidney removal. The operation took approximately three and a half hours, just as a traditional laparoscopy.

The new type of procedures are called NOTES (natural orifi ce translumenal endoscopic surgeries), designed to used natural body orifi ces to remove organs and tissues. The most common body openings used are the mouth, anus and vagina, as was the case of the vaginal kidney donation. You may remember the news of physicians who removed an appendix through the mouth.

Minimally invasive surgeries are good news in terms of recovery. However, some surgeons believe more studies are needed to compare NOTES to traditional surgeries.

Anthony Kalloo, M.D., the director of the Division of Gastroenterology at Johns Hopkins University School of Medicine and the pioneer of NOTES, supports those studies. He says, “Natural orifi ce translumenal endoscopic surgery is the fi nal frontier to explore in making surgery scarless, less painful and for obese patients, much safer. An organ donor, in particular, is most deserving of a scar-free, minimally invasive and pain-free procedure.”

The groundbreaking vaginal removal of the donor’s kidney has been a success. Dr. Montgomery reports, “The kidney was successfully removed and transplanted into the donor’s niece, and both patients are doing fi ne.” Source: EMAX


Updated The Electrode Company Website reveals how to improve patient outcomesThe Electrode Company Ltd (TEC) specialises in non-invasive monitoring, optical sensors and high performance pulse oximetry. A new website (www.electro.co.uk) incorporating a DVD on a breakthrough technology (Subtilis), reveals that developments in oxygen monitoring can lead to enhanced patient outcomes.

On the website, the site index on Subtilis shows how it can improve O� therapy while reducing bed occupancy. Subtilis creates personalised calibration data for each patient episode, this making it independent of both sensor and patient variability.

The key benefi ts of this technology include:• Reducing false oxygen alarms by up to 51%• Improving patient outcomes in up to 87% of cases• Reducing late interventions in up to 23% of cases• Reducing unnecessary interventions by up to 64%

All of the above will help facilitate healthcare effi ciencies leading to potential cost savings.

Visitors to TEC website, www.electro.co.uk, will also see the results of a 36 hospital research survey, involving 1008 pulse oximeter sensors from a variety of sources. Key fi ndings were:

• 14% of sensors surveyed had no error, leaving 86% with errors of some sort.• 13% of the sensors had circuit or optical faults, while 17% had unacceptable wavelength

errors.

The authors of the clinical paper on this survey conclude that “if the accuracy of the sensor is unknown, then every clinical decision made on the basis of this data, is without foundation.”

The Electrode Company’s Lightman® self calibrating microspectrometer was used in this trial. For more information on these ground breaking developments, please telephone TEC on 01291 650279.

The Electrode Company: Ensuring accurate data for better clinical outcomes. Please quote ‘OTJ’

New guidance following laxative errors in NHS

Healthcare organisations are being urged to review their current practice for the administration and use of prescribed laxatives prior to bowel surgery or examination.

The guidance is from the National Patient Safety Agency (NPSA) and has been issued to all NHS and independent healthcare organisations in England and Wales.

It comes after the NPSA received reports of 218 patient safety incidents and one death, between 27 November 2003 and 6 January 2009 involving oral bowel cleansing solutions. Of the 218 patient safety incidents over 90% resulted in low or no harm, with less than 10% causing moderate or severe harm.

Examples of incidents reported to the NPSA include:• A patient being inappropriately prescribed a bowel

cleansing solution despite having a known bowel condition (ileostomy).

• A patient being under-prescribed a laxative drug prior to a colonoscopy, resulting in inadequate bowel preparation and the patients surgery appointment having to be rebooked.

• A patient not being supplied with clear instructions on how to take their prescribed bowel cleansing drug at home, resulting in dehydration.

• A patient, who had received bowel preparation in hospital, being given insuffi cient fl uids by staff, despite having major bowel surgery planned.

Dr Linda Matthew, Senior Pharmacist at the NPSA said: The NPSA is advising all healthcare professionals to review their current practice to ensure that there is clarity over staff responsibilities in relation to the use of these bowel cleansing solutions. Of particular importance is the provision of information and explanation to patients about their use.

Although over 90% of the incidents reported to us resulted in low or no harm, elderly patients and children are potentially at greater risk than adults if these medicines are not used correctly.

Our guidance therefore applies to all healthcare settings where bowel cleansing solutions are prescribed or administered. We hope that these recommendations will improve the safety of these medicines and help to prevent avoidable harm to patients.

Hospital drug reactions ‘common’ One in seven hospital patients experience adverse drug reactions, half of which are completely avoidable, a study found.

The Liverpool University-led research followed more than 3,000 patients over a six-month period. The study found complications ranging from constipation to internal bleeding - and in a few cases death. The researchers said UK hospitals had to improve their monitoring and prescription practices. Doctors agreed it was a major problem and said improvements had to be made.

