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April 2012 Issue No. 259 ISSN 1747-728XThe Leading Independent
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fi nd out more 02921 680068 e-mail [email protected] Issue 259
April 2012 3
The Next issue copy deadline, Wednesday 25th April 2012All
enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51,
Pontyclun, CF72 9YY Tel: 02921 680068 Email: [email protected]
Website: www.lawrand.comThe 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 United Kingdom. Personal copies are available by nominal
subscription.Neither the Editor or Directors of Lawrand Ltd are in
any way responsible for the statements made or views expressed by
the contributors. All communications in respect of advertising
quotations, obtaining a rate card and supplying all editorial
communications and pictures to the Editor at the PO Box address. No
part of this journal may be reproduced without prior permission
from Lawrand Ltd. 2012Journal Printers: The Warwick Printing Co
Ltd, Caswell Road, Leamington Spa, Warwickshire. CV31 1QD
Health and Social Care Bill gains royal assent
The Health and Social Care Bill gained Royal Assent on 27th
March to become the Health and Social Care Act (2012)
The core principles of the Act mean that doctors and nurses will
be able to tailor services for their patients, more choice will be
given to patients over how they are treated, and bureaucracy in the
NHS will be reduced.
The Act will: Devolve power to front-line doctors and nurses:
Health professionals will be free to design and tailor local health
services for their patients;Drive up quality: Patients will benefi
t from a renewed focus on improving quality and outcomes;
Ensure a focus on integration: There will be strong duties on
the health service to promote integration of services;
Strengthen public health: Giving responsibility for local public
health services to local authorities will ensure that they are able
to pull together the work done by the NHS, social care, housing,
environmental health, leisure and transport services;
Give patients more information and choice: Patients will have
greater information on how the NHS is performing and the range of
providers they can choose for their healthcare. And they will have
a stronger voice through Healthwatch England and local
Healthwatch;
Strengthen local democratic involvement: Power will shift from
Whitehall to town hall there will be at least one locally elected
councillor and a representative of Healthwatch on every Health and
Wellbeing Board, to infl uence and challenge commissioning
decisions and promote integrated health and care;
Reduce bureaucracy: Two layers of management - Primary Care
Trusts and Strategic Health Authorities - will be removed through
the Act, saving 4.5 billion over the lifetime of this Parliament,
with every penny being reinvested in patient care.
Andrew Lansley, the Health Secretary, said: The Health and
Social Care Act will deliver more power to clinicians, it will put
patients at the heart of the NHS, and it will reduce the costs of
bureaucracy.We now have an opportunity to secure clinical
leadership to deliver improving quality and outcomes; better
results for patients is our objective.
Professor Steve Field, chair of the NHS Future Forum, said: It
was a tremendous privilege to be able to chair the Independent NHS
Future Forum. All the comments and debate that we heard helped
improve the Bill. Chairing the Future Forum gave me the rare
opportunity to meet a huge variety of patients, the passionate
health professionals and organisations that make the NHS what it
is. Whats vital now is that the Government continues to work
closely with them to put the freedoms the Bill offers into
practice.
Dr Nadim Fazlani, a GP and the leader of a Clinical
Commissioning Group in Liverpool, said: The new structure of the
NHS will give me and my colleagues much more freedom and control to
design care around our patients. No decision about me without me is
a key concept my colleagues and I will be working directly with
patients, giving them a wider choice of where, when and how they
receive their healthcare.The implementation of the Act will now
enable clinical leaders, patients representatives and local
government to all take new and leading roles in shaping more
effective services.
Last Hurdle Removed To Scotland Adopting Heart Valve
Procedure
TAVI now to be normal in England while still blocked for centres
in Scotland
Cardiac specialists are calling on the Scottish Government to
give the green light to a heart valve replacement procedure they
say would transform the lives of over one hundred patients every
year.
Clinicians in England were being told 29th March 2012 by the
health assessment body NICE that Transcatheter Aortic Valve
Implantation (TAVI) can now be regarded as being under normal
arrangements for clinical governance for patients where traditional
open heart surgery to replace faulty valves would be too risky.
TAVI has been available for selected patients across England, Wales
and Northern Ireland for the past four years.
Many patients have already been identifi ed by the
cardiothoracic centres in Scotland as suitable for TAVI but very
few have undergone the procedure and they have all had to travel to
centres in England or Northern Ireland. The Scottish Government had
told MSPs that they would await todays NICE report before making a
decision on allowing the procedure to be carried out in
Scotland.
Clinical Director for Cardiac Services at the Royal Infi rmary
of Edinburgh, Dr Neal Uren, says he hopes this leaves the way open
for TAVI to be offered to Scottish patients in Scotland:
This is a specialist alternative to surgical valve replacement
for people whose aortic heart valve becomes increasingly narrowed,
a condition known as aortic stenosis. TAVI is a proven technology
giving normal lives back to the people who receive it. There is now
very good evidence that it is cost-effective in a carefully
selected high-risk population of older people that NICE has been
looking at who have been turned down for the traditional surgical
approach is too dangerous. NICE examined the procedure in
considerable detail and has recommended that cardiologists in
England should go ahead and offer TAVI in all suitable cases. We
sincerely hope that this will persuade the NHS in Scotland to let
us get on and do the same for Scottish patients.
Professor Keith Oldroyd, a Consultant Cardiologist in Glasgow
says Scottish centres are several years behind their counterparts
in England:
Scotlands track record in adopting innovative technologies in
the area of heart disease is poor and needs to be improved. Even a
country like Greece with its dire economic situation has initiated
a TAVI programme. Across Scotland right now there are around 100
patients who have been deemed suitable for the TAVI procedure, many
of whom have been referred by heart surgeons reluctant to perform
conventional open heart surgery. Now that English patients in this
high risk group will be eligible for it automatically, I cannot see
anything in the way of the Scottish Government allowing TAVI to be
performed in Scotland
Mrs Christina Fyvie (75) lives in Paisley and has been told TAVI
would be the only option for her aortic stenosis as it is too
dangerous to repair her aortic valve using conventional
surgery:
I feel breathless all the time and walking is a struggle. I can
only get out using a wheelchair with my husband helping me. I am
pleased for patients in England but also quite angry that I cannot
get TAVI because I live here. It seems very strange to me that we
have the skills in Scotland to do this but its not being allowed. I
hope Nicola Sturgeon will now act to end this cross border
divide.
Mrs Violet Buyers (85) lives in the Saughton area of Edinburgh
and was told four years ago that open-heart surgery was too risky
to replace her aortic heart valve and that she would be in line to
be one of the fi rst to have TAVI when it became available.
It seems unfair that if I was living in England I would be
almost guaranteed to get the treatment that my specialists tell me
would make a big difference, says Mrs Buyers.
At the moment I am confi ned to the house and can only take
short trips out if someone can give me a lift from door to door as
I cant walk far at all. My doctors are all very apologetic saying
they know there is a treatment that will make me much better but
they cant give it to me.
Issued by the UK TAVI Forum www.taviforum.orgThe NICE Guidance
is at: http://guidance.nice.org.uk/IPG421
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4 THE OPERATING THEATRE JOURNAL www.otjonline.com
Fujifi lm are awarded the All Wales PACS Managed Service
Solution contractFujifi lm Medical Systems UK is pleased to
announce they have been awarded the All Wales PACS Managed Service
Solution contract. The Agreement for around 20 million covers a 7
year period from 2012 to 2019 and will enable Welsh Local Health
Boards and the Velindre Trust, to benefi t from a common PACS
service together with a centralised Vendor Neutral Archive (VNA)
and remote back up all being operationally phased in from 2012 to
2014.
This prestigious national contract has been put in place to
provide an effi cient and cost-effective Picture Archiving &
Communications Service across the whole of Wales. Fujifi lms
Synapse PACS system will replace existing legacy PACS systems
offering a fully integrated web based solution to manage, store,
distribute and retrieve images in an open environment. All images
will be available on demand, with a two second response time for
in-hospital viewing, providing greater access to patient data when
and where required. Comprehensive data security is provided by an
SSL (Secure Sockets Layer) network that operates to modern banking
standards.
The fi rst operational phase from March to June 2012 will
involve the central VNA together with the fi rst of seven Welsh
Local Health Boards being established. Betsi Cadwaladr University
Health Board (BCU) will be the fi rst authority to implement Fujifi
lms Synapse PACS solution. This work will involve three primary
sites and will include local servers and new workstations being
installed together with various CR and DR solutions.
