The Operating Theatre Journal

PRO-Breathe® Laryngeal Airways are available in disposable pvc, disposable silicone or autoclavable silicone. All threeoptions are transparent for clear observation of airway patency and come in either a standard rigid or an Armouflex™reinforced version. Their smooth integrated design gives a superb seal, optimum feel and less risk of patient trauma.PRO-Breathe® Laryngeal Airways are available in a full range of patient sizes, all clearly marked with inflation volumes andinsertion guidelines, with size and colour coded pilot balloons.

These are complimented by PRO-Breathe® single patient use ET tubes, recently rated joint top in a NHS Supply Chainevaluation. Standard, reinforced Armourflex™ and pre-formed nasal or oral tubes are available in a full range of sizes, with orwithout cuffs. Large stocks are held for next day delivery.

The entire PRO-Breathe® range is featured in this year’s PROACT Medical 2010 catalogue which is available now. To downloadthe catalogue online visit www.proactmedical.co.uk. Or alternatively, if you would prefer a printed copy, call our Customer SalesTeam on 0845 051 4244 who will be able to provide you with a free copy.

The PRO-Breathe® range of Laryngeal Airways and Endotracheal Tubes offer costeffective performance and value. Challenge us to see how much you can save.

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Tel: 0845 051 4244 Fax: 0845 051 4255 e-mail: [email protected]

April 2010 Issue No. 235 ISSN 1747-728X

2 THE OPERATING THEATRE JOURNAL www.otjonline.com

T U E S DAY 8 J U N E 2 0 1 0 7 6 P O RT L A N D P L AC E , L O N D O N

M E E T I N G T H E Q UA L I T Y A N D P RO D U C T I V I T Y C H A L L E N G E

Consensus on Safety and Quality

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An IHM recognised conference

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Through a series of presentations, this one day conference has been developed to provide a practical guide to delivering the QIPP agenda, focusing on reductions in Length of Stay through productivity and improvement.

To download a programme or book a place please

visit our website www.healthcare-events.co.ukFor more information call Hanisha on 020 8541 1399or email [email protected]

ChloraPrep® adds ‘New Hi-Lite Orange™’ Tint as data in NEJM shows ChloraPrep® (2% chlorhexidine gluconate w/v / 70 % isopropyl alcohol v/vl) reduced surgical site infections by 41%, compared with the

current standard of povidone-iodineA tinted version of the only licensed, sterile, single patient use skin antisepsis system with 2% chlorhexidine has been launched, making it a truly practical option for surgical teams who want the reassurance of seeing the area of skin prepped. The launch comes as data published in The New England Journal of Medicine demonstrates that use of ChloraPrep® to prep a patient’s skin prior to surgery reduced total surgical site infections (SSIs) by 41 percent compared to use of povidone-iodine solution – the most commonly used preoperative skin preparation around the world. i

Professor David Leaper, Emeritus Professor, University of Newcastle upon Tyne and Visiting Professor, Department of Wound Healing, Cardiff University, commented: ”This new, 2010, piece of research published in the NEJM has shown convincingly that the ChloraPrep applicator containing 2% chlorhexidine can signifi cantly reduce SSIs after clean-contaminated surgery and is clearly superior to widely accepted and ritualistic skin preparation using povidone iodine. There is an added reduction in both postoperative morbidity and mortality related to SSI and a great potential to reduce a major fi nancial burden to the NHS”

This new risk reduction data in surgical site infections is consistent with that already published for the reduction of risk of line related bacteraemias1,ii. ChloraPrep® provides both rapid actioniii against microorganisms and keeps fi ghting bacterial growth for at least 48 hours after application,iv,v whereas iodine is neutralized by blood and other organic matter, reducing its effectiveness to two hours.3 The residual effect of ChloraPrep® allows for added protection for patients against infections after surgery, not just during the procedure.

ChloraPrep® can reduce the number of bacteria counted on patients’ skin by 99.9%.vi Its effi cacy not only lies in the superior antiseptic solution but in the way that it is applied, using a specially designed sterile applicator. It has already been widely adopted by the NHS with great success for skin prep pre and post the insertion of peripheral and central intravenous lines.

For more information contact: CareFusion, Reigate Place, 43 London Road, Reigate, Surrey, RH2 9PW Tel: 0800 043 7546 Email: [email protected]

1 Darouiche RO et al. N Engl J Med 2010;362: 18-22 Pratt et al,Journal of Hospital Infection (2007) 65S, S1-S643 Crosby CT , Mares AK. Skin antisepsis: past, present, and future. J Vasc Access

Devices. Spring 2001:26-31.4 Garcia R, Mulberry G, Brady A, Hibbard JS. Comparison of ChloraPrep and

Betadine as preoperative skin preparation antiseptics. Poster presented at: 40th Annual Meeting of the Infectious Disease Society of America; October 25, 2002

5 Data on fi le. CareFusion.6 Mcdonald CP et al. Evaluation and Routine Performance of a “best practice”

donor arm disinfection procedure; chloraprep; p150. Vox Sanguinis 2006; 94 (Supl.3)

i Darouiche RO et al. N Engl J Med 2010;362: 18-2 ii Pratt et al,Journal of Hospital Infection (2007) 65S, S1-S64 iii Crosby CT , Mares AK. Skin antisepsis: past, present, and future. J Vasc Access

Devices. Spring 2001:26-31. iv Garcia R, Mulberry G, Brady A, Hibbard JS. Comparison of ChloraPrep and

Betadine as preoperative skin preparation antiseptics. Poster presented at: 40th Annual Meeting of the Infectious Disease Society of America; October 25, 2002

v Data on fi le. CareFusion. vi Mcdonald CP et al. Evaluation and Routine Performance of a “best practice”

donor arm disinfection procedure; chloraprep; p150. Vox Sanguinis 2006; 94 (Supl.3)

When responding please quote ‘OTJ’

The UK ODP Message GroupJoining is easy, just send an e-mail,stating your name, e-mail address, position and Hospital to:

[email protected]

New Norwich surgical centre opensHealth bosses are hoping that a new surgical centre which has opened in Norwich will help relieve the “enormous strain” from Norfolk’s overstretched fl agship hospital.

The new primary care surgical centre at the St Stephens Gate Medical Practice was offi cially opened on Tuesday after a £50,000 upgrade of the minor operations theatre and neighbouring rooms at the Wessex Street premises close to the Chapelfi eld Shopping Centre.

The new surgical centre, which is part of the Norfolk Surgical and Diagnostic Centres (NSDC) based in King’s Lynn, will be able to carry out a raft of minor operations - providing a much-needed alternative to the Norfolk and Norwich University Hospital.

Pre and post-surgery appointments can also be carried out at St Stephens Gate, meaning that patients will no longer need to travel to the N&N - freeing up valuable time and resources.

Michelle Kears, practice manager of the St Stephens Gate Medical Practice, said: “We want to offer patients in the Norwich and wider area the opportunity to have these procedures done closer to home in a smaller setting that’s not so threatening like a hospital can be. The partners here invested quite a lot to upgrade the minor operations suite so it will be up to the correct standard for the procedures.”

Various procedures offered at the new surgical centre will include surgery for trapped nerves in the wrist, varicose vein injection and ties, nail surgery and removal of certain skin growths.

In the future it is hoped the centre might be able to provide cataract surgery and endoscopy services for patients living in the Norwich area. Source: The Advertiser PETER WALSH

The Operating Theatre Journal & www.OperatingTheatreJobs.com

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fi nd out more 020 7100 2867 • e-mail [email protected] Issue 235 APRIL 2010 3

The Operating Theatre Journal is published twelve times per year. Available in electronic format from the pages of www.otjonline.comand in hard copy to hospitals throughout the UK. Personal copies are available by nominal subscription.

