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ISSN 1747-728X December/January 2006 Issue No. 183

The

Operating Theatre Journal

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SEE THE DANGERWHENEVER IT APPEARS

References 1. Germaine R.L. St. Am. J. Surg. 2003; 185: 141-145. 2. Maffuli N. et al., J. Hand Surg. 1991; 1, 6A: 1034. 3. Wigmore S.J. & Rainey J.B. BJS 1994; 81: 1480.

Many surgeons are unaware of the threat to which

glove punctures expose their career.1

Unaware that everything they’ve worked so hard

to achieve is easy prey for the blood-borne viruses

that move silently through breached defences.

The fact is that up to 88% of glove punctures

go completely unnoticed.2 But surgeons using

Biogel Indicator Underglove/Reveal were not just

aware, they were visibly aware of such punctures

in 97% of instances.3

So which kind of glove would you put your trust

in? One that doesn’t let you see when you’re at

risk, or one that does.

Biogel® IndicatorTM UndergloveBiogel® RevealTM

Setting the standard in protection

Regent Medical Ltd, Two Omega Drive, Irlam, Manchester M44 5BJ, UK. Tel: 0161 777 2600. E-mail: [email protected] Website:www.regentmedical.com Regent Medical, the Regent Medical logo, Biogel, Indicator, and Reveal are trademarks registered in the UK, US and/or othercountries globally and are owned by Regent Medical Limited.

fi nd out more 0207 100 2867 • e-mail [email protected] Issue 183 DECEMBER/JANUARY 2006 3

l

The Operating Theatre Journal

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‘The OTJ’ Next Issue Copy DeadlineFriday 23rd December 2005

All enquiries:

Mr. L.A.EvansEditor/Advertising Manager

Mr. A.S.FletcherGraphics/Editor

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Publishers of:

The Operating Theatre Journal

The National Association of Assistants in Surgical Practice

is pleased to announce their

4th

Annual Conference & Exhibition

“The Challenges Facing the Wider Surgical Team”

Wednesday 1st – Friday 3

rd March 2006

Bristol Marriott Royal Hotel, Bristol

1st March 2006, Workshops Including:

Suture & Knot tying sponsored by: Ethicon Products Ltd

Medico-Legal , Records & Documentation

Professional Presentations Skills

&

Confident Assessment of the Peri-Surgical Patient:

All workshops are full day with limited delegate places available. It is advisable to book early to avoid disappointment.

Thursday 2nd

& Friday 3rd

March 2006 Main Conference Programme

Including the challenges facing the wider surgical team. We will be hearing from the Royal Medical Colleges on

how we prepare teams for multidisciplinary collaboration. We will also hear about pointing risk towards consent

and how regulation will affect all advanced practitioners. We will have education symposiums for the Surgical

Care Practitioner, Advanced Scrub Practitioner, and Emergency Care Practitioner’s role.

Keynote Speakers Mr. Andrew Raferty

For more information or to request a registration form please contact

NAASP, PO Box 182, Wilmslow, Cheshire, SK9 5GD

Tel No 01625-536577 Fax No 01625-522264

Email: [email protected]

Or visit NAASP website: www.naasp.org.uk

To download your delegate registration & accommodation booking form

Advance notice for advertisers - Copy deadline for the

January 2006 issue of the ‘OTJ’ is the 23rd December 2005

A new publication - The Benefi ts of Using Customised Procedure Packs to Increase Day Surgery Unit Effi ciency - a Time & Motion Study’ was launched at the AfPP conference in Harrogate this October.

In 2000, the Government set a target for 75% of elective admissions to NHS acute hospital trusts to be undertaken as day cases (i). This initiative was promoted by both the Department of Health, which published an operational guide to day surgery (ii), and by the NHS Modernisation Agency, which endorsed more widespread use of day surgery as one of the most effective ways to reduce in-patient hospital stays. Indeed, it was highlighted as a key “high impact” change to improve UK healthcare provision (iii).

However, fi ve years later the Healthcare Commission has drawn attention to a number of ineffi ciencies in the way day surgery is currently undertaken, highlighting the fact that nearly half of the operating time scheduled for cases is not actually used for surgery (iv).

This new publication directly tackles this important issue and raises awareness of the vital importance of running an effi cient day surgery unit. A ‘time and motion’ study based on the busy day surgery unit at Kingston Hospital NHS Trust in Surrey is ‘utilised as an example of how customised procedure packs can help.

Endorsement from the Association of Perioperative Practice (incorporating NATN) is currently being sought.

To receive free copies of this publication please contact: hsdcommunications on 01923 777277 oremail: [email protected].

Referencesi) Department of Health (2000) The NHS Planii) Department of Health (2002) Day Surgery: Operational guide: Waiting, booking and choiceiii) NHS Modernisation Agency (2004) Ten High Impact Changes.iv) Acute Hospital Portfolio Review - Day Surgery Healthcare Commission, July 2005

Contributors:Emma Duffy (RGN) Nurse Manager, Day Surgery Unit, Kingston HospitalAnne Smith (RGN) Theatre Sister, Day Surgery Unit, Kingston Hospital

IS YOUR HOSPITAL’S DAYSURGERY UNIT EFFICIENT?