Commenting on the contract award, Mark van Rossum, General
Manager of Fujifi lm Medical Systems UK, said: We already undertake
an extensive amount of work within Wales and are pleased to further
our national support. Data migration for BCU will begin shortly and
we expect to have the data migration, system installation, user
training and development completed by June. The remaining Welsh
Local Health Boards will then be operationally phased in by 2014.
Through using our Synapse PACS system we are offering users the
latest in modern architectural solutions.
An NHS Wales Informatics Service spokesperson said: Selection
followed a comprehensive tendering and evaluation process. The
award of this framework contract demonstrates how working together
and doing things once for Wales can achieve signifi cant
savings.
For further information on the All Wales PACS Managed Service
Solution contract, telephone Fujifi lm on 01234 326780.
Fujifi lm pioneers in diagnostic imaging and information
systems.
From left to right Andrew Griffi ths, CIO for Health (NWIS) and
Mark van Rossum, General Manager for Fujifi lm at the recent
signing of the All Wales PACS Managed Service Solution contract
with Fujifi lm.
When responding to articles please quote OTJ
Better integrated care could save the NHS millionsThe NHS could
save millions and provide better care by involving more Allied
Health Professionals such as podiatrists in patient care.
Physiotherapists, dietitians, podiatrists, speech and language
therapists and other Allied Health Professionals can have a
dramatic impact on care for people with diabetes, cancer,
musculoskeletal problems and stroke survivors.
Using podiatrists to help treat patients with diabetes can lead
to a drop in foot ulcers a serious complication for diabetics and
distressing foot amputations. There are almost 5,000 leg, foot or
toe amputations in England every year each one costs the NHS around
65,000. Investing in providing integrated foot care and bringing
this number down could save the NHS almost 300 million.
By working together as a team, physiotherapists, speech and
language therapists and dietitians can help stroke survivors regain
independence faster and leave hospital and go home sooner. This
could save the NHS over 7 million every year.
A new series of online tools, launched recently, will help the
NHS identify how therapists can intervene at different stages of a
patients condition to improve patient care whilst saving on
costs.
Health Minister, Lord Howe said: Allied Health Professionals
play a critical role in ensuring patients get integrated care so
they recover quickly after treatment or can manage a long term
condition successfully. Better integration of care is one of the
key elements in the Health and Social Care Bill - not only does it
improve the quality of patient care, but it can also save the NHS
money.
These online tools highlight some excellent examples of when and
how Allied Health Professionals involvement can work and will help
commissioners pinpoint opportunities for better integration of
care.
Shelia Stringer, Senior Physiotherapist and service manager at
the Royal Wolverhampton Hospital NHS Trust said: Although this was
developed as a tool for commissioners it is so much more. It is a
one stop shop of information and evidence that I hope will promote
local discussions amongst all clinicians on how we can improve
services for out patients and deliver the savings the NHS needs to
achieve.
Richard Evans, Chief Executive of the Society and College of
Radiographers said:
AHPs in all their diversity have a vast amount to offer any
healthcare system. In the UK it is it is very important that those
who buy healthcare for patients fully understand what AHPs can
provide in terms of improving the quality of care.
The online tools provide case studies and examples from local
NHS services who have made changes to services to optimise savings
whilst ensuring the best quality of care for patients. Salford
Royal NHS FT reorganised their foot care pathway for people with
diabetes which included annual screening, a preventative foot care
service for patients and education programmes making a potential
saving of more than 1 million over four years. The Stroke REACH
Early Discharge Scheme (Stroke REDS) in Camden, London was
developed to provide seamless transfer of care from the hospital to
the patients home reducing the average length of stay in hospital
leading to a potential 307,000 in acute bed day costs.
The toolkits can be seen at:
http://www.networks.nhs.uk/nhs-networks/ahp-networks/ahp-qipp-toolkits
www.facebook.com/TheOTJ
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fi nd out more 02921 680068 e-mail [email protected] Issue 259
April 2012 5
PROACT awarded NHS Supply Chain Framework agreement for the
Cheetah NICOM
PROACT Medical, the offi cial UK distributor of Cheetah NICOM
(non-invasive cardiac output monitor) are happy to announce that,
NHS hospitals are, for the fi rst time, able to purchase the
Cheetah NICOM (non-invasive cardiac output monitor) from PROACT
through NHS Supply Chain. The NHS Supply Chain Patient Monitoring
framework agreement (FAG 390) covers an initial period of two
years, followed by the opportunity to extend for up to a further 2
years.
Cheetahs NICOM system has been used in a broad range of clinical
settings that include Fluid Optimisation for high-risk ICU and
Theatre patients, quick differential diagnosis in A&E,
Haemodialysis monitoring and Exercise Cardiac Output (ECO) for
heart failure patients. Importantly, this unique and proprietary
technology has been proven to provide accurate and reliable
measurements of Cardiac Output on both conscious and unconscious
patients, even during patient movement, providing non-invasive,
accurate, continuous and real-time information.
Signifi cantly, recent evidence from NICE has suggested that fl
uid optimisation can also dramatically reduce the length of
hospital stay; see http://publications.nice.org.uk/ for the case
study data.
For more information including departmental brochures and case
studies, please visit our dedicated NICOM resource centre:
(www.proactmedical.co.uk/nicom) or contact Leah Lockwood at NHS
Supply Chain on [email protected]
PROACT Medical Ltd Phone: 01536
461981www.proactmedical.co.uk
The New Merivaara Promerix Trust Starkstrom to be appointed
sole
distributor for the Merivaara Promerix
A brand new Operating Table, with modular low design, which can
be configured to suit ALL surgical procedures. The Promerix offers
a unique shoulder section & head attachment, and has full
orthopaedic capabilities. Heavy-duty, electro-hydraulic table for
both general and specialised surgery. Suitable for heavy weight
patients. Motorized 5th Wheel option for reduced moving &
handling issues. Easy-to-use modular design that can be easily
reconfigured according to clinical requirements. Fulfils X-rays and
full length C-arm requirements with a 450mm traversing top -
optional modular carbon
fibre sections also available.
Contact us now for a quotation and free trial:t: +44 (0)20 8868
3732
e: [email protected]: starkstrom.com
Please quote OTJ
Genetic study shows that infl ammatory protein plays a role in
heart disease
Study suggests that anti-infl ammatory drugs could be used to
treat cardiovascular disease
A protein involved in infl ammation, the interleukin-6 receptor
(IL6R), is a contributing cause in the development of heart
disease, new research led by the University of Cambridge has
discovered. The research was published recently in the journal The
Lancet.
The fi ndings suggest that targeting the IL6R signalling pathway
might therefore be an effective way of combatting heart
disease.
Dr Adam Butterworth, who co-led the study from the University of
Cambridge, said: Typically, it can take many years to make safe and
effective drugs to target new disease pathways. However, in this
case, drugs have been previously developed due to this pathways
involvement in autoimmune disease. In fact, one such drug,
Tocilizumab, is already used for treating arthritis, and might
therefore be a viable drug for preventing heart disease.
The research, undertaken as part of the IL6R Genetics Consortium
and Emerging Risk Factors Collaboration and funded by the British
Heart Foundation and the Medical Research Council, analysed human
genetic and biomarker data from more than 200,000 participants
compiled from 82 previous studies. The research focused on the
genetic variant Asp358Ala which is known to affect IL6R signalling
pathways involved in the infl ammatory response.
The researchers discovered that people who carry the Ala form of
the variant have a reduced risk of coronary heart disease (3.4% for
each additional copy of Ala that is inherited). Although this
genetic change in risk is small, the potential reduction in an
individuals risk of heart disease provided by a drug could be much
greater.
Dr Butterworth added: Individuals carrying 358Ala had lower
levels of markers of systemic infl ammation, suggesting that this
variant dampens the infl ammatory response. As carriers of this
variant also had a decreased risk of heart disease, this strongly
indicates that IL6R pathways play a causal role in coronary heart
disease.
Nearly 200,000 people die from cardiovascular disease in the UK
every year, comprising one in three of all deaths.
(Source: British Heart Foundation website).
-
6 THE OPERATING THEATRE JOURNAL www.otjonline.com
Two New Surgical Lights Extend the Polaris Family For small
budgets: Polaris 100 and Polaris 200 by Drger
Drger is now expanding its range of LED lights with Polaris 100
and 200. The development was concentrated on providing a high
quality surgical light without losing sight of the fi nancial
concerns of hospitals. The integrated LEDs (light emitting diodes)
deliver a homogeneous light with a spectrum similar to that of
natural daylight.