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Olympus Surgical Technologies EuropeFrom 1 April 2010, the Olympus Group will be pooling its expertise in the fi eld of minimally invasive diagnostics and therapy under a common Olympus Surgical Technologies Europe umbrella. To this end, Olympus Winter & Ibe GmbH, Celon AG and Olympus Medical Products Czech SPOL. S.R.O. will be joining forces to accomplish a shared presence under a new, single brand.

From its corporate headquarters in Hamburg and at other locations in Teltow (near Berlin) and Perov (Czech Republic), Olympus Surgical Technologies Europe plans to set up a European group of companies in order to ensure its on-going future growth and to extend its position in the world market in the fi eld of minimally invasive diagnostics and therapy.

We have decided to take this step to reinforce our existing network, pool our pan-European expertise and delineate our profi le more clearly with a view to competing on an international scale and enhancing the level of external brand awareness, said Heinz Jacqui, Executive Managing Director of Olympus Surgical Technologies Europe, on the companies strategic positioning under a new umbrella brand.

Being a high-tech specialist for minimally invasive diagnostics and therapy, Olympus Surgical Technologies Europe is the development and production centre within the Olympus Group for endoscopy, high-frequency surgery, systems integration in the operating theatre (ENDOALPHA) and instrument reprocessing for the global market. The newly organised group of companies combines core fi elds of expertise such as research and development, production and service as well as distribution and training Please quote ‘OTJ’

Clinical Study: Biologic Grafts Reduce Postoperative Pain While Creating a

Repair as Durable as Synthetic Mesh in Treating Inguinal Hernias

Cook Medicals Biodesign Inguinal Hernia Graft outperforms synthetic mesh in double-blind study published in the American Journal of Surgery

Results from a clinical study led by Luca Ansaloni, M.D., showed that Cook Medicals Biodesign Inguinal Hernia Graft causes less postoperative pain and discomfort while creating a repair as durable as synthetic mesh when used in Lichtensteins hernioplasty procedures. As published in a recent issue of the American Journal of Surgery, the three-year, 70-patient study determined that patients treated with Biodesign Inguinal Hernia Graft experienced a lower level of postoperative pain as compared with synthetic mesh-based procedures.

The randomised, double-blind inguinal hernia study examined the effi cacy of the Biodesign Inguinal Hernia Graft in treating 35 men compared to 35 men treated with synthetic mesh. Research fi ndings showed that 11 per cent of patients treated with synthetics experienced chronic postoperative pain that limited daily activities, most often resulting from the mesh characteristics as opposed to surgical technique. By contrast, patients in the study treated with Biodesign Inguinal Hernia Graft experienced a lower degree[1] of postoperative pain both at rest and when coughing or moving. Additionally, a three-year follow-up no evidence of hernia recurrence was seen in the study patients treated with the Biodesign graft.

Inguinal hernias occur when soft tissue, generally part of the intestine, forces its way through a tear in the lower abdominal wall or through the inguinal canal and creates a bulge that can be painful when coughing, bending or lifting heavy objects. According to the NHS, inguinal hernias are more common in men and often develop as a result of the frequent heavy lifting, coughing or straining. While hernias arent necessarily dangerous themselves, they can lead to life-threatening conditions if left untreated.

Based on our research fi ndings, biologic grafts are extremely effective when treating inguinal hernias, said Dr. Ansaloni, a general surgeon at St. Orsola-Malpighi University Hospital in Bologna, Italy. Not only did [study] patients recover quickly after receiving the Biodesign Inguinal Hernia Graft, but they experienced less pain and discomfort as compared to patients who were treated with synthetic mesh.

The Biodesign Inguinal Hernia Graft incorporates attributes of a biologic graft resistance to infection and complete remodelling with the added benefi ts of moderate price, ease-of-use and ample shelf life for on-site availability. Upon deployment, the graft reinforces the repair of surrounding tissue and, over time, communicates with the patient’s body, signalling surrounding tissue to grow across the scaffold where the repair is needed. The Biodesign Inguinal Hernia Graft is designed specifi cally for reinforcing the inguinal fl oor and designed to meet special challenges including resistance to infection[2], encapsulation and erosion.

The potential complications associated with the use of synthetic mesh in treating inguinal hernias can cause a signifi cant decrease in quality of life for patients while also increasing procedural recovery time, said Andy Cron, vice president of Cook Medicals surgery strategic business unit. This study comes at a very important time, as the medical fi eld continues to debate the benefi ts of biologic and synthetic treatment options. Dr. Ansalonis research reinforces our efforts to leverage biologic solutions that provide hernia patients with a natural, lasting solution.

About Cook MedicalFounded in 1963, Cook Medical pioneered many of the medical devices now commonly used to perform minimally invasive medical procedures throughout the body. Today, the company integrates medical devices, drugs and biologics to enhance patient safety and improve clinical outcomes. Since its inception, Cook has operated as a family-held private corporation. For more information, visit www.cookmedical.com. Follow Cook Medical on Twitter at www.twitter.com/cookmedicalpr.

[1] American Journal of Surgery 2009. L. Ansaloni, F.Catena, F. Coccolini, F. Gazzotti, L. DAlessando, Pinna AD

[2] Arch. Surg. 2005 June: 140(6):549-60. Helton WS, Fisichella PM, Berger R, et al


The meeting was held at the Warwick HRI Conference Centre and invited Siemens representatives and European advocates to relay knowledge on how to gain the most value from syngo DynaCT. Departments interested in understanding the potential of DynaCT for interventional imaging can contact [email protected] for further information and registration onto the next workshop.

About Siemens HealthcareThe Siemens Healthcare Sector is one of the world’s largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source from prevention and early detection to diagnosis and on to treatment and aftercare. By optimising clinical workfl ows for the most common diseases, Siemens also makes healthcare faster, better and more cost-effective. Siemens Healthcare employs some 48,000 employees worldwide and operates around the world. In fi scal year 2009 (to September 30), the Sector posted revenue of 11.9 billion euros and profi t of around 1.5 billion euros. For further information please visit: www.siemens.co.uk/healthcare.

For more information contact: Kerry Milton, Siemens HealthcareT: 01276 696338E: [email protected]: http://www.siemens.co.uk/healthcare

Building on knowledge, sharing experiences and obtaining practical advice were some of the benefi ts taken away by delegates at Siemens Healthcares inaugural syngo® DynaCT User Meeting.

The forum covered the basics of the software for interventional imaging as well as specialist applications, plus delegates were given hands-on experience of the workstations. Customers were also able to see how accompanying software can enhance diagnosis and treatment to improve clinical workfl ow using the latest software packages including syngo® Embolisation Guidance and syngo® Neuro PBV IR (Parenchymal Blood Volume, Interventional Suite). All delegates felt that the meeting had a benefi cial effect on their clinical practices.

Delegates also heard user experiences from customer speakers from the UK and Europe. Dr. Hacking from Southampton University Hospitals NHS Trust talked about his work with DynaCT in Transarterial Chemoembolisation (TACE), Portal Vein Embolisation (PVE) and complex biliary stenosis while Dr. Hughes from Buckinghamshire Hospitals NHS Trust relayed his initial experiences with DynaCT and spinal interventions. Bringing a European perspective, Dr. Binter of Groupe hospitalier Sud Réunion in France and Dr. Struffert from the University of Erlangen in Germany discussed their experiences with DynaCT and Neuro PBV IR software.

The meeting was very useful, said Beverly Hudson, Superintendent Radiographer at Queen Elizabeth Hospital, part of University Hospitals Birmingham NHS Foundation Trust. Having used syngo DynaCT now for two years, it gave us useful tips to further enhance the way we use the technique to benefi t patients and the department.