Launch of New Publication:

The Benefi ts of Using Customised Procedure Packs to Increase Day Surgery Unit Effi ciency - a Time & Motion Study’

When responding to articles please quote ‘OTJ’

Health Professions Council launch newsletter Sign up for the fi rst issue of ‘HPC In Focus’

The Health Professions Council today launched the fi rst issue of its newsletter titled ‘HPC In Focus’, designed to keep people informed about its work. Marc Seale, Chief Executive said… “We feel that it is very important to communicate with our stakeholders and this newsletter will enable us to do so more effectively.”

The newsletter will be available at the beginning of each month and will be sent by email to everyone who subscribes by emailing [email protected] . It will also be available on-line at:www.hpc-uk.org/publications/newsletter .

The fi rst issue contains an update on renewals, recent fi tness to practise hearings and a report from the fi rst meeting of the professional liaison group who are drafting information for continuing professional development. It also contains a special report on consultations, looking at why HPC consults and how people can get involved in the decision making process.

4 THE OPERATING THEATRE JOURNAL www.otjonline.com

The fi rst ever SP Services Open Day took place on Saturday 30th October and turned out to be a massive success with nearly 100 visitors. Initial feedback is that everyone had a great time and most people managed to pick up a number of discounted products and bargain buys.

The whole event grew to be a lot bigger than fi rst expected andSP eventually needed 9 staff to cope with the demand. 4 staff hadoriginally been pencilled in to take care of the event but after hugeresponse to the fl yers that were sent out, it became clear that morestaff would be needed to ensure that everyone got that personal touch.

Steve Bray commented “At 12 noon I thought to myself that there weremore people in my warehouse than had visited us at Ambex earlier in the year. We were very pleased with the day and I’m sure we will be doing another one in the very near future.”

Many product demonstrations took place which appeared to be of great interest to the watchful crowd. Comments afterwards suggested these were incredibly useful and many new helpful tips and tricks were picked up.

During the Saturday, SP staff and customers also raised nearly £150 fora local charity, the Hope House Children’s Hospice in Oswestry,Shropshire.

SP Services would like to thank everyone that came along for helping to make the day such a success.

SP Services can be contacted on: 01952 288 974 or via their website at: www.spservices.co.uk

SP Open Day Success


Risk to patient safety

A new study raises serious questions in relation to how clinicians understand failures in safety checking tasks in the health care system. One of the ways of managing patient safety involves challenge-response protocols, a process of verbal challenge from one colleague to another as a proposed course of action is stated. This technique of double-checking is also referred to as ‘witnessing’. Errors occurring in this process are typically attributed to negligence on the part of the checker. Automaticity is the term given to skilled action that people develop through repeatedly practising the same activity, for example driving a car. Writing in Health Services Management Research, Professors Toft and Mascie-Taylor argue that individuals who fail in this system are the victims of a socio-psychological mechanism that they have labelled ‘involuntary automaticity’. In this situation only superfi cial attention is given and errors occur without the checker realising it. Given that this situation is induced by the repetition of the work itself, the study suggests that some of the serious adverse incidents in health care occur because the verbal double-checking protocols do not provide the level of safety envisaged. The study also argues that the health care system, and those who manage it, is responsible rather than the individual clinician. This phenomenon poses a major challenge to the NHS and the authors urge the introduction of measures to reduce involuntary automaticity, thereby reducing the risk to patient safety. ‘Involuntary automaticity: a work-system induced risk to safe health care’ by Brian Toft and Hugo Mascie-Taylor is published in the November edition (volume 18) of the Health Services Management Research. HSMR is published quarterly by the Royal Society of Medicine. Its editor is Professor Peter Spurgeon. www.rsm.ac.uk

NEW RESEARCH ON THE EFFECT OF SEATING

POSITION ON UPPER LIMB FUNCTION HAS

IMPLICATIONS FOR MEDICAL WORKERS

A clinical study to test the effect of two seating positions on muscular activation and upper limb function has shown that sitting on a Bambach Saddle Seat while working improves the skill and accuracy with which tasks are performed. The study concluded that sitting in an anteriorly tilted position -– where the pelvis tilts forwards as on the Bambach – helps promote a healthier working posture and may minimise discal pressure, reducing low back pain and the tendency to ‘slump’.

The research, undertaken by the University of Birmingham’s School of Health Sciences and published in this month’s International Journal of Therapy and Rehabilitation* has signifi cant implications for hundreds of GPs, anaesthetists, surgeons and other people working in the medical profession who spend long periods alternating between standing and sitting, and bending and stretching over patients, with hands and arms activated in precision work.

