High demand for oxygen risks system failure, NHS England warns
Demand for oxygen to treat coronavirus patients is running so high in some hospitals that NHS England has warned systems could suddenly fail, risking patient safety.
In a new oxygen alert notice which calls for immediate action by trusts to prevent outages, the NHS warned some hospitals are exceeding the maximum flow of oxygen from their tanks, risking them freezing up and causing vital gas flow “to drop unexpectedly, compromising supply to patients”.
Oxygen delivered through masks or ventilators is a key therapy used to treat life-threatening cases of Covid-19 and if systems break under the current strain, there may be no spares available for repairs, the NHS warned. It said urgent steps to prevent problems must be taken by Friday “to ensure critical oxygen systems are not damaged, compromising patient safety and the whole hospital”.
Barts NHS trust, which runs the Royal London hospital in the capital, said on Tuesday it has asked doctors to limit the amount of oxygen they give to patients to safeguard supplies while keeping patients safe. A problem with oxygen pressure last week at Queen’s hospital in Havering saw doctors move 25 patients by ambulance to the nearby King George hospital in Ilford to keep them safe.
There was also a critical incident with the oxygen supply at Watford general hospital on Saturday, when staff had to tell the public to stay away and some patients were moved out to prevent the system failing.
The NHS England warning states: “Some hospitals are drawing more oxygen from their tanks than the maximum flow for which they were designed. This carries the risk of icing that could cause flow to drop unexpectedly, compromising supply to patients and/or permanent damage to the system.”
One clinician working at Barts NHS trust said they had been told to keep patient oxygen saturation levels between 92% and 94%. The trust said this was “clinically safe”.
“We have reviewed the targets on oxygen percentage for patients to ensure responsible oxygen consumption across our hospitals,” a trust spokesperson said. “Rather than aim for unnecessarily high physiological values we are aiming to keep oxygen levels at what is a safe level for each patient. This does allow us in some cases to reduce oxygen flow rates to the devices we are using.”
Chris Hopson, chief executive of NHS Providers, which represents foundation trusts, said: “We have all been looking at ventilator capacity and saying that’s key, and that’s right. But we’ve now discovered that the capacity of a hospital’s internal oxygen system to support is potentially just as important. If a hospital doesn’t have enough capacity to ventilate patients, it will look to transfer patients to its nearest neighbour.”
Prof Andrew Goddard, president of the Royal College of Physicians, said the oxygen supply problems were a worry that “shows that this is a major pandemic that’s taxing the NHS like nothing has ever taxed it before”.
A spokesperson for NHS Estates said: “Hospital oxygen tanks are fuller than normal, having been filled more frequently in recent weeks as part of preparations for patients with coronavirus, so there is sufficient oxygen supply available. Individual hospitals received guidance in February and again this week on how to safely manage engineering and their increased oxygen usage.”
