Waste anaesthetic gas monitoring

Re: Waste anaesthetic gas monitoring

Anthony Todd — Wed, 11 Jan 2012 21:32:53 GMT

[quote user="Bob Russell"]

Continuous monitoring and an alarm would be ideal but does anyone know of a way of doing this monitoring at reasonable cost? A one day test will miss the detached pipe that happens on the other 364 days!

Servicing/close checking of the state of the anaesthetic system has to be a more efficient thing to do. That £100 is a contribution to this cost!

[/quote]

Depends on why it's being done !

If it's for patient safety then check the equipment, doesn't matter to the patient where the expired anaesthetic goes!

If it's for 'elf 'n safey and we are protecting the operators against persistent exposure [like X rays] then the equipment is an unlikely source of waste anaesthetic.

Our last result gave a level of isoflurane of<0.29ppm over 8 hours if extrapolated from 2hrs 10mins, yes only 2hrs 10mins!!

Whereas the WEL 8 hour TWA is 50ppm.

Then SALUS goes on to say "Annual monitoring is recommended so that continued compliance with the COSHH Regs can be demonstrated and any faults in equipment or working systems are detected early".

Monitor for 30 days, or preferably 365 days and divide to give daily exposure would still cost £100 but at least do the job and protect the operators.

At the moment it is a pure £100 box tick, as Bob has said, protects nobody, and doesn't even detect a slight continuous leak which would be hard to detect in many anaesthetic machines.

Re: Waste anaesthetic gas monitoring

Bob Russell — Wed, 11 Jan 2012 11:47:02 GMT

[quote user="Anthony Todd"]

[quote user="Bob Russell"]I would rather have the whole system checked and certified,[/quote]

Yes but, as we all realise, that doesn't stop the plastic tube being dislodged from the scavenger, whatever system you have, and someone replacing it when they notice. And let's face it, that's the major source of leaks and contamination levels.

Continuous monitoring [like Xray badges] are the only logical, sensible, safe, system, and even that is retrospective, as the leak may have been 30 days ago, and continued for 30 days.....

[/quote]

Servicing/close checking of the state of the anaesthetic system has to be a more efficient thing to do. That £100 is a contribution to this cost!

Re: Waste anaesthetic gas monitoring

Anthony Todd — Tue, 10 Jan 2012 23:30:48 GMT

[quote user="Bob Russell"]

For cheap and cheerful active scavenging try:

http://www.medicalia.co.uk/activent.htm

Not sure what servicing is required with these. A change of filter seems to be about it!

[/quote]

But look at the connection and the way it sticks out; classic position for the tubing to detach for the rest of the day and no one notices.

So you're OK, test kit returns low or zero levels unless it's the day that the tubing falls off.....

Re: Waste anaesthetic gas monitoring

Anthony Todd — Tue, 10 Jan 2012 23:26:16 GMT

[quote user="Bob Russell"]£100 is £100! No point in throwing hard earned money down the drain IMO.[/quote]

Particularly when it doesn't monitor what you want to monitor at all!!

Re: Waste anaesthetic gas monitoring

Niall Taylor — Tue, 10 Jan 2012 20:35:54 GMT

[quote user="Bob Russell"] £100 is £100! No point in throwing hard earned money down the drain IMO.[/quote]

You should see the amount of shower gel my teenage son uses

Niall

Re: Waste anaesthetic gas monitoring

Anthony Todd — Tue, 10 Jan 2012 16:55:19 GMT

[quote user="Bob Russell"]I would rather have the whole system checked and certified,[/quote]

Continuous monitoring [like Xray badges] are the only logical, sensible, safe, system, and even that is retrospective, as the leak may have been 30 days ago, and continued for 30 days.....

Re: Waste anaesthetic gas monitoring

patrick murphy — Tue, 10 Jan 2012 13:49:31 GMT

we just went through the pleasure that is involved in that process, and it appeared that the cannisters are ok

Re: Waste anaesthetic gas monitoring

Rob Loxley — Tue, 10 Jan 2012 13:49:26 GMT

[quote user="Joyce Whitehead"]As an alternative if you have active gas scavenging and can show annual service records then that will suffice, as it will for the Practice Standards Scheme. [/quote]

I assume this is alongside testing the rest of the anaesthetic system/equipment, since verifying the AGSS works doesn't rule out a leak in the patient circuit; though assume you have daily test protocols to check for suchlike.

Suitable AGSS testing is detailed in the relevant British Standard; I'd hope the service/testing is in line with this and I'm not sure how you could do such testing yourself without specialist equipment.

Re: Waste anaesthetic gas monitoring

Bob Russell — Tue, 10 Jan 2012 09:56:04 GMT

[quote user="Niall Taylor"]

[quote user="Mary Davey"]... we have only found one company that provides a device for this and the cost was over £100 which we thought was a bit steep - anyone got any suggestions or do we just need accept that is how much it is going to cost to fulfill this requirement

Mary[/quote]

The cost sounds about right, similar to what we were paying before we cottoned on to the 'no problem as long as you're having annual servicing' thing. It's only an annual cost isn't it, so not that high really?

Cheers,

Niall

[/quote]

£100 is £100! No point in throwing hard earned money down the drain IMO.

Re: Waste anaesthetic gas monitoring

Bob Russell — Tue, 10 Jan 2012 09:54:31 GMT

I agree that one day of monitoring is quite pointless, even if randomly chosen. It is a tick box exercise costing £100!

I would rather have the whole system checked and certified, based on the set up! We do service exchange for our older vaporiser and the ADE system is maintained by us using a servicing kit.

We have piped O2 and I admit that does not get checked as often as some say it should but we would know if there was a major leak because the cylinders would not hold their pressure.

It will be serviced/checked next time they are down in the area!

Re: Waste anaesthetic gas monitoring

Anthony Todd — Tue, 10 Jan 2012 09:20:48 GMT

[quote user="Richard Carter"]under the BSAVA scheme for monitoring isoflo levels once a year.[/quote]

We use this but it requires monitoring for one day, chosen at random, then you send it off for measuring.

This satisfies the training regime apparently.

How this of any value is totally beyond me as it's likely that, on the day, the tube won't have fallen off the scavenger!

I suggested continuous monitoring and extrapolation but that is not in the regs. so can't be done......

Talk about regulation without common sense!!

Be better to use the "there's a strong smell of isoflurane when I stand next to the machine" method, but no, got to have a document and record something.

Re: Waste anaesthetic gas monitoring

Niall Taylor — Mon, 09 Jan 2012 20:42:18 GMT

Mary[/quote]

Cheers,

Niall

Re: Waste anaesthetic gas monitoring

Richard Carter — Mon, 09 Jan 2012 18:18:42 GMT

I use Coltronics (tel 01827 319966) under the BSAVA scheme for monitoring isoflo levels once a year. Seems to work although it does appear to cause a drop in the number of ops that turn up on the planned day. Must be a paper in this somewhere...

Re: Waste anaesthetic gas monitoring

Bob Russell — Mon, 09 Jan 2012 17:38:30 GMT

For cheap and cheerful active scavenging try:

http://www.medicalia.co.uk/activent.htm

Not sure what servicing is required with these. A change of filter seems to be about it!

Re: Waste anaesthetic gas monitoring

Joyce Whitehead — Mon, 09 Jan 2012 16:39:02 GMT

As an alternative if you have active gas scavenging and can show annual service records then that will suffice, as it will for the Practice Standards Scheme. This was sufficient for us to be passed anyway!