There has been widespread research into adverse drug reactions in the community, but this is the fi rst time there has been a study of this size into hospital-based problems. The team looked at patients in 12 hospital wards in Merseyside, but said the fi ndings would be common across the rest of the UK.

Researchers said the drugs most commonly associated with the adverse reactions were anticoagulants, analgesics and diuretics. They reported that a reaction increased the length of stay in hospital by a quarter of a day on average, with elderly patients on a number of different medications being the most susceptible.

The study, carried out for PLos One, the journal of the Public Library of Science, also found that a small number of deaths could be linked to the adverse reactions. In 14 cases, the reactions had contributed to a death and in one case it had directly caused it.

Solution In just under a fi fth of cases, the course of drugs was started outside the hospital, although the adverse reaction, monitoring and continued prescription all happened on the ward. The fi ndings are broadly similar to what has been reported elsewhere in the world, but the team still said the NHS could improve its performance.

Lead researcher Professor Munir Pirmohamed said: “There is no easy solution, but we can and have to do better as it is putting a burden on the NHS. “Hospitals should look to improve their monitoring of patients and doctors should also consider in what situations patients are given drugs, how long they are put on them and consider if it is always necessary.”

Jonathan Fielden, chairman of the British Medical Association’s consultants committee, said it was an international problem that needed addressing. “It is vital that doctors and patients understand the need to regularly review prescriptions and personally tailor treatment to clinical need.”

And Dr Rodney Burnham, of the Royal College of Physicians, added medical schools and doctor training needed to make safer prescribing more of a priority.

Joyce Robins, of Patient Concern, said the fi ndings did not surprise her. “We get a lot of complaints from patients about the lack of checks and procedures regarding drugs in hospital. “Patients say they are not asked about allergies or what medication they are already on. They also say medication comes at all the wrong times. It is something that needs to be tackled.”

Source: BBC


AnaestheticsOperating TheatresOrthopaedicPhlebotomy ServicesRecoverySterile ServicesScrub Nurses

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Eastwood Park develops a new double award in Infection Prevention and Control

Eastwood Park is developing a new double award in its Infection Prevention and Control training portfolio to increase the scope of the training currently available in this crucial area. Following the new Level 2 Award in Prevention and Control of Infection, which was launched by City and Guilds last September, Eastwood Park will be offering the same award in conjunction with their Prevention in the Sluice room course, enabling students to gain a double City & Guilds award.

Angela Palmer, Eastwood Park’s new NVQ Manager said: “We have looked in depth at the two qualifi cations and the criteria for the two courses and we have mapped out a single course which will bring double the benefi ts to our students. The course will focus on the principles of operating safely to prevent infection within this volatile Sluice room environment with particular emphasis on current issues such as C.Diffi cile and MRSA etc.”

The well-established training centre at Falfi eld, which boasts technical training facilities that are second to none in the country, has replicated a sluice room training environment, complete with the relevant equipment for the facilitation of the practical aspects of the course. This enables nursing staff, healthcare workers and those involved in social care to deal with the practical aspects of clinical waste and bodily fl uids.

For further information about dates when the course will become available please contact Eastwood Park on 01454 262777 or [email protected]

When responding please quote ‘OTJ’

Technology the next front in battle against healthcare associated infections The fi ght against Healthcare Associated Infections must continue on all fronts Health Minister, Ann Keen told NHS staff on the 25th February as she toured an exhibition showcasing that latest high tech products designed to beat infections such as MRSA and C.diffi cile

In her keynote speech at an International Healthcare Associated Infections (HCAIs) Technology Summit, organised by the NHS Purchasing and Supply Agency Ann Keen praised the hard work of NHS staff in more then halving MRSA infections, and reducing C.diffi cile rates by over 30% but told delegates that the battle against Healthcare Associated Infections goes on.

Prior to speaking at the event the Minister toured an exhibition showcasing the latest in leading edge products which will form the next front in the battle to beat healthcare associated infections.

Health Minister Ann Keen said: “Tackling infections is a key priority and the NHS has made great progress tackling both MRSA and C.diffi cile but there is still a need to battle infections on every front.

“The amazing innovations such as those on display today will be vital if we are to win the battle against infections such as MRSA and C.diffi cile. As a former nurse myself, I’m especially pleased that the ideas behind many of them came from NHS staff working on the frontline.”

Amongst the innovations on display, the Health Minister saw a revolutionary new temporary isolation room which is on display for the fi rst time. It can be used to rapidly isolate patients who have contracted an infectious condition to prevent further spread. It features a host of new technology including an infection resistant commode, portable hand washing station, and an ‘air door’. These elements have been designed in a modular way to ensure that they can be used in a variety of settings.