It is vital that we share knowledge and practical tips with our customers to ensure they are gaining the best value from equipment and application investment, said Susie Guthrie, AX Product Manager at Siemens Healthcare. syngo DynaCT has wide ranging use in clinical procedures and this meeting explored its potential in a number of areas plus gave useful background information for new users.

syngo DynaCT is compatible with Siemens Artis zee range of interventional angiography systems and enables CT-like cross-sectional imaging by creating 3D soft tissue data sets. It can be used directly in the angio suite without loss of time and additional risk to the patient. Aside from visualising high-contrast objects, the application also makes it possible to obtain soft tissue information while performing interventional procedures for improved decision-making.

Understanding the potential of interventional imaging New and existing syngo DynaCT users gather to share best practice

A


UK Workers Worried SickBritish workers ignore advice to stay at home when ill, despite risk of spreading germsOne in fi ve Brits never considers taking a day off sick even when theyre genuinely ill, according to new research released today by SCA*, one of the world’s leading hygiene companies. A fi fth of workers (19%) say taking time off to recuperate is not an option, citing colleague and managers reactions as concerns. This is in spite of recent pandemics that have led to around one in three workers saying they are more aware of hygiene issues at work than ever before.The survey also revealed that 64% of Brits believe ill colleagues should stay at home to stop germs spreading but they are clearly not practicing what they preach. Even those who are

genuinely unwell are worried about sounding nervous on the phone (26%) when they call in, or the heavy workload they have waiting for them at work (32%) when they return.But battling in when poorly can make things worse, with one in ten believing that their work place hygiene contributes directly to ill-health. Hotspots for germs include our computer keyboard which came out as the highest percentage in terms of offi ce equipment considered to be unhygienic. A shocking 17% of workers admit to never cleaning their keyboard and a 20% never clean their mouse!Rolf Anderson, Senior Hygiene Advisor at SCA commented:Both employers and employees must act responsibly to curb the spreading of conditions such as the common cold, stomach

fl u and infl uenza in the work place. Employers should provide well-equipped washrooms with access to anti-bacterial soap and single-use paper towels. It is also important that employees show respect for their colleagues and stay home from work when they are sick - this would benefi t both parties from both a health and a fi nancial perspective.Employment expert John Lees comments:People worry about phoning in sick as they feel it can be misinterpreted as a lack of loyalty of commitment to the job. It is important however, that when employees really are sick, that they consider the effects coming into the offi ce could have on other staff members and ultimately their employer, by spreading germs amongst the workforce.The research, which was undertaken to support the SCA 2010 Hygiene Matters report*,

also found that only 1 in 5 workplaces are providing their workers with basics such as antibacterial wipes.Meanwhile, a quarter of workers (23%) said our colleagues leave the workplace in a worse condition than they would their own homes. A similar number say they are frequently forced to take steps to make their workplace more hygienic by cleaning up after colleagues in the kitchen or bathroom.SCAs 2010 Hygiene Matters report comprises more detailed research into worldwide cleanliness and hygiene with a focus on nine countries including the UK. It was commissioned to provide a greater understanding of personal-hygiene attitudes and behaviours worldwide, and follows on from the report published in 2009. For further information visit: www.hygienematters.com or www.sca.com


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Full Anaesthetic Gas Measuring Capability for Fukuda Denshi DS-7000

Patient MonitorsFukuda Denshi is a leading supplier of advanced patient monitoring and user-confi gurable clinical information management systems. Now the company is announcing the availability of a new anaesthetic gas measuring capability on its range of compact, lightweight, integrated DS-7000 monitors.

The Fukuda Denshi DS-7000 series of patient monitors now have an inbuilt software capability, allowing them to accept IRMA™ plug-in multigas probes as an optional extra for customers. This is a convenient and practical anaesthesia support option, enabling full system integration without any host device hardware modifi cations.

IRMA mainstream probes, each weighing only 30 grams, can measure C02/02/N20 anaesthetic gases (HAL, ENF, ISO, SEV, DES), provide agent identifi cation and are available in customised confi gurations. All probes are universally calibrated and deliver processed data for display on the DS-7000 LCD screen. They are extremely cost effective, while adding to the system’s mobility. IRMA mainstream probes are designed to overcome the shortfalls of sidestream technologies.

With the new DS-7000 patient monitor and the IRMA anaesthetic gas probes, further opportunities in gas monitoring have arrived! Simply connect the IRMA probe into the digital port of the DS-7000 and start measuring.

For more information on the Fukuda Denshi DS-7000 series of patient monitors and the IMRA gas probes, please telephone the company on: 01438 728065.

Fukuda Denshi and IRMA: Just Plug in and Measure.

New anaesthetic approach blocks pain without interfering with motor function

Washington, DC: Scientists from the Children’s Hospital Boston have found a new anaesthetic approach which stops pain without affecting motor function.

The study group, led by Daniel Kohane of the Division of Critical Care Medicine at Children’s, originally planned to fi nd an agent that would prolong the anaesthetics’ effects. They focused on surfactants, a subclass of “chemical permeability enhancers” that allow drugs to spread more easily throughout a tissue.

As the researchers tested three kinds of surfactant along with the anaesthetics QX-314 and QX-222 - both derivatives of lidocaine - they found that this approach prolonged the sensory block in rats’ sciatic nerves, for nearly seven hours or more depending on the surfactant, but didn’t prolong motor impairment; in some cases the motor block was absent or of very short duration.

This meant that rats were able to tolerate having their paws on a hot plate for long periods, while still being able to balance and bear weight on their legs.

Kohane said: “This was a surprise fi nding...What we’ve discovered really is a new approach; the question now is to fi gure out the mechanism by which it works and look at the effects of other chemical permeability enhancers.”

Kohane believes that surfactant helped the anaesthetic to penetrate sensory nerves, which have little or none of the fatty coating known as myelin, whereas in motor neurons, which have abundant myelin, the active drug gets trapped in the myelin, never entering the nerve itself.

The fi nding could help provide a local anaesthetic for childbirth in humans that would block pain without interfering with the mother’s ability to push or for musculoskeletal disorders where it is important to maintain mobility.

The study has appeared in the online Early Edition of the Proceedings of the National Academy of Sciences. Please quote ‘OTJ’


Their Enthermics solution and blanket warming cabinets provide a cost-effective means of storing and warming a wide variety of clinical items. They can be ordered as a stacked set, or stacked as a new unit with existing ones.

Visit www.centralmedical.co.uk for more information or Tel: 01538 399541 to arrange a free no obligation on-site survey.

TheTheThThThhT iiiirir EE tE tE tEntEnthhhhherher iiiimicmics ss s lllloluolu ititititiotion an a ddddndnd blblblblblabla kkkkknkenkeetttt

FOLLOW THE NICE GUIDELINES AND KEEP YOUR PATIENTS WARM

Central Medical Supplies has the largest range of warming cabinets available in the UK. With over 20 years experience supplying patient warming equipment to the NHS and Private Hospitals, they clearly recognise the need to have blankets, irrigation fl uids and injection fl uids warmed to different temperatures with variable heat control within each environment.

Please quote ‘OTJ’

Rigel wins MOD contract for its new 288 fi eld service kit

Portability and ease-of-use key benefi ts

The new Rigel Medical 288 fi eld service kit has been specifi ed for the electrical safety testing of devices used at dozens of Ministry of Defence medical, veterinary and dental servicing centres around the world.

Fifty units are being supplied as part of a deal which will see Rigel providing training and support to MOD trainers who will be instructing army, navy and airforce technicians on how to use the testers properly in military theatres of operation, including Afghanistan.

The new 288 hand held devices will be used in conjunction with existing testers but meets the much needed requirement for a mobile option.

Using the new testers, technicians will be able to signifi cantly reduce the time involved in undertaking electrical safety checks on devices and equipment used at the military healthcare facilities, using the barcode facility that is available with the tester. Also, the 288’s ability to barcode and recall the test history of a device will be invaluable.

The Medical and General Supplies Team (M&GS) specifi ed the 288 kit after it was assessed by technicians at RAF Henlow in Bedfordshire.

