Modern hospital's engineering needsby S A Mansoor
Today's hospitals depend on a large number of electromechanical, electronic, pneumatic and hydraulic equipment. Most hospital functions, from diagnostic, pathological, medical and surgical matters, as well as all routine cleaning, functioning and upkeep, are related to a vast array of machines and specialised equipments that need skilled and expert hands to keep them serviced and functional. Most of our public, and many private, hospitals are functioning today for over fifteen years or more. Their need for skilled backup and support is an important part of hospital activity, to keep updated and functioning efficiently. This is applicable for almost all medical, pathological and surgical functions, among others, where a large number of complex equipments are in routine daily use.
It is therefore not realistically possible for any hospital to have all the necessary skilled and trained manpower, on their payroll, to ensure that all these complex multifunctional equipment are kept in good order, at the level recommended by the equipment makers.
This write-up proposes that hospitals should go for one or more experienced and trained organisations, on a long term contract basis, to ensure that they can take full responsibility for most equipment, if not all, like X-ray plant, power generation, water supplies, laundry, cooking etc.
Furthermore, it may be possible that such vendors can also be responsible for the overall operation of the equipment, including manufacturer recommended servicing, repair and proper upkeep, scheduled replacement of all needed consumables and spares. Such a vendor can also supply medical oxygen, nitrous oxide and medical air and other needed gases. They will ensure that the Medical Pipeline (MPL) system and all the associated equipments linked to it are kept operating at full capacity at all times with their essential life-saving functions available round the clock in the hospital.
Possible advantages for hospitals:
It will ensure that one dedicated source of expert services is available to the hospital authorities, at all times, for help and assistance in all matters related to all operation, servicing and recommended upkeep and functioning of the MPL systems and the medical equipment directly and indirectly related to it. Preferably, they can also supply all needed medical gases to the hospital, and thus ensure that satisfactory inventory of all medical gases are available at all times based on the hospital's day to day needs.
The relevance and importance of such a package proposal is born by the fact that many public and private hospitals have been operating with the MPL system, the equipment and the associated plants related to it, which are possibly over fifteen years old. Naturally, there may be many leakages in the pipeline systems and related equipments. This is wasting expensive high quality medical gases, like medical oxygen, nitrous oxide and medical air. This wastage of expensive gases is unfortunately not noticeable, unless it becomes excessive! Hospitals lose a large sum of money, because of this invisible and unknown leakage of valuable and expensive medical gases. This also creates the danger of a potential fire hazard in the hospital premises, as medical oxygen and nitrous oxide are both oxidising gases and are highly flammable.
Most filters and dryer elements, which are fitted internally, can get moist or clogged, resulting in the system to perform below capacity, allowing unfiltered gases to leak through! These must be replaced with the necessary standard approved consumables, as recommended by the manufacturer, for the equipment to function effectively at full standard capacity. Such ingress of humid air is a reality, and its passage across ventilators and surgical drills shorten the life of these costly but necessary and essential hospital equipment!
The bacteria filters, incorporated with the vacuum plants, have to be changed after every 30,000 hours (around six months) on a strict basis. In reality, these are not changed at all! Quite often the bacterial filters are by-passed, without any justification! This creates real bacterial hazard to the environment and to the sick and helpless patients who are naturally more vulnerable to the dangers of bacterial infection and related medical complications! Furthermore, continuous passage of body fluids from patients through the vacuum lines tends to clog up the lines, which results in loss of available vacuum. The lines therefore become ineffective and operate under capacity -- a common occurrence in many hospitals.
If all the available equipment in the hospital are well looked after, regularly serviced and the recommended consumables timely replaced, it will ensure that all equipment and facilities are in rated operational condition at all times. This will enable the hospital authorities to service a larger number of patients who can avail these specialised facilities. In effect, it can increase the capacity of the existing hospital system, without extra capital investment.
Hospital authorities should realise that the Medical Pipeline System and related equipment like air, vacuum, hot water supply and all related essential plants are not being properly serviced and looked after, which leads to unnecessary medical complications to the patients, adding workload for the hospital personnel.
It may be noted that the MPL system and associated plants and equipment are closely related to the function of many other equipment which are critically needed for patient care. It is therefore imperative that the above issues should be seriously considered for the improvement of the quality and quantity of medical services that the hospital authorities can provide.
It is a fact that the medical gas supply equipment's performance is related to the efficient functioning of many critical hospital equipment, like OT anaesthesia machine, ventilators, incubators and others, that can seriously hamper patient care in various areas of medical and surgical functions. Unfortunately, this vital link in the system is often overlooked by hospital administrators, with serious and harmful consequences suffered by the innocent patients who become unnecessary victims!
The writer is an engineer, with hands on experience in Medical Pipeline Systems and related hospital equipment
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