Jill Ramsey, lecturer in physiotherapy at the University of Birmingham who supervised the study said: “These days, many activities using the arms and hands are performed in a seated position. However, if the seating rotates your pelvis backwards as most seating does then back pain, reduced upper limb control, and diminished dexterity may result. Our aim was to identify what effect the position of the pelvis has on upper limb function, and we found that indeed seating, and the position a seat places your pelvis, has a signifi cant effect. The subjects, when seated on a Bambach performed signifi cantly better in upper limb tasks than the subject when seated on a fl at seat.”

Seat DesignsThe need for good sitting posture is further reinforced, since prolonged sitting has been shown to predispose individuals to the development of low back pain (Magora, 1972; Wilder and Pope, 1996).

The Bambach Saddle Seat was developed by Australian occupational therapist Mary Gale to maintain the pelvis in an anteriorly titled position without bearing body weight on the knees. The Bambach is shaped like a horse’s saddle and uses the biomechanics of the body to naturally position the spine while supporting the pelvis, promoting perfect spinal balance. When seated in this position, users have complete mobility for seated work, the tendency to slouch is reduced and prolonged sitting without back pain will result.

The StudyIn the study healthy subjects (aged 18-30) with no predisposed back pain performed light physical tasks and their accuracy and the stress on their backs were measured.

Key conclusionsWhen subjects were seated in an anterior pelvic tilt position, with the pelvis rotated forwards, on a Bambach Saddle Seat, upper limb task performance was signifi cantly better than when they were seated in a posterior pelvic tilt position, with the pelvis rotated backwards on a fl at seat. There was increased electrical activity in the lumbar paravertebral muscles in the anterior pelvic tilt position, indicating muscle activation that may reduce slumping. The decreased error rate in the anterior pelvic tilt position (using the Bambach Saddle Seat) appears indicative of enhanced upper limb function. Sitting in an anterior pelvic tilt position should promote healthier working postures and may minimise discal pressure.

Anterior vs Posterior Pelvic Tilt PositionsSeated posture changes the demands placed on the musculoskeletal system. The two seating positions tested in the study were (1) a posterior pelvic tilt position, where the pelvis rotates backwards as with most chairs or sofas, and (2) an anterior pelvic tilt position, where the pelvis tilts forwards as it does in a horse’s saddle or a specially designed chair such as the Bambach Saddle Seat.

Sitting in a posterior pelvic tilt position (a backward tilt) is accompanied by fl exion of the lumbar spine, which may be close to the available range. In this position the muscles relax and the body weight is supported by passive structures such as the spinal ligaments. This added pressure has been associated with slump sitting (Nachemson, 1975).

In an anterior pelvic tilt position, the muscles must be activated to achieve and maintain the position. Sitting in this position provides dynamic spinal movements and upper limb stability (Nwaobi 1987).

* “The Effect Of Two Seating Positions On Upper Limb Function In Normal Subjects”. This study was undertaken at the University of Birmingham in 2005, and was conducted by Amar Gandavadi, PhD Student; and Dr Jill Ramsey & Dr Gill James, lecturers in Physiotherapy at the University of Birmingham. It is published in the International Journal Therapy and Rehabilitation, November 2005. A PDF of the Research is available at:www.bambach.co.uk


l

The Electrode Company Ltd specialises in non-invasive monitoring, optical sensors and high performance pulse oximetry. The company has now published a new Technical Brochure – available to view or request on-line – which reveals that over 30% of pulse oximeter sensors in use do not function as the manufacturer intends, thereby potentially compromising patients’ well being. The comprehensive 16 page brochure is entitled: ‘Clinical impact of LED performance in pulse oximetry’.

The key points of the brochure are emphasised at the outset by way of a summary and include:

• Sensors reading high can lead to insuffi cient O2 being given,

while those that read low can lead to excessive O2 amounts.

• These problems can lead to cataracts, retinopathy and strokes.

• Spectral properties of LED’s largely dictate the accuracy of pulse oximeters.

• Manufacturing and ageing errors impact on LED spectral properties, and if these are not known to be correct, then every clinical decision based on the data is without foundation.

The technical brochure also explains the mechanics of pulse oximetry and the equipment calibration using the Lightman® SpO

2 micro

spectrometer, which relates the magnitude of any wavelength errors to sensor accuracy.

Common faults in pulse oximetry sensors are described along with the relationship between LED wavelength and accuracy. A helpful section reviews how ageing and other factors affect oximetry accuracy and graphical illustrations of LED degradation are provided.

The Lightman is a novel and compact hand held device that makes pulse oximeter testing quick, simple, reliable, accurate and achievable on-site, minimising time lost. For information on this unique device, or for a copy of the Technical Brochure, visit The Electrode Company on www.electro.co.uk or telephone 01633 861772.

Celtic Electromedical: Ensuring accurate data for better clinical outcomes.