The M&GS Team is responsible for the provision and support of general, medical, dental and veterinary material and equipment for Britain’s armed forces, ensuring best value to the customer and the MOD as a whole.

One of the key advantages is that the 288 is light, portable and the integrated barcode reader and printer means equipment can be identifi ed and records recalled quickly, meeting the needs of technicians operating across the MOD in a more demanding mobile environment.

The Rigel fi eld service kit will reduce the time taken to test the electrical safety and operation of a wide range of medical devices and equipment used inhospitals, operating theatres and other facilities.

It offers a fl exible, easy-to-use and accurate solution for testing devices for electrical safety to appropriate standards and guidelines including IEC 62353 IEC/EN60601-1, VDE 0751-1, AS/NZS 3551, AAMI, NFPA-99, MDA DB 9801-2006.

A state-of-the-art Bluetooth barcode scanner enables devices and equipment to be quickly

and easily identifi ed, while test results can be stored within the Rigel 288 safety analyser and printed wirelessly to the rugged battery operated Elite Test n Tag printer.

Traceability is improved as information can be downloaded into Med-eBase - the easy-to-use asset management software. This enables the user to store and manage test results, email html test certifi cates to clients and schedule new work orders, which can then be fully uploaded into a large onboard memory.

The compact, lightweight design and long life battery power of the Rigel 288 reduces downtime between tests, making the instrument practical and highly portable for multi-site use. It features easy-to-follow menu driven instructions for ease of operation and test control of all required electrical safety tests in manual, semi automatic or fully automatic test modes.

Users also have the facility to select from a range of preset test programs or develop their own customised routines.

A large internal memory facilitates the storage of test results for safety audit and traceability purposes. In addition, as well as storing the results of electrical tests, there is also the ability to record user defi ned inspections and measurements from other equipment such as SpO2, NIBP, ECG and other electro medical patient equipment.

The kit comes in a hard wearing, impact and water resistant Pelican carry case featuring dedicated foam inserts to safely hold the instrumentation in place and provide optimum protection during transportation.

Rigel 288 fi eld service kit forms part of a comprehensive range of high performance specialist biomedical test equipment supplied by Rigel Medical, part of the Seaward Group. Rigel Medical is based at Bracken Hill, South West Industrial Estate, Peterlee, County Durham, SR8 2SW.

For more information, including pricing, contact [email protected] or call the Rigel team on +44 191 5878701.

The MOD is using the Rigel 288 for the electrical safety testing of devices at its sites around the world.

When responding to articles please quote ‘OTJ’

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No longer require your copy of the OTJ?

Returned journals are a waste of resources!

Please help us to help you by keeping us up to date with your current address.

This can be e-mailed or faxed to: [email protected] Fax: 07092 097696

or you can justtelephone us during offi ce hours on:

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A message to healthcare professionals

Science, Guidelines and Users Agree: Forced Air Warming is Technology You Can Trust

Forced air warming is a clinically proven and trusted patient warming technology with 125 million patients warmed worldwide, a wealth of clinical research (including more than 170 published papers) and multiple international recommendations supporting its use. The evidence behind forced air warming’s safety and efficacy is overwhelming.1-6

Despite this, some manufacturers of electric blankets, pads and other conductive warming modalities are attempting to plant fears about the safety of forced air warming. One has even claimed that the country’s most prominent method of surgical warming may be contributing to surgical site infections (SSIs) by “blowing air” around the operating theatre, or disrupting laminar air flow.

It is time to put an end to these baseless claims about forced air warming and set the record straight.

These allegations contradict the extensive research reviewed by the National Institute for Health and Clinical Excellence (NICE) during the development of its Clinical Guideline 65: Management of inadvertent perioperative hypothermia in adults. This guideline states that forced air warming does not present an infection risk7, and specifically cited forced air warming as a proven tool for the reduction of SSIs.

Published research papers show that the use of forced air warming does not increase either the risk of wound

contamination in the operating theatre or bacterial contamination of operating theatres.8-12 Research published in the September 2009 issue of the Journal of Hospital Infection found that warming with the Bair Hugger® forced air warming system during orthopaedic surgery does not present an infection risk.11 In fact, when tested during actual surgical conditions, data show a decrease in the bacterial counts around the patient and in the operating theatre when forced air warming was used.10,11

Competitors offering conductive warming products have also recently made statements regarding forced air warming’s performance in laminar flow conditions. While simple logic makes it clear that forced air warming has no impact on laminar conditions, science also supports this. A forced air warming blanket delivers less than one percent of the airflow of a laminar flow system and therefore is unable to affect laminar flow ventilation systems.13

Rely on Evidence and Experience Maintaining normothermia with forced air warming has been demonstrated to reduce costly and serious complications associated with inadvertent hypothermia, including SSIs. The evidence is solid.

For more information on the evidence of forced air warming please visit www.arizant.co.uk or contact us directly at +44 (0) 1924 200550.

1. Sessler, D.I., Moayeri, A. Skin-surface warming: heat flux and central temperature. Anesthesiology 1990; 73: 218–24.2. Giesbrecht, G.G., Ducharme, M.B., McGuire, J.P. Comparison of forced-air patient warming systems for perioperative use. Anesthesiology 1994; 80: 671–9.3. Hynson, J.M., Sessler, D.I. Intraoperative warming therapies: a comparison of three devices. J Clin Anesth 1992; 4: 194–9.4. Kurz, A., Kurz, M., Poeschl, G., Faryniak, B., Redl, G., Hackl, W. Forced-air warming maintains intraoperative normothermia better than circulating-water mattresses. Anesthesia & Analgesia 1993; 77: 89–95.5. Borms, S.F., Englelen, S.L., Himpe, D.G., Suy, M.R., Theunissen, W.J. Bair Hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation. J Clin Anesth 1994; 6: 303–7.6. Brauer, A., Pacholik, L., Perl, T., English, M.J., Weyland, W., Braun, U. Conductive heat exchange with a gel-coated circulating water mattress. Anesthesia & Analgesia 2004; 99: 1742–6.7. National Institute for Health and Clinical Excellence clinical guideline 65, The management of inadvertent perioperative hypothermia in adults – April 2008.

8. Sharp, R.J., Chesworth, T., Fern, E.D. Do warming blankets increase bacterial counts in the operating field in a laminar-flow theatre? J Bone Joint Surg Br 2002; 84: 486–8.9. Tumia, N., Ashcroft, G.P. Convection warmers--a possible source of contamination in laminar airflow operating theatres? J Hosp Infect 2002; 52: 171–4.10. Huang, J.K., Shah, E.F., Vinodkumar, N., Hegarty, M.A., Greatorex, R.A. The Bair Hugger patient warming system in prolonged vascular surgery: an infection risk? Crit Care 2003; 7: R13–6.11. Moretti, B., Larocca, A.M., Napoli, C., et al. Active warming systems to maintain perioperative normothermia in hip replacement surgery: a therapeutic aid or a vector of infection? J Hospital Infect 2009; 73: 58–63.12. Zink, R.S., Iaizzo, P.A. Convective warming therapy does not increase the risk of wound contamination in the operating room. Anesth Analg 1993; 76: 50–3.13. Arizant test data on file; Laminar Flow Filter Catalog. 2010. (Accessed February 20, 2010, at http://www.camfilfarr.com/cou_sve/catalog/upload/health_swe.pdf).


Uplifting Development For Patients With Lower Limb Injuries - New Support Is Comfortable and Cost-effective

A special support which can reduce swelling and complications for patients with lower limb problems is now available to hospitals nationwide.

‘Elevate’ Lower Limb is a ‘cushion support’ with a slightly pliant body which allows injured lower limbs to be lifted to a level around 12 inches above the heart to reduce, minimise or stem the swelling of the injured lower limb.

