To the Editor
I read with interest the article in the recent APSF Newsletter titled ‘New Standards Focus on Piped Medical Gas Systems.’ While it is generally true that the medical gas distribution system ‘…typically does not receive as much attention’ from the anesthesiologist, I would like to point out a common scenario.
I have been a practicing anesthesiologist for 17 years. For most of my professional life, I was unable to easily move my anesthesia machine to accommodate the varied surgical procedures performed in each operating room. Cords or hoses jammed under the castered wheels of the anesthesia machine often immobilized my machine. Occasionally this caused .seconds of terror” when I couldn’t … quite reach my patient.
More than once I have manhandled the machine over oxygen hoses or electrical cords in order to connect a breathing circuit to an apneic patient. It is possible to damage a high pressure gas hose or an electrical cable in this manner and create a fire or environmental hazard in the operating room, as well as to jeopardize oxygen and/or anesthetic delivery to the patient.(1)
Ceiling mounted towers and suspension mechanisms require major physical and financial investments. Tying the cords behind the anesthesia machine limits our ability to follow a patient on his or her way to the surgeon. Neither the anesthesia machine nor the caster manufacturers have a satisfactory solution to this problem. I have designed, patented and am using my own solution which I believe would be of interest to you and to the readership of the APSF Newsletter.
The obstacle clearing device that I have developed rests upon the floor, is assembled around an existing wheel but is not attached to it and serves no weight-bearing function. It moves with the caster and pushes ahead of it the items which an unprotected wheel would otherwise come in contact with. It contributes significantly to the safety of our patients and our co-workers by minimizing the damage inflicted by the casters of anesthesia machines upon ground-based electrical cords and high-pressure gas hoses.(2)
Mr. Nagle’s article in your newsletter points out the need for anesthesiologists to become involved in assuring a properly operating piped medical gas distribution system. The JCAHUs booklet ‘Using the 1994 Joint Commission Accreditation Manual for Hospitals’ for Chiefs of Anesthesia stresses that ‘Anesthesia’s extensive use of gases, monitors and other technologies makes equipment management especially relevant.’ I feel that this obstacle clearing device allows an anesthesia department to more closely comply with the National Fire Protection Agency’s requirements (3) and serves as evidence of positive involvement in a continuous quality improvement process.
John J. Navar, M.D. Corpus Christi, TX
References
- Anderson, WR and Brock-Utne, JG: Oxygen pipeline supply failure: a coping strategy, FFA(SA). J. Clin Monit 1991;7(l):3941.
- Lacoumenta, S and Hall, GM: A burst oxygen pipeline (letter). ‘Anaesthesia’ Jun 19830:596-597.
- National Fire Protection Agency. National Electrical Code 70-10 (110-17); 70-57 (3004); 70E-31(chapt 3,F(l).