Patients at risk from incorrectly

functioning Pulse Oximeters

Please quote ‘OTJ’

Royal College of Nursing launches

new guideline for fasting

before surgeryThe Royal College of Nursing (RCN) is launching a new national guideline for fasting before surgery.

The guideline was launched at the Preoperative Association Conference on the 23rd & 24th of November at the Hilton Brighton Metropole. The aim of the guideline is to address current variations in fasting practice to the benefi t of patients. Under the new guidance the RCN recommends patients can be given water and clear fl uids 2 hours before general anaesthesia and 6 hours for food. Babies can be given breast milk 4 hours before general anaesthesia. Providing clear guidance will benefi t patients in many ways, increasing comfort and well-being prior to surgery and by reducing symptoms such as dehydration and nausea.

The Quality Improvement Programme at the RCN Institute produced the guidance working with a multi disciplinary guideline development group. RCN members identifi ed the need for clinical guidance on this topic, to help nurses and other healthcare professionals deliver evidence based care and improve patient outcomes. The guideline has been endorsed by leading professional organisations such as the Royal College of Anaesthetists.

Dr Ian Bullock, Senior Research and Development Fellow said: “We hope this guideline will be used for adapting policy across trusts and help standardise practice, improving patient experience before and after surgery”. www.rcn.org.uk


P.M.S (Instruments) Ltd are celebrating the fact that they have more Blood Pressure Monitors Approved, Recommended and Accredited to the British Hypertension Society Protocols than any other manufacturer.

The British Hypertension Society (BHS) website now lists a record breaking NINE A&D digital blood pressure monitors as suitable for home and clinical use, as well as TWO ambulatory blood pressure monitors (ABPM).

The clinically validated A&D monitors featured on the BHS website include the UA-767, UA-767Plus, UA-767PC, UA-767V, UA-779, UA-774, UA-787, UA-767Plus 30, and UA-767 Bluetooth digital spot check monitors, which all achieved an “AA” grade as well as the TM-2421 and the TM-2430 ambulatory blood pressure monitors.

Further information on the entire range of A&D monitors is available online at www.pmsinstruments.co.ukor by calling 01628 773 233.

Norfolk and Norwich University Hospital NHS Trust, a hospital with 1,000 beds and more than 5,500 staff, recently purchased ten new SonoSite systems. The purchase comprises eight iLook®25 and two SonoSite 180PLUS ultrasound systems for use across the Trust to assist line placement procedures. The 180PLUS systems will also be used for regional anaesthesia. These complement the TITAN system already in use in the Radiology Department.

Initial feedback on the new SonoSite systems has been promising. Dr. David Wilson-Nunn, consultant anaesthetist and Clinical Governance Lead for Anaesthesia says, “We found the systems to be very good and really convenient, especially when moving them from one theatre to another. The mobile stands are light and easy to manoeuvre. Even those with reservations before the purchase have taken warmly to them. Many would feel reluctant to attempt central line placement without using one now.”

Other feedback included the systems’ compliance with the National Institute for Health and Clinical Excellence (NICE) guidelines and the ability to conduct safer training for central line insertion as the systems enable the vein to be demonstrated clearly prior to attempting cannulation.

The SonoSite iLook25 ultrasound tool is designed to facilitate needle guidance in vascular access procedures. It offers true mobility in a hand-carried unit weighing just under 1.4kg, has a rapid boot-up -- about 5 seconds-- an intuitive interface with a PDA-like touch screen, AC or battery operation (30-60 minute battery life), high quality digital imaging modes: 2D and CPD and can store up to 74 images with easy download through a docking station to provide documentation capabilities to a printer or an electronic storage medium.

The SonoSite 180PLUS offers high quality ultrasound for point-of-care imaging. It is compact, lightweight and offers excellent portability making it the ideal choice for offi ce, clinic and bedside exams. The pulsed wave Doppler provides a sensitive and accurate quantitative assessment of blood fl ow, enabling the user to measure velocities and identify blood fl ow characteristics in arteries and veins. The 180PLUS’ Doppler signals are exceptionally clean thus enhancing diagnostic confi dence for vascular exams.

For more product information please visit: www.sonosite.comor E-mail: [email protected]: 01462 444 800

NORFOLK AND NORWICH NHS TRUST FINDS ITS NEW SONOSITE ULTRASOUND

SYSTEMS VITAL TO LINE PLACEMENT AND ANAESTHETIC PROCEDURES


Showing in your Theatre now!

THE

OPERATING

THEATRE

JOURNAL

‘Patient-centric strategy a crucial basis for EU Healthcare’ advocates

Health First Europe policy statement

At the annual Open Health Forum held by the European Commission’s DG Health and Consumer Protection, Health First Europe (HFE) launched its policy statement outlining a series of recommendations to contribute to the debate on the challenges and future of healthcare in the EU. Speaking at the Forum, Annette Kennedy, the President of the European Federation of Nurses Association (EFN), emphasised that: “There is an urgent need to explore the current context of professional preparedness in Europe to deliver a consistent standard of healthcare to individuals in all countries within the EU in terms of education, competence, codes of practice and clinical outcomes. There is also a real need to develop European accreditation mechanisms, based on national developments and which comply with well-established global frameworks. And there needs to be evidence of validation of standards and transparency of the process used, which is easily recognised across borders.” The EFN, an associate member of HFE, is co-organising a workshop focusing on Health Services.