It has been invented and developed through a collaboration between a Consultant Orthopaedic & Trauma Surgeon at The Ipswich Hospital NHS Trust, Health Enterprise East (HEE), the regional NHS Innovation Hub and a technical textiles company, Precision Stitching Limited.

‘Elevate’ Lower Limb can be used therapeutically for a range of conditions such as lower limb trauma, for example knee ligament injuries or ankle fractures, lower limb surgery including total knee replacement, lymphoedema, deep vein thrombosis, chronic venous insuffi ciency and peripheral oedema secondary to heart failure.

HEE worked with The Ipswich Hospital NHS Trust to build a relationship with a commercial partner to develop, manufacture and market ‘Elevate’ Lower Limb.

Precision Stitching Limited, a well-established manufacturer of medical products based in Nottingham, with its experience, knowledge and current product range proved a perfect match.

Following on from this successful relationship, HEE was able to negotiate an exclusive licence between the Trust and the company.

Patient feedback from The Ipswich Hospital has shown that 80% of patients fi nd ‘Elevate’ to be effective, compared with lower satisfaction scores for two standard methods, a traditional frame or a pile of pillows. Patients tended to fi nd ‘Elevate’ more stable and more comfortable. Nursing staff also fi nd it easier to use and to clean. Furthermore it is a more cost-effective solution for the NHS than the traditional methods, as initial purchase costs are reasonable and re-use costs are minimal.

‘Elevate’ inventor Chris Servant from The Ipswich Hospital said: “Being able to tap into HEE’s resources which include considerable knowledge of licence deals and building commercial relationships was extremely benefi cial. This took the orthopaedic support from being a concept into an actual product. “

The covering fabric of the support is fl uid-proof, latex free and easy to clean insitu with antiseptic, non-alcohol based wipes or solutions. ‘Elevate’ Lower Limb is CRIB5 combination burns tested.

Left to right: Chris Servant (inventor), Patrick Tonks, Director and Ray Armstrong Managing Director, both Precision Stitching Limited

demonstrating the use of ‘Elevate’ with a patient.

‘Elevate’ Lower Limb costs £87.50 + VAT + postage. Order online at www.pslmedical.com When responding to articles please quote ‘OTJ’

You Love Your Job - You Just Don’t Know ItThousands of Brits waste time and energy searching for new jobs every winter, because they fail to differentiate between seasonal blues and job dissatisfaction.

According to business consultant Lindsay Rutland-Dix, the way to separate the two is to ask a few simple questions at the fi rst signs of offi ce demotivation.

It’s easy to feel run-down and fed-up after such a cold, dark and depressing winter, but you have to be careful not to let this cloud your judgment, says Rutland-Dix.

Before you do anything drastic, ask yourself whether jumping ship is really what you want. If you’ve simply fallen into a seasonal slump, you need to recognise that you do love what you do and throw yourself back into it.

Rutland-Dix, who is a Master Practitioner of Neuro Linguistic Programming, has devised ten questions designed to help people spot how happy they actually are in their current job.

These include recognising whether you tell people about what you do; noticing whether your work and home personas are actually rather similar; and looking forward to work social events.

Once a high-fl ying corporate executive, Rutland-Dix has retrained as a life coach and has now launched business consultancy service AimAchievers.com, having worked with global names including IBM, Orange and Colt.

Everyone receives personalised training through tried-and-tested techniques including NLP, says Rutland-Dix.

We tap into a successful mind-set to understand how to achieve specifi c goals.

The fi rst step towards achieving those goals is recognising that you want to achieve them.

Lindsay Rutland-Dixs tips for spotting job satisfaction:

1. Do you tell people about your work and what you do?

2. Do you perceive your job in terms of the things that you do and achieve rather than merely the things that are done to you and the things achieved around you?

3. If you took money out of the equation, can you still fi nd enough that gives you satisfaction?

4. Do you wake up with inspired ideas for things you are currently working on?

5. Do you fi nd you wake up without needing to set an alarm?

6. Is there is little difference between your work and home persona?

7. Do you look forward to work social events such as the Christmas party?

8. Do you choose to keep up-to-date with developments and activity across your industry?

9. Can you imagine yourself in three years having achieved the career progression you desire?

10. Do you fi nd ways to help you colleagues and team and care about the outcome?


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New Paediatric Capnomask®Mediplus, specialising in products for Anaesthetics, Urodynamics, Gastroenterology, and Theatre, is launching a new paediatric Capnomask® for oxygen delivery and side-stream CO2 monitoring.

This new paediatric Capnomask® perfectly complements the range of single-use Capnomask® products (including Adult and Adult-Opththalmic sizes) to accommodate all clinical needs:

• The front dual connector on the Capnomask® facilitates connection of oxygen and monitoring lines at the optimal location. The end tidal CO2 measured is therefore much more accurate and the capnogram, easier to read.

• The 0.22μ fi lter, connected to the capnograph, offers good protection against bacterial contamination.

• The specially shaped Capnomask® Ophthalmic is supplied with an oxygen line and a monitoring line, as well as a 0.22μ fi lter.

For more information on the Capnomask® and other products, please contact Mediplus on 01494 551200, [email protected] or visit www.mediplus.co.uk

Mediplus LtdUnit 7 The Gateway CentreCoronation Road, High WycombeBuckinghamshire HP12 3SUTel: +44 (0)1494 551200 Email: [email protected]: +44 (0)1494 536333 www.mediplus.co.uk Please quote ‘OTJ’

Medic jailed over supplies theftAn NHS medic who stole £23,000 worth of medical supplies and surgical equipment from Glasgow hospitals to sell on eBay has been jailed for 20 months. Anaesthetic assistant Douglas Stevenson admitted taking the items after fi nding buyers online and stealing to order.

Glasgow Sheriff Court heard how the 32-year-old was caught with more than 200 stolen items in his garage. Sheriff Robert Anthony QC said the crime was “despicable” at a time when NHS funding was tight.

The court heard how Stevenson stole supplies and equipment from a number of hospitals in Greater Glasgow, including the Royal Hospital for Sick Children at Yorkhill.

NHS Counter Fraud Services (CFS) began enquiries when manufacturers spotted specialist medical equipment for sale on eBay. The items were identifi ed as having been purchased by NHS Greater Glasgow and Clyde. During the investigation, CFS found that Stevenson’s duties routinely allowed him access to quantities of medical items as surgical needs arose.A subsequent raid by Strathclyde Police and CFS investigators on his home found an “Aladdin’s cave” of more than 200 items of surgical equipment and supplies in his garage. Stevenson later admitted to taking the items directly from storage at the end of each shift and carrying them home in his rucksack. After fi nding buyers as far afi eld as Australia and America through eBay, he would sell direct to them, taking orders and stealing to order.

Passing sentence, Sheriff Anthony said: “This was a despicable offence at a time when NHS funding is tight. ‘Stark warning’ “Anyone else who embarks on this course of action must be dissuaded. This was a gross breach of trust. It was premeditated and for his own gain.”

Maggie Worsfold, from NHS Scotland CFS, said: “When Douglas Stevenson pled guilty to defrauding the NHS he recognised that he had acted dishonestly and that the money he stole should have gone directly into frontline patient care. “This sentence demonstrates that fraud against the NHS will not be tolerated and that money intended for patient care and services will be protected from abuse.

“This sentence should also serve as a stark warning to anyone contemplating fraud that they will be pursued rigorously and CFS will ensure that Scotland’s NHS is protected from fraud.”

Source: BBC


BD launches new device designed to improve safety, accuracy and turnaround time of

blood collection in patients with fragile veins BD Diagnostics, a segment of BD (Becton, Dickinson and Company), announced recently the launch of BD Microtainer® MAP Microtube for Automated Process for hematology testing. This new product is designed to improve the safety, accuracy and turnaround time of capillary blood collection and testing in patients with veins that can be diffi cult to access, such as infants, children, oncology patients and the elderly. The new BD Microtainer MAP product is also the fi rst microtube to be fully compatible with most automated hematology instruments, reducing turnaround time and costs associated with sample transfer and re-labeling.

