EBME
Upscaling life-saving equipment in a crisis
Despite the challenges of international shortages of life-saving equipment, huge volumes of medical devices have been commissioned to provide monitoring and support for patients with COVID-19. Louise Frampton provides an insight into the extraordinary response by the clinical engineering community, during the coronavirus crisis, and the lessons that can be learned for the future.
New field hospitals and new COVID-19 hospital wards within our current NHS hospitals were transformed to provide contingency support for many of the thousands of sick patients with the COVID-19 virus. To commission the medical equipment country-wide required a monumental effort from the clinical engineering community, with many engineers from the public and private sectors teaming up to accelerate the process. The Nightingale Hospital at Excel,
London, was set up in just 10 days, with plans to provide up to 4,000 intensive care beds. The purchasing and commissioning equipment for the equivalent of 10 general hospitals was a huge undertaking – requiring an estimated 112,500 hours of hands-on time to get the devices to the patients. An
international shortage of medical equipment including ICU ventilators, infusion devices and patient monitoring made this even more of a challenge than could ever have been estimated.
Capacity expanded further with additional Nightingale hospitals across England, Scotland and Wales. This was in addition to the extra capacity already created for NHS Hospitals, freeing up more than 33,000 beds – the equivalent of more than 50 new hospitals.
While the nation gave a well-deserved standing ovation to the many healthcare workers that risked their own lives while delivering frontline care, we should also acknowledge the enormous engineering contribution provided behind the scenes, that enabled this care to be delivered safely.
Scaling up access to intensive care was made possible by the hard work of clinical engineers, who worked long hours, away from their families, overcoming significant challenges to turn exhibition halls into emergency field hospitals and operating theatres into ICUs. Dr. John Sandham provided operational advice for commissioning COVID-19 ICU bed spaces, on and off-site in the UK. He explains that an intensive care bed requires much greater volumes of equipment compared to a general bed – including items such as ventilators, patient monitors, defibrillators, syringe pumps, infusion pumps, flowmeters and piped gases. These devices all need to be assembled, checked, and installed into the bed space. To give an insight into the scale of
the effort, each intensive care bed space required, on average, around 15 pieces of equipment to support a single patient. For London’s Nightingale hospital, this equated to over 60,000 pieces of equipment – some of which was highly specialised – such as ventilators, humidifiers and patient warmers. Dr. Sandham points out that kitting out a new 400 bed general hospital, normally takes six months of planning and purchasing: “During normal operating conditions, there are often delays, as the lead in times for manufacturers differ. However, the speed in which the healthcare sector had to respond to the coronavirus was unprecedented.”
The MTS and Avensys team at NHS Nightingale London. 26 l
WWW.CLINICALSERVICESJOURNAL.COM
This speed of response posed some key challenges and required conventional strategies to be adapted: “During the pandemic, buyers had to purchase whatever equipment they could lay their hands on; clinical engineers often did not know exactly what was going to arrive. It was delivered
OCTOBER 2020
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