search.noResults

search.searching

dataCollection.invalidEmail
note.createNoteMessage

search.noResults

search.searching

orderForm.title

orderForm.productCode
orderForm.description
orderForm.quantity
orderForm.itemPrice
orderForm.price
orderForm.totalPrice
orderForm.deliveryDetails.billingAddress
orderForm.deliveryDetails.deliveryAddress
orderForm.noItems
EMERGENCY PLANNING


The air separation plant – cryogenic plant which will take liquid oxygen and fill gaseous medical oxygen into either J- or W-size bottles – had to be flown 8,000 miles to the King Edward Memorial VII Hospital in two specially laid-on aircraft.


from manufacturers was not possible. With the PHE modelling in mind it was clear that the oxygen production on site was inadequate to support such numbers, even with a stockpile of prefilled bottles. With both concentrators running in parallel, if one plant became defective, the bottle charging capability would be lost, and the resulting loss in pressure would ultimately mean insufficient oxygen being delivered to patients. Technical support for the concentrator plant is usually provided by the manufacturer once a year; it undertakes planned preventative maintenance (PPM).


A logistical challenge to get engineers on site However, organising engineers to attend is a logistical challenge, and it can often take a number of weeks from the placing a first call to a manufacturer, to their staff arriving – even for emergencies. With the Falklands lagging behind the UK in terms of effects of COVID-19, there is an additional 14-day quarantine period in force for anyone coming off the South Atlantic Air Bridge (the UK MOD flight from the UK). Given that any technical support staff we do get are likely to be stuck on the Islands – increasing the likelihood of no on-site support, we soon realised that any engineering issues would need to be addressed by our ‘in- house’ team. If the oxygen manufacturing plant remained operational, there would only be a constant supply of oxygen for 54 per


cent of expected patients, even taking account the extra capacity provided by the newly supplied portable oxygen concentrators. The stockpiled J-sized bottles are expected to last 12 hours each, supplying ten litres per minute, and with both plants running close to capacity the ability to re-charge medical oxygen bottles would be lost.


Risk of contamination There is a sizable cache of empty industrial oxygen bottles on the Islands waiting for return to the UK, but while it was confirmed that the KEMH does have the capacity to fill these bottles via its ‘bullnose’ connections, any contamination in the bottle cannot be verified. As medical oxygen is a pharmaceutical product, it is a drug administered by a doctor, and the risk of potential contamination was deemed unacceptable. BOC in the UK is, in fact, currently converting W-size bottles and supplying the NHS to make up the shortfall of J-size bottles, but the turnaround for getting emptied bottles to the UK, filled, and returned to us in the Falklands would be too long. At the time of writing, the MOD has negotiated for a substantial number of converted W-size medical oxygen bottles for immediate issue, and is currently investigating flying the bottles to the South Atlantic. The UK MOD has secured an air separation unit (ASU) – a cryogenic plant which will take liquid oxygen (LOx) and fill gaseous medical


oxygen into either J- or W-size bottles (or any other-sized bottles). This is a significant piece of machinery, and will require three civilian engineers to install and commission, and a further five military personnel to operate on a shift basis. The capability uplift the ASU represents is considerable, as it can fill eight bottles simultaneously (both pin- indexed and bullnose), it has enough LOx for 600 charges. The ASU itself will be installed at RAF Mount Pleasant, enabling the installation and operational crew to remain in quarantine on the base – eating, sleeping, and working separate from all other personnel, thus negating the need for the 14-day quarantine. The UK MOD, in conjunction with the Falkland Islands Government, will then look to ferry lorry loads of bottles to Stanley and the KEMH, where emergency bottle caches have been set up, as required.


Spare beds ready in the ITU. 32


Lucky thus far In reality the Falkland Islands have been lucky thus far, as the number of COVID-19 patients has been relatively light. This has allowed clinical and engineering staff to draft new procedures for this unprecedented situation, and to see if they work, thereafter altering them as required. The ‘Plan, Do, Check, Act’ approach has allowed us to review and improve systems we have put in place – a luxury many countries have simply not enjoyed. The Achilles heel for the KEMH will always be logistical supply; however, we have enjoyed strong support from the UK MOD in this area. The Engineering team has been forced to consider actions they would not have think about normally, raising issues in areas that were previously unknown, as well as successes in other areas. Our next focus will be to how to support the hospital if the current pandemic requires us to maintain this higher level of day-to-day activity for a sustained period. Our strategy here is to put arrangements in place so we can wind down to effectively carry on as normally as possible, and then simply revert to the higher operational tempo in short order.


IFHE IFHE DIGEST 2021


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116