Mel Read, Honorary Chair of HFE welcomed the Forum’s programme and explained: “A patient-centric strategy is the necessary basis for making healthcare decisions. To this end, and through the launch of our policy statement, we would advocate improved access to healthcare as an important EU investment through appropriate budget allocation, equitable and cross-border access for patients in the EU, and better utilisation of collective EU expertise and resources.”

HFE’s policy statement is the result of a stock-taking of the various initiatives and strategies put forward by European policy makers of late as a means of improving healthcare for EU citizens. It identifi es and elaborates on common themes within the critical action areas such as the future of EU Health Strategy; improving access to services in the EU; patient mobility and related topics (e-health, patient information and safety, etc.), and better regulation linked to the Lisbon Agenda. These themes are namely:

1. Access to better healthcare in the EU2. Innovation of healthcare therapies and access processes3. Continual quality improvement of EU healthcare4. Investment in healthcare’s human resources

Under the patronage of David Byrne, former European Commissioner for Health and Consumer Protection, Health First Europe is a voluntary platform of diverse healthcare stakeholders including patients, healthcare workers, academics, experts and industry. HFE aims to ensure that equitable access to modern, innovative and reliable medical technology and healthcare is regarded as a vital investment in the future of Europe.

For the full policy statement as well as further information about HFE, please visit the website www.healthfi rsteurope.org

Top of the Class


The surgical glove with built-in hydration

The new Gammex® PF HydraSoft® powder-free latex surgical glove rehydrates your skin as you wear it. Its innovative synthetic inner coating uses Ansell’s HydraSoft® technology to retain the moisture in your skin, countering the damaging effects of continual glove-wearing and frequent contact with anti-bacterials. HydraSoft® technology also makes the glove easy to don, even when you are double-gloving for greater security. And it gives a softer feel to the glove, meaning greater comfort for you. Gammex® PF HydraSoft® builds upon the established reputation of the Gammex® PF glove, the standard for patient and surgeon protection in operating theatres throughout Europe.

Gammex® PF HydraSoft®

Ansell UK Ltd Northgate Business Centre 38 Northgate - Newark Notts NG24 1EZ UK Tel : +44 (0)1636 642 843 Fax : +44 (0)1636 642 844 http://www.anselleurope.com E-mail : [email protected]

Gammex® PF HydraSoft®


Hitchin, November 2, 2005 - Dr. Paddy McMaster is a consultant in the Paediatric Intensive Care Unit (PICU) at City General Hospital, one of the biggest and busiest acute care hospitals in the country. With a staff of 6,700, the 1,300 bed hospital is part of University Hospital of Staffordshire NHS Trust and has a turnover of £200 million. It serves a population of almost 500,000 people in North Staffordshire and provides a range of speciality services for more than 3,000,000.

Dr. McMaster is one of six consultants who run the Paediatric Intensive Care Unit (PICU), which has eight beds and is one of only two PICU’s in the region. At the beginning of this year the unit acquired a SonoSite TITAN hand-carried ultrasound system. The system is used predominantly for central line placement and occasionally for arterial lines. Dr. McMaster thinks the TITAN system is well suited to PICU’s needs because “it is easily carried, has a small footprint transducer with high resolution image quality for infants and the system is also suitable for echocardiogram, neonatal head and abdominal imaging.”

Even though the system has only been in the unit for a matter of months, Dr. McMaster can recall specifi c examples where the system proved to be indispensable: “The TITAN was extremely useful when an obese teenager with meningococcal sepsis came in with severe respiratory distress, having had

SonoSite TITAN™ High Resolution Ultrasound System Proves Indispensable at University Hospital of Staffordshire NHS’ Paediatric Intensive Care Unit

a lot of resuscitation fl uids (60 ml/kg IV bolus fl uids) and more going in but still no palpable pulses. As one of the intensivists was securing the airway, we used the TITAN system to locate the femoral artery, which we were unable to feel, and hence achieved central venous access to give adrenaline and an arterial line for monitoring blood pressure. She went on to make a full recovery,” says Dr. McMaster. “We also use the TITAN for echocardiograms for congenital heart disease.”

Dr. McMaster fi nds the TITAN the ideal solution for most of his scanning needs in the PICU and believes SonoSite’s systems are the best hand carried systems on the market. He likes the fact that it’s always close at hand just in case he has to make a quick diagnosis. Without his SonoSite TITAN system he would have to either borrow one from the adult ICU or use the Radiology department’s portable ultrasound machine for venous access, which is less suitable on account of its larger probe. Failing these options he would have to transport the patient round the hospital to where there was an available ultrasound system. This type of upheaval can be stressful on younger patients. Fortunately for Dr. McMaster and his PICU team, this is not the case.

