A hospital in London almost ran out of oxygen last weekend because it was treating so many coronavirus patients at the same time.
The incident, at a hospital which hasn’t been named, sparked fears that huge numbers of patients needing breathing support could run oxygen pipelines dry.
Large numbers of ventilators running at once could lead to pressure drops in hospitals’ central oxygen supplies or even lead to them running out, officials warned.
NHS England has since written to hospital bosses asking them to work out their limits for how many devices could safely be used at once.
It raises questions about whether hospitals can cope with the delivery of more ventilators being sourced by the Government.
Currently around 8,000 ventilators are in use across England trusts. But it is thought some 30,000 COVID-19 patients will require one.
A further 569 deaths were recorded yesterday – the third day in a row that a new one-day high in fatalities has been revealed.
An unnamed London hospital almost ran out of oxygen for coronavirus patients last weekend because it had to treat so many (Stock image of a medical oxygen tank)
Trusts have been advised to calculate exactly how many patients can be treated using oxygen machines at once. Pictured, oxygen tanks being delivered to the new NHS Nightingale hospital at the ExCel centre
The coronavirus can, in severe cases, lead to pneumonia and leave patients in need of life support machines which help them to breathe.
Those pump pure oxygen out of tanks and through tubes directly into a patient’s airways so their failing lungs can get enough of it into their blood.
Hospitals have central pipelines of high-flow oxygen which pump the gas into ventilators from a large reservoir tank.
After the oxygen shortage crisis at the weekend, NHS bosses urgently warned all hospital trusts in England to consider limiting how many patients were hooked up to oxygen-based therapy at any one time, The Times reports.
This includes mechanical ventilators – which push air into the lungs of a patient who is physically unable to breathe by themselves – and continuous positive airway pressure (CPAP) machines – which supply oxygen through a face mask.
In a letter on Monday, NHS England said it was a ‘critical safety concern’.
The hospitals’ liquid oxygen storage tanks, known as vacuum insulated evaporators (VIEs), have limited capacity.
The letter said that if the demand from multiple wall-mounted CPAP machines exceeds the maximum capacity of the VIE delivery system, there is a risk of ‘rapid pressure drop in oxygen supply pipes’, which are kept at a safe level for patient treatment.
‘This could lead to a failure of oxygen delivery systems throughout the hospital, including to patients on face masks, CPAP, ventilators and [in] operating theatres’, the letter said.
Extra strain on the VIE could also lead to it rapidly becoming run down, NHS England said.
‘Both of these situations present a potentially significant risk to multiple patients simultaneously.’
Trusts have been advised to check the capacity of their oxygen tanks and calculate exactly how many patients can be treated at once.
They should then set a limit on the number of machines available to prevent systems becoming overloaded.
If too many coronavirus patients are having support with their breathing, it could cause the hospital’s oxygen supply to fail for all patients, the letter said.
This would result in the supply being switched off all together, putting potentially hundreds of patients’ lives at risk.
The letter is problematic because it comes amid a race to ramp up numbers of ventilators ‘significantly’ in the next couple of months.
It’s thought that some 30,000 patients will need ventilation, or up to 93,000 by May in a worst case scenario, according to predictions by healthcare data analysts, Edge Health.
Britain’s National Health Service has around 8,000 ventilators at its disposal. But more are being bought from abroad or being built domestically by manufacturing companies including Dyson, Siemens and Rolls-Royce.
At least 1,500 ventilators a week could be rolling off British production lines by the end of the month to help in the fight against Covid-19.
The NHS is set to get 30 new ventilators next week with the Government promising ‘hundreds’ more to follow.
At the same time, experts warn oxygen supplies could run out if the coronavirus crisis worsens.
Gas suppliers have allegedly been told to quadruple production to help hospitals prepare and military drivers may be requisitioned to do the deliveries.
Mr Hopson, the chief executive of NHS Providers, which represents hospital trusts, said the NHS was right to warn of oxygen depletion during the pandemic.
‘This is a very serious matter,’ he said. ‘The particular characteristics of coronavirus mean that hospitals are likely to be using many more ventilators and much more oxygen than they normally do.
‘We understand that the usage of CPAP machines on a systematic basis can use up significant amounts of oxygen. So it makes sense to highlight the risk of both how quickly oxygen supplies might be depleted and if that happens the potential risk to the core oxygen flow system.
‘No hospital would want to knowingly run the risk of having all its oxygen throughout the hospital fail at once, because of the impact on the patients using the oxygen, because oxygen treatment is so central to life-saving care.’
Current ventilator systems in British hospitals are highly sophisticated pieces of equipment that are both mechanical and electrical
Ventilation with oxygen can be the difference between life and death for many critically ill COVID-19 patients. Pictured, stock of a critical care patient on ventilation
Ventilation with oxygen can be the difference between life and death for many critically ill COVID-19 patients.
But recent developments have highlighted that doctors will need to make grave decisions about which patients should be prioritised to receive equipment.
The British Medical Association, which represents doctors, has warned that staff may be faced with difficult decisions over scarce resources, including ventilators.
It may involve withdrawing treatment from an individual who has a lower chance of surviving compared to another patient.
At the same time, experts warn oxygen could run out if the coronavirus crisis worsens.
Gas suppliers have allegedly been told to quadruple production to help hospitals prepare and military drivers may be requisitioned to do the deliveries.
Mr Hopson, the chief executive of NHS Providers, which represents hospital trusts, said the NHS was right to warn of oxygen depletion during the pandemic.
‘This is a very serious matter,’ he said. ‘The particular characteristics of coronavirus mean that hospitals are likely to be using many more ventilators and much more oxygen than they normally do.
‘We understand that the usage of CPAP machines on a systematic basis can use up significant amounts of oxygen. So it makes sense to highlight the risk of both how quickly oxygen supplies might be depleted and if that happens the potential risk to the core oxygen flow system.
‘No hospital would want to knowingly run the risk of having all its oxygen throughout the hospital fail at once, because of the impact on the patients using the oxygen, because oxygen treatment is so central to life-saving care.’
Ventilation with oxygen can be the difference between life and death for many critically ill COVID-19 patients.
But recent developments have highlighted that doctors will need to make grave decisions about which patients should be prioritised to receive equipment.
The British Medical Association, which represents doctors, has warned that staff may be faced with difficult decisions over scarce resources, including ventilators.
It may involve withdrawing treatment from an individual who has a lower chance of surviving compared to another patient.