With an outer diameter of only 620 mm, the Polaris 200
integrates a total of 66 LEDs and reaches a maximum brightness of
up to 160 klux. The 48 LEDs of the Polaris 100 - with the same
outer diameter - delivers a brightness of up to 120 klux. Both
versions are dimmable to 40 klux. For endoscopic surgical
procedures an additional LED provides ambient light, while the
major light is switched off.
Homogeneous light Each individual LED is embedded in a special
lens refl ector system that bundles the light beams. The result is
a homogeneous column of light with 200 mm diameter, providing a
depth of illumination of 750 mm (L1+L2 at 60% of maximum strength).
Polaris 100 and 200 offer deep cavity illumination with no need for
focus adjustment.
True colors At a color temperature of 5,600 K, which corresponds
to natural daylight at noon, Polaris 100 and 200 ensure excellent
contrast and natural colors. The rendering index R9 of 93 is
exceptionally good. The R9 value specifi es the rendering quality
of red tones which are crucial for the evaluation of different
tissue.
Effi cient thermal management Like all light sources LEDs
generate heat which infl uences signifi cantly the life span of
LEDs. In order to increase the service life and the effi ciency of
the light Drger has developed a thermal management system that
protects the components and ensures that the maximal temperature of
the upper side of the light head does not exceed 35 degrees
Celsius,. With an average of 30,000 operating hours, the LEDs of
Polaris 100 and Polaris 200 are effi cient and need almost no
maintenance.
These new OR lights feature the well-proven classic round design
of the Polaris family with circular handles on the top which allows
non-sterile personnel to position the light heads easily. Sterile
personnel can adjust the lights by using a sterile central
handgrip. All settings are accessible via the intuitive control
panel at the light head and the optional wall mounted control
unit.
Drger Medical GmbH is the manufacturer of the Polaris 100 and
Polaris 200.
Drger. Technology for Life Please visit www.draeger.com for more
information. When responding to articles please quote OTJ
New information to help improve patient outcomesNew information
that will help put the NHS on the side of patients and improve
results for patients has been published recently. As part of the
Governments drive to improve results for patients, new detailed
information on 20 of the 30 NHS Outcomes Framework indicators,
which measure the care patients receive, has been published by the
NHS Information Centre.The fi gures provide a regional and local
snapshot of how the NHS is performing against the Outcomes
Framework. Crucially, they illustrate where there are variations in
outcomes highlighting the importance of the Governments approach of
concentrating on results, not targets.For example, liver disease
mortality rates have increased nationally over the last decade, but
have decreased in the last few years in London and the South East,
while rates were twice as high in the North West compared to the
East of England in 2009.The Government committed to focus on
outcomes not process targets in 2010 and announced last year that
the NHS would be held increasingly to account for measurable
results, including whether a patients treatment was successful,
whether they were looked after well by NHS staff, and whether they
recovered quickly after treatment. Health Secretary Andrew Lansley
said:
The information published today is another step towards shifting
the health service towards the benefi ts for people who matter -
patients.
Crucially, we arent telling doctors and nurses how to do their
job the approached adopted by the previous Government. We are now
clear about what the NHS should achieve, not telling the NHS how to
do its job. These results will shine a light on results achieved
and where performance needs to be improved.The publication of the
fi gures today means the NHS can be held to account for all aspects
of care that patients receive, and is part of a drive to make the
health service more transparent. They provide a basis for driving
improvements in the future through the Secretary of States Mandate
to the NHS Commissioning Board, expected in the next few months and
will allow the NHS to take action where patient outcomes are not as
good as they should be.NHS Medical Director Bruce Keogh said:
Patients rightly expect the NHS to provide care that is
effective and safe. And one of the things that makes for a positive
patient experience is when everything joins up seamlessly as they
move from GP surgery to hospital to community clinic or social care
provider. So through the Outcomes Framework, and the information
released today, the foundations are being laid to achieve just
that.
The full data for the NHS Outcomes Framework 2010/11 indicators
can be found here: https://indicators.ic.nhs.uk/webview/
To tackle the issue of liver disease, the Government will
shortly be publishing a Liver Strategy. Further details on the
Alcohol Strategy can be found at: http://www.homeoffi
ce.gov.uk/publications/alcohol-drugs/alcohol/alcohol-strategy.
Nuffi eld Staff Celebrate
Qualifi cationsStaff at the Nuffi eld Health Taunton Hospital
are celebrating their exam success!
Senior Health Care Assistant Irene Murray, and Healthcare
Assistant Fran Cooke, both of Taunton have received their certifi
cates in NVQ Levels 2 and 3. The qualifi cations cover a range of
subjects in health and social care.
Out Patient Manager Nicky Edwards, of Burnham on Sea, not only
manages the team but also is a qualifi ed assessor for NVQ. She
said, The course equips the staff with all they need to provide a
high quality service to our patients here at the Nuffi eld.
It also allows them to take on more responsibility and further
their careers. We are very fortunate at the Nuffi eld to have such
committed and expert staff.
Hospital Director Paul Taylor said Nicky has done an excellent
job in leading the staff through this training and continuing to
develop the outpatient services at the hospital.
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8 THE OPERATING THEATRE JOURNAL www.otjonline.com
Fukuda Denshis new DS-7700 Central Monitor is packed with
functionality
Fukuda Denshi is a leading supplier of advanced patient
monitoring and user-confi gurable clinical information management
systems, as well as cardiac monitoring and imaging technology. The
companys latest addition to their Dynascope range is the DS-7700
Central Monitor, packed with functionality for more fl exibility,
more precision and more continuity.
The DS-7700 has a unique dual display design to provide
unparalleled patient data clarity and clear alarm identifi cations.
It offers continuous, accurate and clear monitoring of patients
with a range of multi-display view options and functionality
features.
The DS-7700 offers increased continuity with patient data
transfer or exchange between two DS-7700 systems being enabled via
the TCP/IP network. Additionally full wired or wireless networking
is available and once the system is connected to a DS-LAN, other
bedside information from different wards can also be viewed.
Fukuda Denshi have improved the accuracy of arrhythmia analysis
by designing new in house databases including AHA, MIT- BIH and CU
which are incorporated within the DS-7700. These improve QRS and VF
detection whilst decreasing false detection of arrhythmia during
noise.
The DS-7700s various functionalities provide comprehensive
monitoring by displaying:
Up to 24hrs trendgraph in one screen using the Graph Trend
function.
Tabular Trend, displaying up to 48hrs of data.
NIBP List with HR, SpO2 and PR parameters.
ST Measurements.
Up to 200 alarm generated waveforms that have been saved for
recall using the Recall function.
Specifi c colour codes to each patient linked to the
requirements of each nursing team.
For more information on the DS-7700 Central Station Monitor,
call Fukuda Denshi on 01483 728065.Fukuda Denshi: Healthcare bound
by technology. When responding to articles please quote OTJ
How ECT helps severely depressed Aberdeen researchers have
discovered how a controversial but effective treatment in
psychiatry acts on the brain in people who are severely
depressed.
Electroconvulsive therapy or ECT - which involves anaesthetising
a patient and electrically inducing a seizure - is the most potent
treatment option for patients with serious mood disorder.
Despite being used successfully in clinical practice around the
world for more than 70 years, the underlying mechanisms of ECT have
so far remained unclear.
Now a multidisciplinary team of clinicians and scientists at the
University of Aberdeen, Scotland, has shown for the fi rst time
that ECT affects the way different parts of the brain involved in
depression communicate with each other.
In a paper published in the journal Proceedings of the National
Academy of Sciences they show that the treatment appears to turn
down an overactive connection between areas of the brain that
control mood and the parts responsible for thinking and
concentrating.
This stops the overwhelming impact that depression has on
sufferers ability to enjoy life and carry out day to day
activities.
This decrease in connectivity observed after ECT treatment was
accompanied by a signifi cant improvement in the patients
depressive symptoms.
Professor Ian Reid, Professor of Psychiatry at the University of
Aberdeen and Consultant Psychiatrist at the citys Royal Cornhill
Hospital, led the study which involved using functional MRI to scan
the brains of nine severely depressed patients before and after ECT
and then applying entirely new and complex mathematical analysis to
investigate brain connectivity.