“Clinical laboratories are focused on preventing specimen identifi cation errors that can lead to misdiagnosis of patients. We at BD are pleased to introduce the BD Microtainer MAP product to address this healthcare issue,” said Tom Polen, President, BD Diagnostics – Preanalytical Systems. “BD is committed to continuing our history of innovation in helping improve patient safety and healthcare worker safety, while enhancing workfl ow effi ciency.”

The BD Microtainer MAP tube is the fi rst low-volume collection system to accommodate standard, full-size patient identifi cation labels, thus reducing the risk of labeling errors. This feature offers a signifi cant improvement over traditional microcollection tubes, which are incompatible with standard labels due to their size. This disparity can lead to dangerous labeling errors that may result in misdiagnosis and incorrect patient treatment.

The preanalytical phase is a critical step in the diagnostic process, with signifi cant impact to patient health, healthcare worker safety, and workfl ow effi ciencies. Historically, low-volume capillary blood collection has increased test result turnaround time due to incompatibility with automated testing instruments and a higher risk of patient identifi cation errors.

The innovative design of the BD Microtainer MAP tube enables automated processing with 81 percent less blood than venous systems, improving test turnaround time and laboratory effi ciency. This is a critical improvement for patients from whom it is diffi cult to obtain a suffi cient blood sample to perform critical diagnostic tests.

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Skills for Health urges employers to grasp apprenticeship

opportunitySkills for Health has welcomed the increased uptake of apprenticeships within the health sector but says more employers should be taking advantage of the opportunities they offer.Chief executive John Rogers said: The increase in apprenticeship numbers is great news but this is only the start. There are many more health sector employers who could also benefi t from an apprenticeship scheme and I urge them to grasp the opportunity. For example, the sector has an ageing workforce, with 73 per cent of staff over 35. There is an urgent need to recruit and develop new talent. Apprenticeships offer a fl exible and affordable way to do this, with 100 per cent training funding available for apprentices aged 16 to 18, 50 per cent funding for those aged 19 to 25 and limited funding for those over 25. He added: They also offer employers a way to unlock talent in their local communities, while giving young people the chance of a fulfi lling and rewarding career. The Department of Health last week announced that the NHS in England had exceeded its aim to recruit more than 5,000 apprentices during the last 12 months a fi ve-fold increase. Speaking before the NHS Apprenticeship Conference held on 25 February, Health Secretary Andy Burnham said: I am delighted that we have hit the target to create an extra 5,000 apprentices. We must do all we can to provide high quality routes into jobs so that we can ensure we have a highly skilled and highly motivated NHS workforce for future generations Skills for Health is actively promoting the take-up of apprenticeships within the health sector, and offers a range of materials, advice and guidance to help employers implement successful programmes. These include new online resources, including details of over 80 different types of apprenticeships now available within healthcare. The resources also provide video testimony from employers who have experienced fi rst-hand the benefi ts that apprenticeships can bring. These include Yorkshire Ambulance Service Locality Manager Paul Palfreeman, who said; Patient care has defi nitely improved since we have taken on the apprentices. They’re answering the calls quicker, were speaking to the patients much more regularly, were keeping them informed and were developing the staff as we go along. Hereford PCT Training Centre Administration Manager Helen Pryce said: Taking apprentices has had a real impact on the department as a whole because they can come in and they can offer valuable support, they bring with them enthusiasm, they’ve very keen to learn and it helps our team to provide a more effi cient services. NHS Herefordshire Qualifi cations Manager Sharon Hempton-Smith said: There would be a shortage of nurse trainees if we didn’t have the apprenticeship route they are at least 40 to 50 per cent of the entry into nurse education. University of Leeds, Yorkshire and Humber Lead for Pharmacy Gill Risby said: It brings to us a lot of skills that we wouldn’t always expect. Younger apprenticeships come with a wealth of IT skills that some of our longer-standing employees won’t have. NHS Herefordshire Interim Managing Director-Provider Services Richard Carroll said: Its been a great success for us and its very positive to see young people coming on in leaps and bounds having been given the opportunity. For further information on the health apprenticeship resources available from Skills for Health, visit:www.skillsforhealth.org.uk/apprenticeships

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E.C.M.O [ Extracorporeal Membrane Oxygenation]Part one, Peaks and Troughs

Introduction:Extracorporeal Membrane Oxygenation [E.C.M.O] is a technique developed to support patients who’s cardiac and respiratory functions are so severely impaired either by trauma or disease that they can no longer sustain life without supplementary support .E.C.M.O. support is used to treat pulmonary distress in premature babies. The treatment is only suitable for newborns over 2ks in weight, below this weight the blood vessels are so fi ne and delicate that they would not support the necessary blood fl ow required through a cannulated site.For newborns who are suitable for the application of E.C.M.O. there is a 75% chance of survival.

A new idea?The term E.C.M.O. was coined in the 1970s, when it was used to perfuse isolated organs outside of the body, the original idea was devised by physicians Frey and Gruber in 1885. And the necessary gaseous exchange was facilitated by a constant fl ow of oxygen through an inclined rotating cylinder which was coated with a thin fi lm of the patient’s blood.This idea was studied and further developed, and in 1937 work started on the fi rst heart lung machine, pioneering the way for open heart surgery. The designer, Gibbon, developed a system whereby anti-coagulated blood was directly exposed to oxygen, in what became known as fi lm, or bubble oxygenation.This groundbreaking development did however have its drawbacks. The heart-lung machine could only be used for short periods of time, a few hours maximum, before complications such as haemorrhage or even total organ failure occurred. In 1956 Clowes further developed the idea and the membrane oxygenator was born.

In this device the gaseous compounds where separated from the liquid compounds by a membrane.

This period was post second world war, when building, engineering and medical techniques were moving forward in leaps and bounds. New materials were available for use in the fi eld of medicine, and the heart lung machine was soon to be used with some success.The Procedure:The E.C.M.O. machines are much similar to the more commonly used heart lung machines. Cannulae are sited in the most patent and accessible blood vessels, and anticoagulants are administered to assist with blood fl ow and arrest coagulation.The patient’s blood is pumped via the E.C.M.O. through a membrane oxygenator, this emulates the gaseous exchange function of the human lungs, carbon dioxide is removed and is replaced with oxygen. The oxygenated blood is returned to the patient and the cycle continues.There are several types of E.C.M.O with veno-arterial [VA] and veno-venous [vv] being the most prevalent.In VV, deoxygenated blood is extracted from the venous system, oxygenated and returned to the venous system.In VA, deoxygenated blood is extracted from the venous system, oxygenated and returned to the arterial system via a pump, thus providing cardiac support The E.C.M.O. professionals:This is a highly complex and sophisticated procedure, a typical E.C.M.O. team would normally consist of intensive care physicians, perfusionists, respiratory care therapist and registered nurses, these highly trained personnel are further trained to the highest possible standard to perform this delicate and potentially lifesaving procedure.How long can a frail newborn sustain this major intrusion?Veno – Venous E.C.M.O. can provide the necessary life giving oxygen required for life for several weeks. This gives the under developed respiratory system precious time to mature.E.C.M.O. would probably not be the automatic fi rst choice of treatment of the physician.