The SonoSite TITAN ultrasound system offers full diagnostic capabilities. This includes high quality imaging; colour power Doppler (CPD); pulsed wave (PW) Doppler; Tissue Harmonic Imaging (THI); M-mode; SiteLink

DICOM and onboard DICOM. It offers units the choice whether to use the system in its Mobile Docking System set-up or as a mobile point-of-care solution using the mini-Dock. On account of its rugged, durable design it can meet the demands of mobile applications including potential droppage and substantial wear and tear. There is an upgrade path for new capabilities, including Triple Transducer Connect (TTC) that allows for rapid application changes. It has reliable, fast technology – its state-of-the-art ASIC based system cold boots in seconds and offers highly consistent performance and it comes with a convenient industry standard fl ashcard allowing for high capacity on-board information storage.

About SonoSite

Headquartered near Seattle, Washington, USA, SonoSite (www.sonosite.com) is represented by eight subsidiaries and a global distribution network in over 75 countries.a. SonoSite’s small, lightweight systems are expanding the use of ultrasound across the clinical spectrum by cost-effectively bringing high performance ultrasound to the point of patient care. The Company employs approximately 470 people worldwide.

SonoSite, Ltd., a wholly owned subsidiary of SonoSite, Inc. based in Hitchin, Hertfordshire, oversees a direct sales distribution network in the UK as well as operates the Company’s European Service Centre and provides sales and marketing support for SonoSite’s European offi ces.

For more product information please contact by e-mail: [email protected] or visit www.sonosite.com or Telephone: 01462 444 800

Dr. McMaster fi nds the TITAN the ideal solution for most of his scanning needs in the PICU


Venous thromboembolism in patients, also known as deep vein thrombosis (DVT) due to its common manifestation in the deep veins of the legs, is being ignored in UK hospitals despite clear, evidence-based guidelines on the use of preventative treatments. The fi ndings, which are published in the November edition of the Journal of Royal Society of Medicine, follow a 24-month survey on medical inpatients in two major English teaching hospitals. Deep vein thrombosis rose in prominence due to its association with long-haul fl ights, however, venous thromboembolism (VTE) is the most preventable cause of

mortality in hospitalised medical inpatients. It is a potentially fatal condition with an annual incidence of 1-3 per 1000 per year and contributes to approximately 10% of all hospital deaths in the UK. The study assessed 1062 patients of which 89% were found to have moderate and high risk of developing VTE. Of this category, 71% did not receive any form of prophylaxis. Of the 29% who did, prophylaxis was implemented correctly in only 4% of moderate and high-risk patients. Presentations about the recommended guidelines to fellow clinicians, after the fi rst round of data collection, only increased use of prophylaxis to 31%.

Deep vein thrombosis prevention

is ignored in UK Hospitals The survey noted that the under utilisation of prophylaxis in medical inpatients was in marked contrast to the practice on many surgical wards.

Lead researcher, Dr Abdul Shlebak, said the situation was unsatisfactory.

“Clinicians and policymakers need to act on these fi ndings if we are to reduce the incidence of VTE and prevent fatalities in hospitals,” said Dr Shlebak.

Amongst the authors’ recommendations are: a DVT tick sheet attached to drug charts for all patients when admitted; greater understanding of DVT in medical and nursing education; and establishing dedicated antithrombotic teams charged with the task of raising awareness and auditing prophylaxis rates.

An accompanying editorial in the JRSM describes the current low level of thromboprophylaxis in UK hospitals as unacceptable and urges physicians to take greater responsibility by being aware of the evidence on VTE and act accordingly. ‘Venous thromboprophylaxis in UK medical inpatients’ by ST Rachid, MR Thursz, NA Razvi, R Voller, T Orchard and AA Shlebak is published in the November 2005 issue (volume 98) of the Journal of the Royal Society of Medicine. JRSM is the fl agship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi.



l

With the traditionally “diffi cult” fi rst year well and truly under their belts – Sam and Tina, the two directors of Kirkham Young, now have their sights fi rmly set on the next phase of their company’s development. As Sam comments “in our fi rst year we have reached some fairly signifi cant milestones - ensuring our branding was strong and had a high profi le in the market, and securing a number of signifi cant sole and preferred supplier contracts. We successfully completed campaigns for a range of customers and, most importantly, ensured we exceeded our clients’ and candidates’ expectations every time.”

Tina adds “moving into our second year we were delighted with the reception our ‘hangover’ coffee morning received at AfPP this year – it offered us an excellent opportunity to chat informally with clients old and new over a coffee, Danish or even a red bull for those in need of a pick me up! “

Now settled into their brand new offi ces, Tina and Sam are moving the company onto the next level with the employment of their fi rst two new team members, ensuring that their unique approach to customer service and specialist recruitment continues to take the market by storm! They would like to extend a big ‘thank you’ to all their clients for the encouragement and support they have given since the company launch.