The research involved University colleagues Dr Jennifer Perrin,
research fellow in mental health, and Professor Christian
Schwarzbauer, Chair in Neuroimaging, who devised the new
mathematical method for analysing the connectivity data which
enabled the fi ndings to be made.
Professor Schwarzbauer said: With this new method we were able
to fi nd out to what extent more than 25,000 different brain areas
communicated with each other and how the brains internal
communication patterns differed before and after ECT treatment in
severely depressed patients.
Professor Reid said: ECT is a controversial treatment, and one
prominent criticism has been that it is not understood how it works
and what it does to the brain.
However we believe weve solved a 70 year old therapeutic riddle
because our study reveals that ECT affects the way different parts
of the brain involved in depression connect with one another.
For all the debate surrounding ECT, it is one of the most
effective treatments not just in psychiatry but in the whole of
medicine, because 75% to 85% of patients recover from the
symptoms.
Over the last couple of years there has been an emerging new
perspective on how depression affects the brain.
This theory has suggested a hyperconnection between the areas of
the brain involved in emotional processing and mood change and the
parts of the brain involved in thinking and concentrating.
Our key fi nding is that if you compare the connections in the
brain before and after ECT, ECT reduces the connection strength
between these same areas - it reduces this hyperconnectivity.
For the fi rst time we can point to something that ECT does in
the brain that makes sense in the context of what we think is wrong
in people who are depressed.
As far as we know no-one has extended that connectivity idea
about depression into an arena where you can show a treatment
clearly treating depression, changing brain connectivity.
And the change that we see in the brain connections after ECT
refl ects the change that we see in the symptom profi le of
patients who generally see a big improvement.
Researchers now hope to continue monitoring the patients to see
if the depression and hyperconnectivity returns. They also want to
compare their ECT fi ndings with the effects of other therapies
used to treat depression such as psychotherapy and
anti-depressants.
Professor Reid added: Although ECT is extremely effective, it is
only used on people who need treatment quickly: either people who
are very severely depressed, who are at risk from taking their own
life and who perhaps cant look after themselves - or patients who
have not responded to other treatments.
The treatment can also affect memory, though for most patients
this is short-lived. We monitor the memory function of all our
patients receiving ECT in Grampian, and we fi nd that function
returns to normal within a few months.
Given the impact of depression itself on memory, it is perhaps
unsurprising that such a rapidly acting treatment has this effect:
certainly, the patterns of brain changes we have observed are
consistent with this.
However if we understand more about how ECT works, we will be in
a better position to replace it with something less invasive and
more acceptable. At the moment only about 40% of people with
depression get better with treatment from their GP.
Our fi ndings may lead to new drug targets which match the
effectiveness of ECT without an impact on memory.
Professor Schwarzbauer added: The new method we devised for
analysing the brains functional connectivity in depression could be
applied to a wide range of other brain disorders such as
schizophrenia, autism, or dementia, and may lead to a better
understanding of the underlying disease mechanisms and the
development of new diagnostic tools.
The study was funded by the Chief Scientist Offi ce.
-
fi nd out more 02921 680068 e-mail [email protected] Issue 259
April 2012 9
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INNOVATIVE MEDICAL APPS GIVE INSIGHT INTO JOINT ISSUES
Education app developer 3D4Medical has released new versions of
theirinnovative Pro creations for knee, hip, shoulder, ankle &
foot, and hand &wrist study.
The new products, from the worlds most successful medical app
developer,are designed to help medical and healthcare
professionals, physicaltherapists, medical students, and anyone
with pain or discomfort in thoseareas to learn more.
Featuring detailed graphics and animations, the apps allow users
to cutacross the joint with their fi nger and see mutliple
cross-sections.
They can also cut away layers to reveal muscles, blood vessels,
nerves andconnective tissue, and see muscles, blood vessels, nerves
and connectivetissue, and see examples of disease states and
treatments, and muscles andligaments in action.
The developers want to replicate the success of their Muscle
System Pro IIIapp, which has been downloaded more than 200000 times
and been one of the top fi ve grossing iPad medical apps on the
AppStore for the past two years.
Project Manager Breda Jackson said: Anyone with an interest in,
or problems with, knees, shoulders, hips, ankles, feet, hands or
wrists will fi nd these apps useful.
As well as studying cross-sections, users can zoom in on certain
sections,and rotate the entire area. They can also view the joint
from variousangles, not just the standard anatomical options.
They provide a unique insight into how the joints work, and
potentialcauses for pain and discomfort.
Versions are available for the Mac and iPad through the
AppStore. Videodemonstrations are available at
www.3d4medical.com.
3D4Medical was established in 2004 and now employs 50 people at
theiroffi ces in Ireland and California.
The companys turnover in 2010-11 was 4m and their products have
featuredin several Apple iPad advertising campaigns, including the
iPad is Amazingand Appendre campaigns from 2011.
Music soothes surgery patientsPlaying music to patients
undergoing surgery reduces their anxiety and could improve healing,
research suggests.
Easy listening music and chart classics can lessen fear among
patients who stay awake during surgery but require a local
anaesthetic.
Experts at the Department of Plastic and Reconstructive Surgery
at John Radcliffe Hospital in Oxford analysed data from 96 patients
split into two groups.
The fi rst group was played music during their surgery while the
second were operated on in the usual operating theatre
environment.
Both groups included patients undergoing plastic surgery for
trauma to their bodies as well as those having planned NHS
reconstructive surgery.
Anxiety levels were measured through the patients respiratory
rate and asking them to rate their anxiety using an established
scale.
Both measurements were fi rst taken when the patient was on the
operating table (just before the surgical procedure started) and,
secondly, at the end of the operation (while the patient was still
on the operating table).
The research, published in the Annals of the Royal College of
Surgeons, found the group played music scored around 29% less on
anxiety levels and had an average of 11 breaths per minute versus
13 breaths per minute in the other group.
The research is the fi rst to examine the effect of music on
patients undergoing both planned and emergency surgical operations
whilst awake.
Hazim Sadideen, a plastic surgical registrar who led the study,
said: Undergoing surgery can be a stressful experience for patients
and fi nding ways of making them more comfortable should be our
goal as clinicians.
(UKPA)
-
10 THE OPERATING THEATRE JOURNAL www.otjonline.com
Mlnlycke Health Care introduces a new innovative solution for
patient warming
Mlnlycke Health Care, one of the worlds leading providers of
single-use surgical products, today announces the launch of BARRIER
EasyWarm, a new active self-warming blanket that brings simplicity
to peri-operative patient warming.
The BARRIER EasyWarm is an innovative yet uncomplicated product
for patient warming that is being introduced to hospitals. The
blanket is easy to use, for both staff and patients, as once it is
opened and unfolded, the air activated blanket self-warms. Unlike
current products on the market, there is no need for any extra
equipment or devices, and the blanket will maintain its temperature
for up to 10 hours which enables it to be used to warm the patient
before, during and after surgery.
A patients core body temperature normally drops after the
induction of anaesthesia which mean that peri-operative hypothermia
is a common side effect of surgical procedures.1 This in turn
brings about poor outcomes for patients, including increased risk
for complications and distress, leading to elevated treatment
costs.2,3 Minimizing the risk of infection also reduces length of
hospitalisation. Preventative measures such as preoperative patient
warming and active warming during surgery, have been demonstrated
to have a good effect on avoiding hypothermia.4
An ordinary blanket isnt very effective and the temperature
management products currently used by hospitals are just too
complicated, says Dr. Mark Kyker, M.D, a US cardiac
anaesthesiologist and the inventor of the active self-warming
blanket. This product is the fi rst true easy-to use solution for
peri-operative warming.
The results of a clinical study to assess the safety and effi
cacy of the BARRIER EasyWarm active self-warming blanket in
preventing hypothermia demonstrated that intra-operative
temperature was maintained at a stable level for 2.5 hours in the
68 patients evaluated for effi cacy.5 A drop of 0.6 C was recorded,
compared to a typical temperature drop of 1-1.5 C on induction of
anaesthesia, showing that BARRIER EasyWarm helps to prevent
hypothermia. In addition, patients expressed a high level of
comfort.
The BARRIER EasyWarm active self-warming blanket will be
available in most European markets, starting from Q2 2012.
For more information, visit:www.molnlycke.com
References:1. Barash PG (ed). ASA Refresher Courses in
Anesthesiology. 1993; 21:Ch 7.2. Andrea Kurz, M.D. et al,
Perioperative normothermia to reduce the incidence of
surgical-wound infection and shorten hospitalization, The New
England Journal of Medicine, volume 334, may 9, 1996, number 193.
