IHEEM AE CONFERENCE 2023
Eddie McLaughlan, IHEEM Council member and Chair of the Technical Platform Committee, chaired the ‘Update from the IHEEM Technical Platforms’ session.
being drafted, healthcare has changed so much, and the HTM hasn’t kept up to date. I also totally accept what was said earlier – we don’t need somebody to tell us what each HTM says; it’s how to interpret the guidance.” Graeme Dunn’s view was that most of the AEs for Medical Gases were now in a position where they needed to provide some interpretation. He said: “This is because we know that if we apply the guidance in the current HTM, it’s not resulting in practicable solutions.” He continued: “The scoping document took time to develop from the HTM re-write, which is currently under way.” Moving to discuss some of the key things the Medical Gases Technical Platform was discussing, Graeme Dunn said: “Well, we really need to look at flowrates and diversity factors. On a new hospital project I’m involved with, I’ve had the good fortune to have a really good meeting with an intensive care consultant and an anaesthetist. Their views on flowrates and what modern medical equipment takes are quite different from the engineers’ view. So, we need to look at flowrates and diversity factors – particularly in relation to respiratory wards in the event that we need to future-proof for a pandemic. As engineers, we can’t do this alone; we have to have engagement with clinical people, which still needs to be facilitated.” Moving on, Graeme Dunn said that, as
any Medical Gas APs would know, ‘surgical air is gone’. He expanded: “There’s very little requirement now for 7 bar air in the theatre environment, so the likelihood is
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Speaking on behalf of the IHEEM Water Technical Platform, Paul Nolan said one of the Platform’s key functions was ‘focusing on anything we can do to promote the AE role’.
that such air will disappear in the revised HTM.” He explained: “We’re also seeing evidence that medical air at 4 bar pressure is dropping right off as well, which needs to be considered when we are looking at replacing medical air plants. We still have considerable trouble convincing people that when they go to replace a medical air plant, for example, they really should not be considering a like-for-like replacement – because the demand now is going to be considerably lower than when that plant was originally specified.” This could not only affect the plant’s long- term performance, but also had a financial impact on the purchase cost.
Decommissioning nitrous oxide plant Meanwhile the sector was now – Graeme Dunn explained – actively looking at decommissioning nitrous oxide in medical applications, and he was doubtful there would now be any new nitrous oxide systems installed. He said: “We’re looking at Entonox on the ventilation side of things, and it being delivered in rooms where the ventilation air change rates are perhaps not at the required levels for it to be administered.” He added that with BOC having integral valve cylinders, there was ‘an awful lot more use’ of such cylinders to deliver Entonox in healthcare facilities, ‘even when the pipe provision is there’. He said: “Here you can have instances of that Entonox cylinder being provided to a patient, despite them being accommodated in a room never designed, ventilation-wise, for that purpose.” He believed the sector would probably
During the COVID epidemic, we drafted some guidance on the reprocessing of respiratory masks, to give people some pointers on the technology that can be used, and some of the pitfalls
Brian Kirk, Decontamination Technical Platform 34 Health Estate Journal September 2023
Fire Safety Technical Platform Chair, Maz Daoud, a former London Fire Brigade firefighter, is now National Fire Safety Lead at NHS England.
still see AGSS systems used, because if nitrous oxide ceased to be used, there would be other anaesthetic gases that would need removing from the atmosphere and safely disposing of. He said: “We also have the issue of ‘cracking’, and whether we should use an AGSS system that simply disposes of the gas without treating it in any way.” There was, he noted, cracking technology available – the effectiveness of which was ‘possibly up for debate’. Graeme Dunn said: “We’re looking at commissioning tests – and at changes proposed to training and competence – how training is delivered, and how competences are being assessed.” Work on the medical gases HTM was ‘ongoing’, with a programme established, and ‘some good people working on it’. Mark Richards, one of the founding members of the Electrical Technical Platform, and the next speaker, explained that the ‘ETP’ had been going since 2014, ‘providing technical responses to queries from healthcare establishments’ APs across the board’. He told delegates: “Like most of the other Technical Platforms, we mainly comprise Authorising Engineers, and we too are looking for volunteers to join us – particularly with the current decarbonisation of the healthcare estate. We’d particularly welcome hearing from experts in batteries and battery energy storage systems to supplement our membership.” Mark Richards explained that the
Platform had ‘been involved quite heavily with BS 7671’, as regards contributions to the regulations, and has several members on each of the Committees that drive the standard. He said: “We’ve successfully – just recently with the amendment to BS 7671 – changed the scope of birthing pools in Section 7, and have changed regulation 422.2.1 regarding protective escape routes; when BS 7671 came out last year, this was causing some consternation
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