Factors affecting choice include, the need for technical support, the cost of such extreme intervention, and physiological complications such as the effects of prolonged use of anticoagulants and antibiotics. We would hope that the fi scal concerns of treatment would not be a consideration in a perfect world, but we all know that this is not a perfect world and costs have to be included in the equation, being possibly the greatest dilemma causing sleepless nights for the physician. E.C.M.O. is a long and expensive procedure,The time limit for care of the newborn on E.C.M.O.is approximately 21 days, although a patient at the Stanford university in the U.S.A. survived for a total of 62 days . This period was surpassed in Taiwan in January 2008, after a patient who survived drowning was treated for 117 days.Technological advances continued, and in 1972 E.C.M.O. was applied in respiratory failure in both newborns and adults. Later in 1976 it was reported that a newborn, baby Esperanza, had received E.C.M.O. and had thankfully survived.The news of baby Esperanza’ survival soon fi ltered across the countries medical institutions, and was received with fervour. A major breakthrough had occurred.Peaks and TroughsAs with all aspects of life there are peaks and troughs, the peak being the survival of baby Esperanza. The trough would present itself in 1974.During this year a randomised study was conducted V.A. E.C.M.O. against more conventional treatments. The study concluded that patients mortality rates among the E.C.M.O treatment was as high as 90%, and there were no signifi cant mortality rate difference between the two styles of treatment. The earlier fervour felt by the medical fraternities soon waned and interest dampened within many research groups.Research was continued by one Kolobow.

His research varied from earlier work in that his aim was to prevent further damage to the already diseased lung by reducing the motion of the lung [pulmonary rest] He applied a few ventilator supportive breaths, this technique became known as “Low frequency positive pressure ventilation” [L.F.P.P.V.]With this technique the idea was to dissociate the inspiration of oxygen and the expiration of carbon dioxide, the procedure acquired a somewhat lengthy title, [“low frequency positive pressure ventilation extra corporeal carbon dioxide removal” even the anacrynin “L.F.P.P.V- E.C.C.O. 2-r” is quite a mouthful.However long the name, a peak was forming again, and results showed mortality rates as low as 49%, and later several centres within Europe recorded success rates of well over 50%.Kolobows, technique proved to have less detrimental effects on blood cells, coagulation and the internal organs, however these reports were regarded in the U.S.A. as uncontrolled observations and would require further correlative evidence. Perhaps another trough was potentially set to be furrowed. When the results from Europe were studied in the U.S.A. this further refi ned version of E.C.M.O. gained renewed interest, and was given another chance in treating patients with A.R.D.S. [acute respiratory distress syndrome] In 1994 at the pulmonary intensive care unit of the latter-day Saints Hospital in Salt Lake City A. H.Morris conducted a randomized control trial [R.C.T.] He used the newest European altered techniques against the now more advanced conventional techniques. Once again the studies showed what were seen as insignifi cant differences between the two treatments 42% survival for the more conventional treatment, and 33% for the E.C.M.O. treatment.

All views expressed within this article are the views of the author Trevor R Toman


News and Job Alert from Kirkham Young

Leading specialist recruitment consultancy Kirkham Young continues its programme of ongoing improvement in the service it offers to its customers by providing a dedicated industry news and job alert system to subscribers.

The highly regarded agency, dedicated to the medical and scientifi c sectors, prides itself on working with the best range of medical and laboratory equipment companies in the market, ranging from global blue chip organisations to exciting start up ventures. This is backed by a solid commitment to exceptional levels of customer service endorsed by ISO accreditation.

“Our customers have always regarded us as so much more than a CV service” commented director Tina Young. “We are often asked for information regarding market trends, recruitment law and company news and the launch of our news subscription service is all part of that commitment to being a fully rounded industry specialist.”

As part of their pledge to offer an unrivalled service to candidates and companies alike, all registered candidates with the agency now receive regular alerts for a variety of opportunities including sales, marketing, technical support and management roles as well as being able to keep up to date with current industry bulletins.

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NHS staff numbers in England increase for second year running to reach just

over 1.43 million, census shows.

The NHS workforce in England has increased for the second year running to reach just over 1.43 million, a census by The NHS Information Centre showed recently - 25th March 2010

Staff numbers reached 1,432,000 in 2009 - an increase of 63,300 (4.6 per cent) on the previous year. The latest fi gure is a 333,650 (30.4 per cent) increase on 1999 and represents a 2.7 per cent average annual increase over the last decade.

The census covers hospital, community, general and personal medical services. The census overview of selected staff groups shows that at 30 September 2009 the NHS employed:

• 725,580 professionally qualifi ed clinical staff up 23,750 (3.4 per cent) on 2008 and 183,810 (33.9 per cent) on 1999, with an average annual increase of 3.0 per cent over the last decade.

Within this group the NHS employed:

• 375,500 qualifi ed nurses (excluding bank nurses) 4 - including practice nurses up 7,080 (1.9 per cent) on 2008 and 73,490 (24.3 per cent) on 1999, with an annual average increase of 2.2 per cent over the last decade.

• 149,600 qualifi ed scientifi c, therapeutic and technical staff 5 up 7,040 (4.9 per cent) on 2008 and 47,200 (46.1 per cent) on 1999, with an annual average increase of 3.9 per cent over the last decade.

• 51,500 hospital doctors in training 6 up 2,320 (4.7 per cent) on 2008 and 19,980 (63.4 per cent) on 1999, with an annual average increase of 5.0 per cent over the last decade.

• 40,270 GP contracts 7 - up by 2,550 (6.8 per cent) on 2008 and 9,310 (30.1 per cent) on 1999, with a 2.7 per cent annual increase over the last decade.

• 36,950 consultants - up 2,040 (5.8 per cent) on 2008 and 13,630 (58.4 per cent) on 1999, with an annual average increase of 4.7 per cent over the last decade.

• 24,310 midwives (excluding bank staff) 4 up 650 (2.8 per cent) on 2008 and 3,410 (16.3 per cent) on 1999, with an annual average increase of 1.5 per cent over the last decade.

The census also shows the NHS employed:

• 377,620 staff in support to clinical staff 8 up 22,610 (6.4 per cent) on 2008 and 81,000 (27.3 per cent) on 1999, with an annual average increase of 2.4 per cent over the last decade.

• 236,100 NHS infrastructure support staff 9 up 17,040 (7.8 per cent) on 2008 and 64,900 (37.9 per cent) on 1999, with an annual average increase of 3.3 per cent over the last decade.

Within the latter group the NHS employed:

• 44,660 managers and senior managers up 4,750 (11.9 per cent) since 2008 and 20,370 (83.9 per cent) since 1999, with an annual average increase of 6.3 per cent over the last decade.

The census also shows increases in the headcount of most staff groups; including school nurses, healthcare assistants and community matrons.

It also shows a decrease in the headcount of practice nurses, health visitors and nursing assistants and auxiliary staff.

Chief executive of The NHS Information Centre Tim Straughan said: Following a dip in numbers in 2007, the NHS headcount has increased for the second year running to reach a record high.

This census shows how the 1.43 million strong workforce is made up of different proportions of staff groups, providing a meaningful snapshot of who is working for our health service.

Full copies of the reports are at: http://www.ic.nhs.uk/pubs/nhsworkforce


DEPUTY TO THEATRE MANAGER OPERATING DEPARTMENT PRACTITIONERS SCRUB/RECOVERY NURSES Salary: Negotiable depending on experience Full Time: 37.5 hrs per week Shifts: To include evenings and weekends

We are looking to appoint staff to join our multi speciality department. We require experienced, flexible and highly motivated qualified theatre practitioners in anaesthetics, scrub and recovery.