Inadvertant perioperative hypothermia, Costing report Implementing
NICE guidance, NICE clinical guideline 65, April 20084.Just B,
Trevien V, Delva E, et al. Prevention of intraoperative hypothermia
by preoperative skin surface warming. Anesthesiology
1993;79:214-8.5. Study to assess the safety and effi cacy of an
active self-warming blanket used to prevent hypothermia. Data onfi
le, Mlnlycke Health Care, 2012.
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Inspection changes underwayBeginning April 2012 the Care Quality
Commission (CQC) is starting to introduce improvements to the way
it inspects health and social care services. The changes follow a
consultation by CQC on how it regulates.
The changes, which will be phased in, mean that CQC will inspect
most services more often. It will inspect most hospitals, care
homes and domiciliary care providers at least once a year. It will
inspect dental and other services at least once every two
years.
The regulator will continue to re-inspect those services that
fail to meet the government standards and will inspect any service
at any time if there are concerns about poor care.
Most inspections will continue to be unannounced. To help do
this, CQC is recruiting extra inspectors. This means that
inspectors will be responsible for a smaller number of services
than in the past. They will be able to spend more time getting to
know the services, checking the information they have on each, and
responding quickly to concerns about the quality of care.
Inspectors will be able to spend more time inspecting and less time
on paperwork.
Our inspectors have continual oversight of all 16 government
standards. Under the new system, inspections for most types of
service will focus on a minimum of fi ve, one from each of fi ve
chapter headings in CQCs Guidance about Compliance. Which standards
they inspect will be tailored to the type of care provided and the
information CQC currently has about the service, including the
concerns that people have told us about. Inspectors will be able to
focus their time and resources on services that are at higher risk
of delivering poor care.
We will judge whether or not providers are meeting the
standards. We will focus on where providers are not meeting the
standards but include positive fi ndings where we see them.
Experts in different aspects of care often join our inspections,
including members of the public who have experience of care. We
will be making more use of experts in the future.
3.5m Fitzwilliam Hospital extension openA 3.5 million expansion
at a hospital in Peterborough, which will increase the number of
patients it can treat, was offi cially unveiled on Monday 19 March
.
Ramsay Health Care has completed the extension at Fitzwilliam
Hospital, in Bretton, creating a new state-of-the-art operating
theatre and an ambulatory care unit that will allow more
day-surgery patients to be treated.
Currently, Fitzwilliam carries out between 6,000 and 7,000
surgical procedures each year, for a mixture of private and NHS
patients.
However, with the building of its third major operating theatre
and the new day-surgery unit, it should be able to increase the
number of procedures to around 9,000 a year over the next couple of
years.
The building was offi cially opened by the Mayor of
Peterborough, Cllr Paula Thacker, yesterday morning.
She said she was impressed with what she saw.
Cllr Thacker said: The new facility is excellent. It is spotless
and spacious and I was delighted to offi cially open it with the
theatre manager and staff.
The hospital deals with NHS patients as well as private so it is
an excellent hospital to have in Peterborough.
The hospital has provided private healthcare to the city for the
last 29 years, extending its services to NHS patients fi ve years
ago.
Currently, around half of the procedures carried out at the
hospital are on NHS patients.
The new theatre will provide surgical facilities for complex
operations such as joint replacement or major abdominal surgery,
while the rest of the project has also included an expanded
radiology suite and six new premium care bedrooms.
The hospital is already an Orthopaedic Centre of Excellence and
provides pioneering care for those suffering from cartilage
problems, with some methods including the use of cell-based
therapy.
The new ambulatory suite will give the hospital the ability to
deal with more day-surgery patients who can have their procedure
and go home without being admitted.
Carl Cottam, general manager of the hospital, said: Were
delighted that this major development for the hospital is now
complete and fully operational and very grateful to the Mayor of
Peterborough for offi cially opening the facility.
The additional capacity will help us to meet the growing demand
for theatre space and the changing pattern of operative care.
The new ambulatory care unit will allow more patients to benefi
t from the increasingly popular option of day case surgery.
Source: the evening telegraph ADAM UREN
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12 THE OPERATING THEATRE JOURNAL www.otjonline.com
Wood Green opens Xograph Imaging SuiteWood Green, one of the
largest animal re-homing centres in Europe has undergone a 3.6M
re-development which includes a new state-of-the-art surgery
complex, proudly housing The Xograph Imaging Suite. This modern
suite is a self contained diagnostic facility incorporating the
very latest digital X-ray equipment for routine, general and dental
veterinary imaging.
This prestigious development marks 25 years of animal welfare at
the Godmanchester Centre near Huntingdon. The original surgery is
over 20 years old with its ageing X-ray equipment compactly
positioned in a converted storage room. The spacious Xograph
Healthcare Imaging Suite includes the VetView 30, a general purpose
X-ray system, with an ImagePilot digital acquisition console along
with a dedicated digital intraoral imaging system known as the
ProSensor.
Vanessa Cunningham, Head of Veterinary Services at Wood Green
says: As an animal welfare charity its really exciting that Xograph
Healthcare has helped both in the supply of our new digital X-ray
units as well as assisting us with the layout of the facility.
Their equipment is simple to use and understand. Joanne Mellor,
Xographs area representative is friendly and helpful, showing a
real empathy for the Charity, whilst at the same time helping us fi
nd the right equipment for our needs. With Xographs support we have
been able to exceed our expectations and the new surgery facilities
will have modern, up-to-date equipment benefi ting the animals in
our care.
Peter Staff, CEO at Xograph Healthcare said I am delighted that
we have had the chance to work with such a forward-looking
organisation. I am especially impressed with the amount of work
that has gone into making the new centre as eco-friendly, effi
cient and sustainable as is possible.
www.xograph.com
Picture: Vanessa Cunningham, Head of Veterinary Services at Wood
Green, Paul Hunter, Executive Team Manager - Facilities at Wood
Green, Dave Morgan, Director of Facilities at Wood Green with
Joanne Mellor, Veterinary Territory Manager at Xograph Healthcare
Ltd and Peter Staff, CEO at Xograph Healthcare Ltd.
When responding to articles please quote OTJ
National Institute for Health & Clinical Excellence (NICE)
to Develop Medical Technological Guidance for the Revolutionary
Ambu aScope
Development of guidance for intubating scope will now
commence.
The NICE Medical Technologies Advisory Committee (MTAC) has
concluded that the Ambu aScope has met all the selection criteria
required to be considered for medical technological development.
The selection criteria include the following headings:
* Claimed Additional Patient Benefi t
* Claimed Healthcare System Benefi t
* Patient Population
* Disease Impact
* Cost Considerations
MTAC will now commence development of Medical Technologies
Guidance for the Ambu aScope.
aScope disposable intubating scope The Ambu aScope is a
disposable, single-patient-use fl exible intubating scope that has
a lightweight ergonomic handle, with an easy-to-steer thumb design.
It utilises camera technology that ensures a good, clear image
which is displayed on the Ambu aScope Monitor. It is indicated for
use in the management of unanticipated or anticipated diffi cult
airways and for visualisation during percutaneous dilatory
tracheostomy (PDT). It can be used in either awake or anaesthetised
patients, orally or nasally and it is the fi rst and only single-
patient-use device of its kind on the market.
The primary role of an anaesthetist is to maintain the airway.
This can often be diffi cult to manage and problems may be
anticipated or unanticipated. When a patients airway cannot be
managed or maintained, outcomes can be severe, even resulting in
death. The ability to visualise anatomy is paramount and the Ambu
aScope allows anaesthetists not only to see anatomy clearly, but
also to navigate and place breathing tubes accurately.
If an alternative surgical airway is required at the front of
neck (e.g. a tracheostomy), the Ambu aScope allows clinicians not
only to safeguard whilst performing the procedure, but also to
rescue when tracheostomy tubes displace.
Displaced tracheostomy tubes were found to be the biggest cause
of death in Intensive Care Units in the National Audit of Major
Complications of Airway Management in the UK (NAP4), published by
the British Journal of Anaesthesia, March 29th 2011, edited by Dr
Tim Cook, Chris Frerk & Dr Nick Woodall. Because of this, the
study made the recommendation that all Intensive Care Units should
have access to fl exible scopes and the Ambu aScope makes this
recommendation entirely achievable.