The innovations were developed as part of the HCAI Technology Innovation Programme which aims to speed up the development and adoption of new and novel medical devices and/or cleaning related technologies in the health service to further help combat HCAIs.

In autumn 2007 a series of workshops were held with NHS staff to fi nd out what they needed in the form of technology to help combat infection. This process generated over 150 ideas, the best of which are now being developed and are on display at the summit.


You Saw It In:

Available in Print and via the “World Wide Web”

S-Nerve ultrasound tool offers multiple advantages for regional anaesthesia

Anaesthetists at the Plastic and Hand Surgery Day Unit of Leeds General Infi rmary have chosen the excellent image quality and user friendly operation of SonoSites S-Nerve point-of-care ultrasound tool to help them in ultrasound needle guidance for administration of regional nerve blocks.

Dr Frank Loughnane, a consultant anaesthetist, explained: Since purchasing from SonoSite, we have graduated to an ultrasound-based practice. Ultrasound is much faster for block placement, which is important with busy trauma and elective lists, and makes a pronounced difference in terms of patient comfort. We are also able to reduce the volume of local anaesthetic by 30 to 50 % for some patients, and safety is probably improved in a number of areas, particularly for supraclavicular blocks where there is a well-recognised risk of pneumothorax.

The S-Nerve is ideal for our needs. The image quality is signifi cantly better than systems we have worked with previously, and there is no delay between patients for adjusting the system or interpreting images. We are a teaching hospital and for training purposes it is very simple to use. SonoSite also offers a fi ve year guarantee which, in terms of maintenance and ongoing costs, was an important factor in determining allocation of scarce resources. Overall we are very happy with the system. It ideally suits our regional anaesthesia practice.

About SonoSite SonoSite, Inc. (www.sonosite.com) is the innovator and world leader in hand-carried ultrasound. Headquartered near Seattle, Washington, USA, the company is represented by ten subsidiaries and a global distribution network in over 100 countries. SonoSite’s small, lightweight systems are expanding the use of ultrasound across the clinical spectrum by cost-effectively bringing high performance ultrasound to the point of patient care. The company employs over 600 people worldwide.

SonoSite, Ltd., a wholly owned subsidiary of SonoSite, Inc. based in Hitchin, Hertfordshire, oversees a direct sales distribution network in the UK and provides sales and marketing support for SonoSite’s European offi ces.

For more information about SonoSite products, please contact:Alexander House, 40A Wilbury Way, Hitchin SG4 0APT +44 (0)1462 444 800, F +44 (0)1462 444 801Email: [email protected] Website www.sonosite.com

Lack Of Knowledge And Confi dence In Basic First Aid

Could Be A National Epidemic!Imagine you are one of the 250,000 people who are involved in road traffi c collisions every year. You are unconscious and not breathing. There is a very strong chance that no-one around will have the basic skills required to provide emergency fi rst aid - potentially putting many lives at risk - according to new research released today.

A national survey of 1,855 people commissioned by DK and the UKs leading First Aid Providers St John Ambulance, St Andrews Ambulance Association and British Red Cross to mark national First Aid Awareness Week (2nd -9th February) showed that 77% of people either don’t know how to administer cardio-pulmonary resuscitation (CPR) or they are unsure of how to do it.

Fewer than 1 in 4 people are able to say defi nitively that they are confi dent about CPR and only 7% of young people (16-24) would be confi dent enough to perform CPR.

Other key fi ndings are:

Millions of people lack the knowledge to undertake basic First Aid procedures. Most people consider themselves incapable of performing the simplest of techniques or treating minor household injuries. The majority don’t know the correct practice for treating a nosebleed (59%) or someone who has fainted (57%). This is particularly worrying in light of the fact that almost 4,000 people in the UK die in accidents in the home every year*.

1 in 3 people wouldn’t know what to do if their toddler was choking The survey highlighted some of the most important fi rst aid procedures that everyone should know and revealed an alarming lack of knowledge of even the most common scenarios. One in three people dont know how to respond to a toddler who is choking, and one in four would be of no use to a person suffering an asthma attack.

Men are more confi dent about putting their knowledge and skills to use 30% of men would feel suffi ciently confi dent to resuscitate a casualty, compared to just 20% of women. Watching TV programmes such as Casualty and ER can boost fi rst aid confi dence; nearly one in fi ve people (18%) said that they might be confi dent enough to resuscitate a casualty as they’d seen it performed on television!

More than 2 in 5 people don’t know that there are two emergency phone numbers The survey also asked if people know that there is another telephone number for emergency services, apart from 999; 43% of people in the UK didn’t know that they can also dial 112.