In addition to your strong clinical skills, you will possess:

The personality to work as part of a small dedicated team The capacity to plan equipment and consumable requirements Team leadership skills Ability to participate in on-call duties The ability to work to tight deadlines

Necessary qualifications

Registered Nurse level 1 or ODP Teaching and assessing qualification is desirable but not essential

In return for your expertise we offer:

Competitive Salary Package 25 days annual leave (pro rata) Contributory Pension Scheme Private Healthcare Life Assurance Ongoing Training Subsidised staff restaurant

For further information or to arrange an informal visit please contact: Nina Jackson, Theatre Manager on 01883 337419 or email [email protected] A full job description and application pack can be obtained via Lynn Coote, HR Administrator on 01883 337407 or by email [email protected] All offers of employment in respect of these appointments will be subject to receipt of a satisfactory Enhanced Disclosure Certificate from the Criminal Records Bureau. North Downs Hospital, 46 Tupwood Lane, Caterham, Surrey CR3 6DP Committed to quality, equality and opportunity for all. www.ramsayhealth.co.uk

NORTH DOWNSHOSPITAL

Second Annual Conference and Annual General Meeting 28th May 2010. To be held at:

The Royal College of AnaesthetistsFor further information contact: Conference cost (lunch included)PA (A) Swift House Association of PA (A) members £80-006 Cumberland Way Non members £90-00Darwen BB3 2TRTelephone 07952 873378E-mail [email protected] Website: http://www.anaesthesiateam.com/news.php

SonoSite supports regional anaesthesia

training in the South West

The South West Regional Anaesthesia (SoWRA) Group runs a popular regional anaesthesia course, and is supported by SonoSite through the loan of equipment and training aids.

This initiative is helping Trusts in Devon and Cornwall to expand their use of ultrasound for regional nerve blocks, as Dr Matthew Grayling, a consultant in anaesthesia at the Royal Devon and Exeter Hospital and secretary of SoWRA, explained: Our aim is to promote local interest in regional anaesthesia techniques, using local expertise to provide cost-effective training and establish a good foundation in high quality anaesthesia care in the region. SonoSite and other manufacturers have been very generous by loaning equipment and teaching us to use their instruments, helping us to invest more in developing the course and providing a forum to improve regional nerve blocks in the South West.

In addition, we have both S-Nerve and MicroMaxx® systems for anaesthesia use at the Royal Devon and Exeter Hospital, as well as some older SonoSite devices. These instruments offer excellent durability and are very easy to use. The portability is also an important factor, making it very easy to move the instrument around the patient and between anaesthetic rooms.

For information and to register on SonoSite structured training courses, log on to: www.sonositeeducation.co.uk

For more information about SonoSite products, please contact Sonosite:Alexander House, 40A Wilbury Way, Hitchin SG4 0APT +44 (0)1462 444 800F +44 (0)1462 444 801Email: [email protected] Website www.sonosite.com


www.OOperati ngperati ngTTheatreheatreJJobs.comobs.com

ODP / Anaesthetic Nurses – UK widebpas is a charitable organisation which provides abortion and sexualhealth services to women and men across the UK.

We are looking for self-reliant and dependable Operating DepartmentPractitioners (or Anaesthetic Nurses) to provide dedicated assistance tothe Anaesthetist and deliver professional and high standards of clientcare within the operating theatre.We currently have excellent opportunities in the following Clinics:Rosslyn Clinic, RichmondSalary: £27,899 – £32,808 per annum pro rata32.5 hours per week – Tuesday to SaturdayWiston Clinic, BrightonSalary: £23,976 – £28,885 per annum pro rata22 hours per week – Monday to ThursdayDanum Lodge Clinic, DoncasterSalary: £23,976 – £28,885 per annum pro rata11.5 hours per week – Tuesday and WednesdayBenefits include salary comparable with Agenda for Change, 34 days’annual leave including public holidays (pro rata for part-time staff),pension, training and development opportunities.More information and application forms are available viawww.bpas.org or by emailing [email protected] or bycalling 0207 612 0211.Please visit our job pages for other job opportunities working for bpasacross the UK.All applicants must be pro choice.

bpas is an equal opportunities employer.Registered Charity Number 289145.

Vale Healthcare is a private healthcare provider delivering excellent services in Cardiff, Vale of Glamorgan and across South Wales. We combine the best consultants with the latest technology offering a rapid access service for a wide range of conditions. The Cardiff Bay Clinic, a Diagnostic, Treatment and Outpatient Clinic opened in September 2008 and our 25 bed hospital opens in June 2010 at Hensol, Vale of Glamorgan.

The Cardiff Bay Clinic offers an endoscopy suite and minor op theatre whilst at the hospital we will have two state of the art digital operating theatres.

We are looking for individuals to join our dynamic theatre team that covers both our Cardiff Bay Clinic and Vale Hospital site.

This is a fantastic opportunity to join a new company and to help establish a new service, offering a 5 star service to our patients.

Appropriate quali cations are required to be a current registered practitioner and demonstrate Continuing Professional Development (CPD). Enhanced CRB checks will be required for successful candidates.An application form can be downloaded from our web site. Alternatively, please send your CV to Jackie Freeston, HR Department, Vale Healthcare, Hensol Park, Vale of Glamorgan, CF72 8JY [email protected] date for applications 25th April 2010.

Operating Department Practitioners Scrub Nurses Theatre HCA’s

OR Fire Erupts Into Legal BattleLawsuit says electrosurgical device ignited wet surgical prep.

A woman who was severely burned in an OR fi re during breast reconstruction surgery is suing the plastic surgeon who allegedly ignited a surgical prep at the incision site with an electrocautery device.

Last December at St. John Medical Center in Tulsa, Okla., E. Bradley Garber, MD, allegedly swabbed Connie Plumlee with a chlorhexidine gluconate and alcohol prep and then turned on a cautery device before the alcohol had evaporated. The surgical prep and the drapes caught fi re. The fi re was so intense that it melted the endotracheal tube, burning the inside of Ms. Plumlee’s mouth, according to documents fi led this week in District Court for Tulsa County. Ms. Plumlee and her husband, Jack, are suing for Dr. Garber and the hospital for $600,000.

Ms. Plumlee told KOTV News on 6 that when she woke up in recovery she had bandages on her face and the upper half of her body. A hospital staff member asked if she knew what had happened. “He had tears in his eyes,” said Ms. Plumlee. The staffer said: “You were burned.” Each year between 550 and 650 surgical fi res occur in the United States, according to the ECRI Institute.

Ms Plumlee alleges that Dr. Garber told her the injury was not serious and that she wouldn’t scar. However, Ms. Plumlee says that her face and lips are now deformed and will require surgery. She’s in pain, developed shingles and also claims that she can no longer teach school.

Attorneys for Dr. Garber and St. John Medical Center told reporters they could not comment on the case.

Source: Outpatient Surgery Magazine

Medical devices will effectively extract fumes during keyhole surgery

Removing smoke without ireCardiff University spin-out Asalus is launching a range of medical devices that it claims will signifi cantly improve the safety and effi ciency of laparoscopic surgery.

Founded on the inventions of Neil Warren, manager of the Wales Institute of Minimal Access Therapy (WIMAT), the group believes that in the next few years its latest instruments will change the way doctors perform keyhole surgery on the abdomen.

Dominic Griffi ths, director of the group, said that surgeons are currently faced with a range of diffi culties in performing these operations, including smoke contamination (caused by electrosurgical ablation), traumatic tissue removal and a cooling down of the body cavity. ’A lot of these problems can be overcome using better-designed instruments,’ explained Griffi ths. ’For instance, smoke fi lling the operating area is a common problem for surgeons during laparoscopy. Existing technology sucks the smoke out of the body using a vacuum. This not only cools the body down, but also dries it out.’

Griffi ths added that an alternative would be to let the smoke escape through incisions in the body. However this can contaminate the operating theatre and is not ideal for longer operations, which can take up to four to six hours.

Asalus claims its smoke-removal device removes the need for both of these methods. Based on existing technology used in the electronic and automotive industry, the system creates a needle-sized incision that can remove the smoke instantaneously without altering the body temperature of the patient.

Using funding from venture capitalist Fusion IP, Asalus plans to commercialise its smoke-clearance device, alongside a novel access port and multifunctional manipulator, by 2012. The group has fi led a patent for all three systems and hopes to release further details in the next six months.

Documents

The Operating Theatre Journal