Availability of airway management equipment The Ambu aScope was
launched in October 2009. The motivation to launch such a device
was born from evidence that there is a general shortage of fl
exible intubation scopes due to the prohibitively high cost of
existing technology. The aim of the aScope platform is to address
the issue of availability of appropriate airway management
equipment, a problem that is extensively highlighted in the NAP4
study. A number of recommendations made by NAP4 relate to making
the necessary equipment available. In the executive summary it was
stated that:
The project identifi ed numerous cases where awake fi breoptic
intubation (AFOI) was indicated but was not used. The project
methods did not enable us to determine why AFOI was not used but
there were cases suggesting, lack of skills, lack of confi dence,
poor judgement and in some cases, lack of suitable equipment being
immediately available. This latter problem was prevalent on
ICU.
The NAP4 study highlighted the issue of availability in relation
to mortality and morbidity within the anaesthesia room and the ICU.
Due to the low start-up and ongoing costs of the Ambu aScope, as
well as its ease of use, it is now viable to have fl exible scopes
in every department or situation where their use may be indicated,
making anaesthesia and PDT safer for all.
The decision by NICE to evaluate and develop guidance for this
technology will be welcomed by those with an interest in airway
management.
There have been calls to increase the availability and use of fl
exible scopes from recent high profi le publications and groups
such as the National Tracheostomy Safety Project. In the UK over
150 NHS hospitals have bought the Ambu aScope.
Keith McCallum Managing Director Ambu
Statement by Dr Ellen OSullivan, President of the Diffi cult
Airway Society, 8th March 2012 This is a positive move forward in
addressing the issue of availability of suitable equipment within
the area of airway management. Availability of and familiarity with
fl exible intubation scopes was a signifi cant and recurring theme
in the National Audit into Major Complications of Airway Management
in the UK (NAP4). The Diffi cult Airway Society is encouraged to
see that NICE is developing guidance within this area Dr Ellen
OSullivan, email [email protected]
Contact For further information about Ambu aScope, please
contact: David Edwards Sales & Clinical Director, Ambu UK
Email: [email protected] Mobile +44 (0)7753 916 879 For more
information, please visit www.ambu.co.uk
-
fi nd out more 02921 680068 e-mail [email protected] Issue 259
April 2012 13
King sher Solution / Blanket Warming Cabinets
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Rainforest remedy could spell end of dental pain
First westerner to live with secretive indigenous people aims to
bring painkiller plant to the masses
An ancient Incan toothache remedy, for centuries handed down
among an indigenous people in the rainforests of Peru, could be on
the cusp of revolutionising worldwide dental practice.
The remedy, made from an Amazonian plant species from varieties
of Acmella Oleracea and turned into a gel for medical use, has
proved hugely successful during the fi rst two phases of clinical
trials and may hasten the end of current reliance on local
anaesthetics in dental use and Non-Steroid Anti-Infl ammatory Drugs
(NSAIDs) in specifi c applications.
Cambridge University anthropologist Dr Franoise Barbira
Freedman, the fi rst westerner to be invited to live with the
Keshwa Lamas in Amazonian Peru, is leading efforts to bring this
wholly natural painkiller to the global marketplace as an organic
alternative to synthetic painkillers.
In doing so, the company she founded, Ampika Ltd (a spin-out
from Cambridge Enterprise, the Universitys commercialisation arm)
will be run according to strict ethical guidelines, and will be
able to channel a percentage of any future profi ts back to the
Keshwa Lamas community who agreed to share their expertise with
her.
With no known side-effects during the past fi ve years of Phase
I and II trials, Dr Freedman, who has continued to visit and live
among the Keshwa Lamas over the past 30 years, is confi dent the
stringent Phase III trials (multi-location trials across a diverse
population mix) will be the fi nal hurdle to clear. If successful,
Ampikas plan is to bring the product to market in 2014/15.
She said: The story began in 1975 when I fi rst went to live
among the indigenous people of Peru. We were trekking through the
rainforest and I was having terrible trouble with my wisdom teeth.
One of the men with me noticed and prepared a little wad of plants
to bite onto. The pain went away.
The Amazonian rainforest plant used in the remedy
When it came back a few hours later, he had foreseen the need
and kept plant material in his hunters bag for me.
I forgot all about the wisdom teeth problem for many years until
Cambridge-based neuroscientist Dr Mark Treherne asked me to bring
some medicinal plant samples back in order to test them for
neurological research. Almost as an afterthought I remembered to
include the one Id used on my teeth. It was added to the bottom of
the list, but somehow the list got reversed and it was the fi rst
one tested back in the UK. It was immediately successful and weve
never looked back.
During the time I have spent with the Keshwa Lamas Ive learnt
all about the different plants and leaves they use for everyday
illnesses and ailments. I fi rst went to Peru as a young researcher
hoping to learn more about what was a secretive community who were
experts in shamanism. Along the way Ive learnt a great deal about
natural medicines and remedies; everything from toothache to
childbirth.
This treatment for toothache means we could be looking at the
end of some injections in the dentists surgery. Weve had really
clear result from the tests so far, particularly for
peridodontological procedures such as root scaling and planing, and
there are many other potential applications. The native forest
people described to me exactly how the medicine could and should
work and they were absolutely right. There are a range of mucous
tissue applications it could benefi t, and may even help bowel
complaints such as IBS (irritable bowel syndrome).
The Keshwa Lamas remedy represents the fi rst clinical trial of
a natural product in Peru using the International Convention of
Clinical Trials, of which Peru is a signatory, the gold-standard
for clinical trials that is recognised across the Pacifi c and
Atlantic regions.
Dr Freedman, who will visit the Peruvian community again in the
coming weeks, has already been able to channel some early funding
to the Keshwa Lama to help in the creation of a medicinal plant
garden to conserve plants and plant knowledge related to womens
health and maternity care with the express aim of preserving wisdom
for future generations.
She added: We think the remedy is better than current treatments
because NSAID drugs are systemic and have long-term effects; the
plant
product is not systemic and does not have any known
side-effects. We think people prefer to use natural products and
this is particularly the case for baby teething for which, to my
knowledge, there is no clinically tested natural alternative.
The dentists who carried out the Phase 2 trial reported a high
level of satisfaction among their patients who disliked injections
and did not need to use painkillers after the periodontological
procedures.
twitter.com/#!/OTJOnline
There was also a higher rate of patient return for further
appointments than average for the group with which the plant gel
was used. The gel works by blocking nerve endings (sodium channel
pathways).
Ampika has a portfolio of plant-based drug development,
particularly related to womens health conditions and Type 2
diabetes, which it hopes to develop in the coming years.
http://www.ampika.co.uk
Medical Devices study daySaturday 28 AprilRoyal Bolton Hospital
- NHS Foundation TrustOrganised by the Association for
Perioperative Practice (AfPP), the study day will offer
practitioners a greater insight into the legal and practical
requirements of medical device competency assessment. The session
will also provide hands-on training on key theatre equipment and a
best practice discussion.
Time: 9.30am 4.00pmCost: 25 to AfPP members or 35 to
non-members. Student fee 10.Book your place online, or students
please contact: Jody Craddock
Email: [email protected]: 01423 882 945Website:
www.afpp.org.uk/events
-
14 THE OPERATING THEATRE JOURNAL www.otjonline.com
The UK ODP Message GroupJoining is easy, just send an
e-mail,stating your name, e-mail address,position and Hospital
to:
[email protected]
STARKSTROM SOLE UK SUPPLIER OF THE MERIVAARA PROMERIX TABLE
As part of its integrated range of operating room and critical
care area equipment, medical engineering specialist, Starkstrom, is
now able to offer the Merivaara Promerix operating table, suitable
for both general and specialised surgery, including bariatric
procedures.
The Promerix is a heavy duty, electro-hydraulic mobile operating
table, whose modular table top can be confi gured to suit each
surgical procedure and patient in the best possible way. Its fl
exibility and strength means it can be used for patients weighing
over 50 stone. The Promerix features:
Table width extenders and a unique shoulder device and head
support A motorised wheel for reduced staff moving and handling
issues Detachable carbon fi bre sections that can be confi gured
according to the
surgeons requirements, including split legs with footplates for
gastric bypass procedures
Excellent access for surgeons Low table height capabilities
The tables electro-hydraulic adjustments are controlled via
user-friendly hand or foot control units, or a wireless infra red
remote control unit. It comes with a comfortable, soft moulded
mattress, and is ergonomic and easy to use and maintain.For further
information: www.starkstrom.com [email protected]
Infection Prevention Society Welsh Branch National
Conference
Delegate registration is open for the IPS Welsh National
Conference. This event is FREE for all attendees.
