HEALTH & SAFETY
A Burning Need For Better Training
Richard Radford, Managing Director of medical gas control specialist BPR Medical, explains the urgent need for improved training and education around the risk of medical oxygen fires.
Last November, an inquest heard how terminally-ill patient Sharon Reid ‘blew herself up’ when she lit a cigarette while breathing oxygen from a cylinder at a hospice in Somerset.
The inquest heard that life-long smoker Sharon – who died in the accident - knew about the danger of smoking while using oxygen therapy. However, she was taken to the ‘smoking room’ by a care assistant who was unaware of the risk and no warning signs had been posted at the entrance to the room.
stop the flow of oxygen in the event of a fire - may not be fitted. Firebreaks are now a standard requirement in all oxygen installations (concentrators, cylinders and liquid oxygen) and are vital in preventing fire from spreading and limiting patients’ injuries. Untrained staff have even been known to remove firebreaks from tubing, or to cut tubing to insert a firebreak, both of which pose a serious risk to the patient.
Unfortunately, this is not an isolated incident. Although the Department of Health does not publish data on the number of fires involving medical oxygen, media reports suggest they are a regular occurrence. Despite the warnings, as many as half of all patients continue to smoke while on oxygen therapy. Birthday candles, gas stoves, sparks from electronic devices, even static from clothes, can all result in oxygen-saturated materials igniting.
The danger is particularly acute in care homes and hospices. Firstly, the high concentration of vulnerable and oſten immobile patients makes quick evacuation impossible, meaning the potential consequences of a fire are much more severe than in a residential home.
Then there is the high number of staff, both permanent and agency, as well as visitors, who may inadvertently put a patient at risk through lack of awareness, and who need to be aware of the risks associated with medical oxygen.
What’s more, while some patients benefit from the NHS Home Oxygen Service, it is not uncommon for care homes to own their equipment, or for back-up cylinders to be offered to other residents. As a result, patients can miss out on essential safety advice and accessories (cannulae and tubing) can sometimes be sourced privately. This means that firebreaks – small, inexpensive devices that are inserted into the oxygen tubing to
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So, what can be done? Firstly, as Sharon’s case highlights, a greater emphasis on staff training is needed. While there are excellent examples of care homes ensuring all staff are aware of the risks, oxygen safety training is by no means universal. Even a basic understanding that patients should never - under any circumstances - smoke while on oxygen, even if they are outside, could make an enormous difference.
Visitor awareness is also a priority. Oxygen hazard signs should be prominently displayed, especially if the home has a dedicated smoking area.
Finally, care homes should ensure they use the right accessories. This includes appropriate soſt tubing and cannulae fitted with firebreaks to minimise the impact of a fire. To this end, BPR Medical is currently working with hospices and care homes to develop a single use kit that will address the issue.
Sharon’s death was tragic and avoidable, and her case exposed the high stakes involved in ignoring the dangers associated with fire and medical oxygen. With the Care Quality Commission (CQC) asking all care homes to review their fire safety procedures following the Grenfell Tower fire, better oxygen safety training and awareness should be high on the list of priorities.
www.firebreaks.info
www.bprmedical.com
www.tomorrowscare.co.uk
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