Kirkham Young can be contacted by telephoning 0870 787 3134 or E-mailing: [email protected]: www.kirkhamyoung.co.uk

Kirkham Young goes from

strength to strength!Gambro Hospal Ltd, a wholly owned subsidiary of Gambro AB, has released a new brochure on how APD therapy from the company can achieve peak performance to prolong home treatment.

The brochure reveals a fl ow diagram, which reveals the effect of combining Serena™ with PDC software, plus using Gambrosol™ trio solutions with BREAKPoint™ software for Serena.

Serena simplifi es the exchange process of APD and provides a continuous fl ow with, no pulsating peaks. PDC software determines the real dialysis capacity of the peritoneum and Gambrosol trio fl uids actively limit peritoneal membrane damage byguarding against the formation of GDP’s. BREAKpoint works with Serena to optimise dialysis, simplify the prescription and personalise treatment.

In this way, APD therapy from Gambro has the potential to prolong home treatment.

Also on the brochure is a summary of how Gambro’s CAPD system provides worry-free exchanges by using integrated colour coded clamps. It also features the PDC 203i protective cap, which effectively disinfects the Gambro CAPD connector of the patient after every exchange. This system brings freedom within everyone’s reach.

For a copy of the attractive new APD/CAPD brochure from Gambro Hospal, or for more information on any of the products mentioned above, please telephone Gambro Hospal on 01480 444000.

New Brochure from Gambro on prolonging home APD treatment

When responding to articles please quote ‘OTJ’When responding to articles please quote ‘OTJ’


Happy Christmas from

Medical Professionals

Theatre DivisionDecember 2005

Amit, Dominic and Andrew would like to take this opportunity to thank all

their Locums for their hard work and continued support throughout 2005.

Medical Professionals urgently need nationwide the following staff for

bookings in 2006; Orthopaedic Scrub, Ophthalmics, General Surgery,

Anaesthetics, Recovery, Trauma & Plastics, Theatre Nurses. We will

continue to offer throughout 2006 our unique Recommend a Friend Bonus,

Great Rates of Pay and flexible locum opportunities nationwide.

Come and join the team.

Happy Christmas

October 2005. The Horder Centre, a registered charity specialising in planned orthopaedic surgery and the treatment of musculo-skeletal conditions, has opened a brand new, purpose-built, radiology facility, which uses state-of-the-art digital imaging equipment.

This new system provides a much-simplifi ed solution to taking patient X-Rays, whilst bringing great benefi ts to both patients and Clinicians.

The advantages of this computerised, digital system, known as PACS (Picture Archiving and Communications Systems) are many. For example, the traditional means of taking X-Rays meant a fi lm would go through various stages of wet processing in order to show the image, taking between 5 and 10 minutes before a consultant could read the data.

The new equipment enables images to be viewed immediately, with the actual processing taking just 50 seconds, and it not only allows images to be instantly available but simultaneously viewed. Clinical diagnosis is enhanced in that the system allows simultaneous clinical review between consultants and radiology staff, images can be easily manipulated to yield more clinical information, and both current and previous patient

The Horder Centre opens state-of-the-art Radiology facility

The Horder Centre’s new state-of-

the-art digital imaging equipment

Gambro Hospal Ltd, a wholly owned subsidiary of Gambro AB, has published its new brochure on MARS ® the innovative Molecular Adsorbents Recirculating System dedicated to assist in the fast recovery of hepatic functions.

The brochure outlines the key indications for the application of MARS in liver diseases. These include liver failure and liver dysfunction following chronic liver diseases such as viral hepatitis, acute liver failure of varying etiology, graft failure or dysfunction after liver transplantation. All the listed indications for MARS are supported by a comprehensive list of clinical references in the brochure together with helpful circuit diagrams for patient connection as well as photographic details showing the complete system set up.

The basis of MARS therapy is the elimination of water-soluble and albumin bound substances which accumulate during liver failure. This enhances the regeneration of liver cells and at the same time reduces plasma toxicity. MARS is compatible with standard dialysis machines and CRRT- devices and requires minimum staff involvement during treatment.

For your copy of the MARS brochure, or for more information on the MARS system please telephone Gambro Hospal on 01480 444000.

Gambro Hospal: A better way to better care

Gambro’s new MARS® brochure demonstrates how it assists in the fast recovery of hepatic functions

following liver failure

images can be viewed on the same PC for comparison. From the patient’s perspective, waiting times and unnecessary exposure to radiation are signifi cantly reduced.

Di Thomas, Chief Executive at the Centre, says that it is therefore not surprising that hospitals are opting for this superior technology, likening these changes to the domestic market, where there has been a signifi cant shift from traditional cameras, which require processing, to ‘digital’ technology.