Further details are below and online:
https://www.eventsforce.net/ipswnc2012
Organiser: Infection Prevention SocietyDate and Time: Tuesday
10th July 2012, 8.45am 15.30pmLocation: SWALEC Stadium,
CardiffCost: FREE for all delegatesRegistration website:
https://www.eventsforce.net/ipswnc2012
Programme: Opening address including details on the IPS
strategy: Tracey Cooper Using Root Cause Analysis (RCA): Judy
Potter Results of the Point Prevalence Survey 2011 in Wales: Dr
Eleri Davies Acinetobacter at UHW: Speaker TBC Pseudomonas in taps
(the Gwent experience): Dr Neil Carbarns Lessons from the vomit
bowl - surviving and learning from a major outbreak of Norovirus:
Tracey Cooper E. coli O157 in a South Wales kebab house: Gemma
Northey Discovering NDM1 and implications for infection prevention
and control: Professor Timothy Walsh Antimicrobial Stewardship in
ABMU Health Board: Sin Davies Catheter association urinary tract
infection (CAUTI): Julie Coslett
Aims for the meetingThe conference will have two themes. The fi
rst will focus on signifi cant incidents that have occurred across
Wales and the lessons that can be learnt from them. The second is
on emerging antimicrobial resistance and management. This one day
conference represents an important educational activity for the
Welsh Branch in an area of current strong clinical and commercial
interest.
When responding to articles please quote OTJ
ISG Delivers New Maternity Suite At Norfolk Hospital
ISG has secured a further project with The Queen Elizabeth
Hospital Kings Lynn NHS Foundation Trust, taking a 600,000 scheme
to refurbish and modernise the Central Delivery Suite (CDS) in the
hospitals maternity unit. The scheme follows ISGs successful
delivery of a new Day Surgery Unit and a 1.4 million Aseptic Suite
at the hospital last year.
This latest project sees ISG strip out the existing facility and
reconfi gure the unit to deliver upgraded accommodation for women
who may require the specialist support of healthcare professionals
during labour. Mechanical and electrical services will be replaced
and upgraded as part of the scheme, which also sees the contractor
carry out structural reinforcement of steel columns to support the
installation of new state-of-the-art neonatal equipment within the
suite.
The fast-track project will be carried out within the hospitals
busy maternity unit and robust measures have been put in place to
minimise any potential disruption to staff and patients throughout
the duration of the works, which are scheduled for completion in
the spring.
ISGs Bernard Clarke, managing director - South East, commented:
The challenges of live environment working are multiplied when
delivering complex hospital refurbishment projects. Experience and
specialist expertise are essential attributes of the successful
contractor operating within the sector and it is extremely pleasing
that ISG continues to generate repeat business opportunities with
key healthcare clients like The Queen Elizabeth Hospital Kings Lynn
NHS Foundation Trust.For further information about ISG, its
companies and its offerings, please visit our website
www.isgplc.com
Musgrove Park Hospital To Be A Trauma UnitMusgrove Park Hospital
has been designated a Trauma Unit as part of a new network
providing emergency care to patients with life threatening
injuries.
The Musgrove Park Emergency Department, which treats more than
48,000 patients every year, is part of the new specialist trauma
network in the NHS South region which becomes operational on Monday
2 April 2012.
Consultant Dr Cliff Mann, said: The new major trauma network for
the south west will ensure patients get the very best specialist
care in the right place at the right time.
Here at Musgrove Park patients will benefi t from the skills and
technology available to us. As part of the major trauma network we
will be able to draw on the resources in our local trauma centres
to give our patients every chance of survival and recovery.
More than 150 patients are brought to the emergency department
at Musgrove by the Devon and Somerset Air Ambulance every year.
The new network will mean that patients with specifi c
specialist needs will be treated at Major Trauma Centres in
Plymouth and Bristol.
New theatres open at Abergele HospitalClwyd West Darren Millar
AM has welcomed news that brand new operating theatres have been
opened at Abergele Hospital.
The hospital, which was earmarked for closure in 2006, has been
revamped as part of a 1.5 million hospital development programme.
Orthopaedic operations will now take place in new, modern operating
theatres at Abergele. Improvements to Glan Clwyd Hospital will see
orthopaedics moving from Abergele over the next few months, and
ophthalmology services re-locating there from H.M. Stanley Hospital
in St Asaph.
Darren said: Im delighted that patients will benefi t from these
new state of the art theatre at Abergele Hospital. It just goes to
show that the campaign to safeguard the future of the hospital was
well worth it.
Abergele Hospital has provided high quality health care to
thousands over the years and the investment it has received will
help it to care for many thousands more.
He added, The Welsh Labour Governments record breaking cuts to
the NHS are putting pressure on frontline services so any
investment of this kind is to be welcomed.
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In its medical technology guidance on the CardioQ-ODM, the
National Institute for Health and Clinical Excellence (NICE)
asserts that this unique technology can be used across the entire
surgical population, in people who are having major and high-risk
surgery.
And, whilst Pulse Pressure Wave Analysis (PPWA) interventions
requiring arterial access can only be applied to approximately 10%
of patients, randomised trials of Oesophageal Doppler Monitoring
(ODM) therapy have demonstrated that ODM can be used on 99% of
surgical patients under general anaesthesia.
The CardioQ-ODM is the only therapy to directly measure blood ow
in the central circulation. Minimally invasive, easy to set up and
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signal, which is highly sensitive to changes in ow, measures them
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The NHS National Technology Adoption Centres (NTAC) audit of
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-
16 THE OPERATING THEATRE JOURNAL www.otjonline.com
A Handbook of Ophthalmic Nursing Standards and ProceduresISBN:
9781905539796 March 2012 M&K Publishing A4 format 160 pages
29.00
Lynn Ring MSc, BSc (Hons), RN1, RNT, IP, ENB 346 Advanced
Clinical Nurse Specialist, Ophthalmology, Epsom and St Helier
University Hospitals NHS Trust, UKMiriam Okoro MSc, Dip Management,
RN, SEN, ONC, 998, Manager of an ophthalmic day case unit, Surrey,
UK
This A4 format handbook has been developed to assist the nurse
working in an ophthalmic environment and provide the patient with
safe and consistent ophthalmic nursing care.
The authors discovered within their own unit that healthcare
professionals, both registered and non-registered joining the
workforce were often shown slightly different ways of doing things
by the more experienced members of the team which led to confusion
for the new starter. They felt it was a bit like driving, bad
habits can slip into everyday practice and although not unsafe, it
was at times contradictory. So they went back to basics and
developed standards of care, which act as the benchmark for the
ophthalmic practitioner.
All the guidance has been written using the term healthcare
professional (HCP) which specifi cally relates to all staff working
with ophthalmic patients regardless of registration. Non-registered
practitioners are specifi cally highlighted in relation to
prescription only medicines (POM) when the reader is reminded to
comply with local policy, which may need a countersignature from a
registered nurse or other such additional step even following
satisfactory competence assessment. It is hoped that using clinical
guidance like this helps the HCP to provide effective, effi cient
ophthalmic care.
CONTENTS INCLUDE: Communication Visual Acuity Testing Ocular
Medications The Ophthalmic Outpatient Department Biometry The
Ophthalmic Accident and Emergency Department Slit Lamp and
Tonometry a guide for the new ophthalmic nurse Additional Standards
Using Specifi c Equipment Next Steps Using Standards
Further information: M&K Publishing (an imprint of M&K
Update Ltd) Tel: 01768 773030 [email protected]
WWW.MKUPDATE.CO.UK
Preoperative Assessment and Perioperative Management ISBN:
9781905539024 July 2011 M&K Publishing 428pp illustrated Price:
39.00
Edited by: Mark Radford, Divisional Director of Nursing
(Surgery) University Hospitals Coventry and Warwickshire NHS Trust,
UK Visiting Professor at Birmingham City University, UKAlastair
Williamson, Consultant Anaesthetist Good Hope Hospital, Heart of
England Foundation Trust, UKClare Evans, Consultant Nurse
(Perioperative care) Bristol Royal Infi rmary, University Hospitals
Bristol Foundation Trust, UK
Pre operative assessment of the surgical patient is a key part
of the perioperative process. However, it is one that cannot be
separated from the other aspects of perioperative management, both
clinical and administrative, that ensures the safe and effective
treatment of surgical patients. There are a number of books on the
market that examine perioperative management anaesthesia and
surgical nursing that are only able to touch on the pre-operative
assessment process. Pre Operative Assessment & Perioperative
Management sets out to be different, by bridging the gap between
these texts and the evolving and developing area of practice that
pre operative assessment has become in modern healthcare.