Majority of UK residents don’t own a fi rst aid manual despite the fact that the majority of people (57%) don’t own a fi rst aid manual, seven out of ten people claim that they would feel more confi dent in treating a number of conditions if they could refer to a fi rst aid manual.

Now in its 9th edition DK’s First Aid Manual is still the only guide to be written and fully authorised by the UKs leading fi rst aid providers St John Ambulance, St Andrews Ambulance Association and the British Red Cross.

[*According to a recent survey by RoSPA, every year in the UK almost 4,000 people die in accidents in the home and 2.7 million turn up at accident and emergency departments seeking treatment.] When responding please quote ‘OTJ’


DOCTOR SURGEON NURSE ANAESTHETIST ODP GP PARAMEDIC RADIOGRAPHER BIOMEDICAL SCIENTIST DENTAL NURSE DENTIST

SURGEON DOCTOR NURSE ANAESTHETIST PARAMEDIC ODP GP RADIOGRAPHER BIOMEDICAL SCIENTIST DENTIST DENTAL NURSE

DOCTOR ANAESTHETIST NURSE SURGEON ODP PARAMEDIC GP

RADIOGRAPHER BIOMEDICAL SCIENTIST DENTIST DENTAL NURSE DOCTOR SURGEON NURSE ANAESTHETIST ODP GP PARAMEDIC RADIOGRAPHER BIOMEDICAL SCIENTIST DENTAL NURSE DENTIST

NURSE DOCTOR SURGEON ANAESTHETIST GP PARAMEDIC ODP

RADIOGRAPHER BIOMEDICAL SCIENTIST DENTIST DENTAL NURSE ODP GP SURGEON NURSE ANAESTHETIST DOCTOR PARAMEDIC BIOMEDICAL SCIENTIST RADIOGRAPHER DENTIST DENTAL NURSEDOCTOR NURSE SURGEON ANAESTHETIST ODP GP PARAMEDIC

DENTAL NURSE BIOMEDICAL SCIENTIST RADIOGRAPHER DENTIST DOCTOR ANAESTHETIST NURSE SURGEON ODP PARAMEDIC GP

RADIOGRAPHER BIOMEDICAL SCIENTIST DENTIST DENTAL NURSE DOCTOR SURGEON NURSE ANAESTHETIST ODP GP PARAMEDIC RADIOGRAPHER BIOMEDICAL SCIENTIST DENTAL NURSE DENTIST

DOCTOR NURSE SURGEON ANAESTHETIST PARAMEDIC ODP GP RADIOGRAPHER BIOMEDICAL SCIENTIST DENTAL NURSE DENTIST DOCTOR ANAESTHETIST NURSE SURGEON ODP PARAMEDIC GP

DENTIST RADIOGRAPHER BIOMEDICAL SCIENTIST DENTAL NURSE

We are currently recruiting Medical Professionals to work on a part time basis with the Royal Air Force

Reserves throughout the United Kingdom.

If you would like to attend one of our Presentation Days or require further information contact our

Recruiting Team at:

Telephone: 01334 839471 Ext 7974 E-mail: [email protected]

www.raf.mod.uk.rafreserves

Make your move to New Zealand!Make your move to New Zealand!Based in the City of Sails, Auckland District Health Board (ADHB) is one of the leading public healthcare providers within New Zealand. We’re currently looking for Registered Nurses and Anaesthetic Technicians (ODP/A) to join our teams.

We have over 32 theatres (adult and paediatrics) covering neurosurgery, cardiothoracic, transplants, vascular, general, urology, orthopaedics, ORL (including major head and neck surgery), obstetrics and gynaecology. We are looking for skilled and enthusiastic Registered Nurses and Anaesthetic Technicians (ODP/A) looking to relocate to our beautiful country. We have a number of vacancies available, offering varied hours of work in our state of the art facilities based in the centre of our biggest and busiest city.

Auckland City Hospital is a major teaching hospital, offering a supportive environment for education and learning. Come and join us in working towards our vision: Healthy Communities, Quality Healthcare.

We are able to provide assistance with relocation expenses.

For more information, please contact:Nurses: Michelle Luoni, [email protected] or call +64 9 638 0364. Ref 021182Anaesthetic Technicians: Todd Clay, [email protected] or call +64 9 623 6441.

Ref 018361

or apply at www.adhb.govt.nz/careers.

fi nd out more 020 7100 2867 • e-mail [email protected] Issue 222 MARCH/APRIL 2009 15

Seeking ex Royal Army Medical Corps Operating Theatre Technicians (OTT)

Operating Department Assistants (ODA)Operating Department Practitioners (ODP)

Come and join OTT Reunited forNewsletters and Reunions, over 135 members worldwide.

Contact Ken Hannah at [email protected]

or telephone 01733 453462 for details

Documents

The Operating Theatre Journal