MEDICAL GAS PIPELINE SYSTEMS
attitude and commitment.” The oxygen concentrator system is all linked up to SHJ’s K’nect portal, so that, from its offices in Chesham, its can see all the temperatures, via 10 different temperature sensors, as well as the ampage it is running at. Stafford Scopes added: “We know the cost of electricity per amp/hour, so we can tell the Trust exactly how many litres of air are being produced per minute, and the costs entailed. All the data is collected by our Empower system, which sends it to us here, and we then host it and present it on our K’nect portal, which the Trust’s Estates Department can access any time.”
He went on to explain that the concentrator at Charing Cross Hospital is currently supplying oxygen at a rate of up to 850 litres/min exclusively to COVID-19 wards at the site, supplying all the wards and theatres in the Riverside Wing, equating to about one-third of the site’s overall oxygen capacity. He added: “The project, of which I am very proud, entailed completing an amazing amount of work in a short time. It’s great to have a team of engineers who will respond with the commitment and enthusiasm that those from SHJ demonstrated on this project.”
Asked to ‘ramp up’ ICU capacity Shane King said: “In early March the Trust was asked to ramp up its ICU capacity, and, based on the numbers required across the area, we didn’t have sufficient oxygen capacity from the VIE at Charing Cross. BOC was unable to upgrade the VIE, or to provide us with any additional temporary capacity. Had we – working with our hard FM provider, CBRE, and SHJ – not come up with a solution, we might not have been able to safely provide the Level III emergency care beds at Charing Cross. As soon as we became aware of the increase in patient numbers requiring oxygen therapy, we began looking at our oxygen distribution network, to try to balance where the clinicians wanted to put the additional beds with our oxygen and medical air infrastructure. Once numbers were firmed up, and the clinicians had identified which wards might be suitable for stepping up to critical care units, we reviewed all the infrastructure, and did a lot of work on upgrading the hospital’s ring main to enable us to move oxygen around the site. When we were looking at the calculations for Charing Cross, we were significantly short. The VIE had an output capacity of 1,833 litres, but we were looking for a requirement somewhere close to 3,050 litres in total.”
Close adjacencies sought Shane King explained that he and the Estates Management team were looking to put the additional intensive care beds in close adjacency to the existing ICU
42 Health Estate Journal October 2020 Upgrading pipework
The compact plant layout in a standard high-roof shipping container.
beds up on the eleventh floor of the hospital’s main tower block. However, once it became clear there was not enough VIE-piped oxygen, SHJ came in and began discussing how the additional oxygen capacity could be optimally provided – whether via additional standby manifolds, or temporary VIEs. He said: “That is when SHJ suggested that the only other practical option would be to install an oxygen concentrator. While such concentrators are always mentioned on medical gas training,” he added, “I had never worked with one operationally before. We were fortunate that this particular concentrator had become available, and although several Trusts were interested in it, we were able to obtain the funds to purchase it. Between purchasing it, and installing and connecting it, however, we had some deliberations about how we could use this Oxygen 93, and whether it could be used with our pure oxygen, or used separately. It was agreed that it should be used separately, to supply the Riverside Wing.” Once this has been decided, the Wing’s oxygen supply was disconnected from the main medical gas ring main, and the whole building and another adjacent area were then supplied from the oxygen concentrator. “At Charing Cross Hospital,” Shane King explained, “even where COVID-positive patients didn’t occupy a whole ward, they occupied part of it. The concentrator ended up serving three wards, and has the potential to serve all day theatres and ‘Recovery’ in the Riverside Wing and the adjacent area.”
The shipping containers from Adaptainer were delivered in the first week of April, with the installation of all the plant completed, and the concentrator tested, completed, and operational, by the end of that month. Shane King added: “In addition, the work included upgrading the oxygen pipework within the wards to get the required flow rates to the beds, and installing both an emergency standby manifold, and an emergency link to the VIE. All of this work was undertaken by our Estates Management team, SHJ, and CBRE. The scheme involved a lot of detailed design and calculations.” He added: “Clearly there was a significant increase in oxygen demand flow rates across the site and the building. Some of the wards we were working on had COVID-19 patients on them, so we had to devise ways to upgrade the pipework in the wards concerned, while minimising risk to patients and staff. We did this by creating local ring mains in the wards, downstream of the AVSUs. We also undertook some significant reinforcement and upgrading of the medical gas ring main – the main distribution infrastructure – to enable it to carry the oxygen with acceptable pressure drops.
“SHJ was extremely helpful – especially in the very flexible way its team approached the work, including via extended hours working, and its staff being prepared to work within COVID-19 designated areas. We all did some very long days. Pleasingly, it all came together and proved well worthwhile, and we managed to stay ahead of the capacity requirements, which were changing daily.”
Praise from the Trust’s Chair The Trust’s Chair, Paula Vennells, also praised SHJ’s work; in a letter of thanks to Stafford Scopes, she said: “When I thanked the Imperial Estates team for their work, they told me how grateful they were for the support from SHJ. They were especially appreciative for your supporting the Estates teams across all sites in the detailed assessment of existing piped medical gas system capacity to meet increased ICU ventilator requirements. They also thanked SHJ for its work on the redesign of systems and installation of new pipework infrastructure to provide adequate oxygen and medical air flow capacity to designated points of use, as well as for the turnkey solution in supplying and installing the innovative oxygen concentrator plant – increasing site oxygen capacity by 850 L/min when conventional liquid oxygen supplies were unable to meet estimated demand, often working in close adjacency to COVID-19 positive patients.”
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©Estates and Facilities Management Department, Imperial College Healthcare NHS Trust
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