In order to achieve this Pre Operative Assessment &
Perioperative Management has set out to deliver the core clinical
aspects of practice, linked to the education and service
development needs of a perioperative service. The challenge for
such a book is to integrate this knowledge effectively, using the
best evidence base, for use in every day practice. The brief to the
contributors was to help defi ne pre operative assessment utilising
their expertise to draw out some of the leading practices and
thoughts of the day. They have achieved this, ensuring that the
reader has access to some of the leading experts in international
perioperative practice. They have done this in an open and
accessible style that will guide the reader though some complex and
demanding subjects to enable them to deliver better front line care
to surgical patients.
Contents include:Introduction - The evolving role of the Pre
Operative Team Assessment of Risk: Perioperative Patient History
Taking Clinical Examination Assessment of the airway Pre Operative
Assessment of cardiovascular risk in non cardiac surgery and Pre op
management of current disease Pre Operative Assessment of pulmonary
function and Pre op management of current disease Pre Operative
Assessment of endocrine & Renal function and Pre op management
of current disease Pre Operative Medication + Pharmacological Opt.
For surgery (+ Alternative Med) Pre Op assessment and Management of
concurrent neurological disease Pre Op Management of concurrent
Haematological disease Blood products and Perioperative transfusion
management The Infant & Child Day Case Surgery Preparation for
discharge Consent for surgery & anaesthesia Development of a
Elective perioperative system The Need for Change: Systems redesign
for Perioperative Services Audit and Evaluation of Pre Operative
Service Developing a program + competency framework Developing
protocol/guidance to support Pre Op services
Further information: M&K Publishing (an imprint of M&K
Update Ltd) Tel: 01768 773030 [email protected]
WWW.MKUPDATE.CO.UK When responding please quote OTJ
When responding please quote OTJ
-
fi nd out more 02921 680068 e-mail [email protected] Issue 259
April 2012 17
Tel: 01303 840 882 Fax: 01303 840 969
[email protected]
www.sophiebellandassociates.co.uk
CAMBRIDGESHIREDEPUTY THEATRE MANAGER
You will be a dynamic individual with a strong character &
proven track record to support & develop the team to deliver a
first class patient experience. You will be expected to
review, develop, update & implement policies &
procedures as well as ensuring compliance by the team to National
Care Standards & other legislative requirements. As an
experienced practitioner, youll also be hands-on as part of the
team & have
good working knowledge across a wide range of procedures. You
will have at least 2 years experience as a senior staff member
& applications from existing Deputy Theatre
Managers are most welcome.
Tel: 01303 840 882 Fax: 01303 840 969
[email protected]
www.sophiebellandassociates.co.uk
CHESHIRETHEATRE PRACTITIONERS
You will be a skilled Perioperative Practitioner with Scrub
& Anaesthetic or Recovery skills to join this busy department.
You will be a good team player with several years current
experience working in an already established UK team, & will be
expected to
provide & maintain a high quality service. Support from a
strong management team will be provided as well as the opportunity
to work alongside expert clinicians. Ideally you will have
comprehensive orthopaedic & general scrub skills & you will
be required to provide flexible skills in either Recovery or
Anaesthetics. You will work a flexible shift
pattern of 37.5 hours per week, weekends & on call hours
will be worked on a rota basis.
Issues in Perioperative and Operating Theatre Management -
2012
13th September 2012 - Manchester
CALL FOR SPEAKERSWe have three slots available and are seeking
contact from clinical managers and perioperative health
professionals who would be willing to speak at the above planned
event. Although it is envisaged the primary target audience will be
health professionals, associated managers and workforce planners we
are keen to hear from all who have a working and managerial
interest in this area.
This event will explore the following key themes:Risk assessment
Human factorsCompetency and good practiceProductivityWorkforce
planning and future trendsEffi ciency New ways of workingTraining
and development New and developing practices
IF YOU WOULD LIKE TO PRESENT AT THIS EVENT WE WOULD LIKE TO HEAR
FROM YOU.(Typically this will be a 35 minute presentation followed
by a Q&A session)
We are keen to provide an event that offers the latest clinical
innovation, ideas and evidence base so that attendees can take data
and information back for use at their place of work. Do note we are
unable to include course module/programme presentations.
Further information please contact:Mike Roberts, Director,
M&K Update LtdThe Old Bakery, St. Johns Street, Keswick,
Cumbria, CA12 5AS
[email protected]: 01768 773030 fax: 01768 781099
www.mkupdate.co.uk
Merrick rally backs charityThe organisers of the Merrick Forest
Stages Rally are throwing their weight behind a charity founded by
competitor and rescue volunteer Rachel Medich.
Rally2Raise supports four charities: Cancer Research UK, the
Nystagmus Network, the MS Society and the Joanne Bingley Memorial
Foundation for post-natal depression.
Rachel, who lives near Aberdeen and works as an operating
department practitioner with the NHS, raises funds through various
rally-related actvities, from selling cakes at events, to this year
competing in her distinctive yellow and blue Nissan Micra.
The navigator-turned-driver took part in her fi rst championship
event, the Snowman Rally, last month, when she drove the Micra as
course car on one of the forest stages. She was co-driven by fellow
fund-raiser Marieanne Gray.
Rachels next event is the Coltel Granite City Rally on April 14,
when Katherine Begg will be making her debut as a navigator.
The Merrick will be offering the Rally2Raise crew free entry to
the September 1 event, which will again be based in Wigtown and
count as the penultimate round of the MSA Scottish Rally
Championship.
Competitors will also be invited to make a donation to the
charity when they enter online through the event website.
We are delighted to name Rally2Raise as our nominated charity
for this years Merrick, said rally manager Allan Marshall. Rachel
and the girls are raising funds for such very good causes.
Hopefully our efforts will help them in reaching their target.
Although still six months away, Mr Marshall said planning for
the Merrick was already well underway.
The stages have been chosen and we will again be offering
competitors one of the most compact routes in the Scottish
championship. Were delighted to be basing the event in Wigtown for
the third year running, and, and we will be pulling out all the
stops tomake the 2012 Merrick one of the best ever.
TbM
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TSoG
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Be sure to view the latest vacancies from the following
organisations:
Theatre Practitioners Recovery Nurses Anaesthetic Nurses ODPs
Scrub Practitioners
Nurse Practitioners Medical Representatives and Clinical
Advisers
www.OOperati ngperati ngTTheatreheatreJJobs.comobs.comA one-stop
resource for ALL your theatre related Career opportuniti es
-
18 THE OPERATING THEATRE JOURNAL www.otjonline.com
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Its easy to subscribe, just visit our website at
www.otjonline.com and pay via Card or Paypal.
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Subscribing to the OTJ costs 14.00 per year for delivery in the
UK or 21.00 overseas. Alternatively just fi ll in your address
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Rigel passes the test in South Africa
Technicians at South Africas National Department of Health are
using Rigel Medical analysers for
training purposes.
Rigel Medical analysers have been specifi ed for a ground
breaking project in South Africa designed to improve standards of
medical device safety and performance inspection.
The Rigel 288 electrical safety analyser, Uni-Pulse defi
brillator analyser and Uni-Sim - the fi rst all in one vital signs
simulator - are among several precision testers being used by the
National Department of Health in Pretoria for its health technology
audit and asset management scheme.
This aims to create seven teams of highly trained technicians
and equip them with the skills required to understand better the
importance of electrical safety testing and how to service and
maintain medical equipment properly.
Once qualifi ed, they will be embarking on a programme of safety
and performance inspections of biomedical equipment using the Rigel
instruments.
The move will improve national safety testing procedures,
ensuring more electrically operated equipment such as x-ray
machines, ECGs and blood pressure units used at healthcare and
hospital facilities throughout South Africa are safe for use by
both medical staff and patients.
Rigel Uni-Therm (formerly the 377) electro surgical analyser and
Med-eBase PC database software, which provides enhanced electronic
recording and management of testing programmes, are also being used
to improve the technicians skills.
Ms Ncumisa Ndlovu, director - health technology management from
the Department of Health - MP said the Rigel testers offered more
advanced features and high specifi cation that meet the department
requirements.