The need for oxygen supplies is a safety requirement of any hospital, not just endoscopy units. JAG requires services to comply with all safety and regulation notices. The NHS advises that all oxygen should be piped (or the service should have a plan to achieve this).
Following several serious incidents involving oxygen stored in and administered from cylinders, the National Patient Safety Agency (NPSA) issued a Rapid Response Report in September 2009 focusing on oxygen safety in hospitals. The principles outlined in the report are applicable to all medical gases stored in cylinders. Key points include:
- Services should minimise the use of cylinders and increase the amount of piped gas used where necessary
- Reliable systems should be in place for stocktaking and checking medical gas cylinders, ensuring adequate supplies are always available
- Services should minimise risks of confusing oxygen and medical compressed air
- Services should prescribe medical gases in all situations in accordance with British Thoracic Society (BTS) guidelines (acknowledging that the BTS guidelines do not cover critical care)
- Services should ensure pulse oximetry is available in all locations where oxygen is used
- A multidisciplinary team should be responsible for reviewing medical gas-related incidents, and developing a policy and training programme.
For new endoscopy builds piped oxygen must be included. For existing facilities, there are safety requirements for all gases and it is preferred that recovery bays have piped oxygen, although JAG recognises that some facilities have a mix of both. In this case, a risk assessment would be required. JAG does not support an entire area being serviced by mobile oxygen and this would not be acceptable by today's hospital standards.