Allied to the improvements in technology, are the improvements made to the design of the outpatients department. The new radiology room has been specifi cally built for the purpose and has been lead lined to conform with all of the rules & regulations surrounding X-Rays. In keeping with the rest of The Horder Centre, the modern layout means that patients have a pleasant, comfortable and less stressful experience prior to having their X-Rays.

This type of system will also be rolled out across the NHS in England, with the intention that nearly all images will be stored, transmitted and viewed digitally.

Di Thomas added, “With all the changes which are taking place in the health economy, including Choose and Book, where patients may opt to have their care in Independent hospitals, this new technology will be incredibly important, and having the facility to transmit images electronically between hospitals in the future will be a giant leap forward for the Health Service in general.”

She continued, “The Horder Centre prides itself on staying at the forefront of the latest advances in hospital technologies, and is continually looking ahead for the next challenges.”

For further information contactDi Thomas Telephone: 01892 665577 Fax: 01892 662142 E-mail: [email protected]

or visit our newly launched website www.hordercentre.co.uk


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Next stage of notifi cation exercise to reduce risk of Variant

CJD transmission beginsPrecautionary measures to reduce the possible risk of transmitting vCJD through surgical procedures are to be extended. Around 50 people who have received blood transfusions will be traced and notifi ed of their potential exposure to vCJD.

This follows an announcement in July 2005, when around 100 blood donors were told they may have a greater chance of carrying the vCJD agent, compared with the general population. Blood from these donors had been given to three people who later developed vCJD and experts advised that it was not possible to exclude the donated blood as a possible source of that infection.

The CJD Incidents Panel has now advised that certain other patients who received blood from some of these donors should also be contacted, so that additional precautions can be taken against the possibility of further transmission.

The UK blood services are contacting hospitals where the donated blood was issued, requesting their help in identifying patients involved. This process is likely to take a number of months to complete. Patients will be informed on a case by case basis and will be offered advice and support. The notifi cation of patients and their general practitioners is being co-ordinated by the blood services together with the health protection agencies

The likelihood of a person who may be infected with vCJD going on to develop symptoms of the disease is uncertain. It is possible that an infected person may never develop symptoms, but until a reliable blood screening test becomes available, it is sensible to proceed on a precautionary basis to protect public health.

Medical Professionals, one of the leading medical recruitment agencies in the UKurgently require Theatre staff for Recovery, Scrub and Anaesthetics positions for

Private and NHS Sector bookings nationwide.

MEDICAL PROFESSIONALSSuite 4, Goldlay House, Parkway, Chelmsford, Essex CM2 7PREmail: [email protected] online at www.medical-professionals.co.ukMedical Professionals are an equal opportunities employer.Medical Professionals is a trading style of Nursing Professionals Ltd

on 0845 045 6611(24 hour on-call service)

Call Daren, Amit, Dominic or A

make your agency nervous...


Newly launched company, Lemonchase, is the exclusive distributor of Designs for Vision (DfV) loupes to surgeons and dentists in the UK. The Company has been established by Nick Lemon and Mark Chase, both of whom are well-known specialists within the fi eld of magnifi cation and lighting.

Nick Lemon comments, “Designs for Vision loupes are the magnifi cation choice of an amazing 95% of US and UK surgeons and 50% of US dentists. With these kind of statistics we know we are offering the best products available to the medical community. The aim of Lemonchase is to make DfV products easily available to the UK market. We are confi dent DfV will remain the brand of choice for the country’s top surgeons.”

Good lighting is extremely important when using magnifying loupes. Lemonchase offers a choice of Designs for Vision light units. The Xenon 300 (the whitest and brightest available), the 4-Bulb Quadrilite 6000 and the BFL Fibre-Optics system. All are available with a range of mounting and cabling options.

Lemonchase also distribute Seiler microscopes, one of the top US manufacturers with a ‘high-end’ reputation for ENT microscopes and Colposcopes. “Seiler offer excellent value,” continues Nick, “and their modular construction means that accessories can be added retrospectively”

“After all the years we’ve spent working within the areas of magnifi cation and lighting we understand the requirements of the medical community,” says Nick. “As such we are well placed to offer qualifi ed advice and expertise within this specialist area as well as providing the fi nest products.”

To contact Lemonchase by phone call 01892 752305 or fax 01892 752192 or E-mail Nick or Mark on [email protected]

AUTODETECT™ SYRINGE

A SPRING LOADED SYRINGE FOR EPIDURAL

PROCEDURES

Goldshield are pleased to announce the availability of the AutoDetect™

Syringe, which is a unique “Spring Loaded Syringe” for

Epidural Procedures marketed by the Hospital division

of Goldshield Pharmaceuticals under an exclusive

agreement with Indigo Orb Inc of California, USA .

Product summary

The AutoDetect™ Syringe is an automatic Loss-of-Resistance (LOR) syringe, which permits automatic

detection of the Epidural and Peritoneal cavities. A coaxial compression spring under 20kPa tension is

released when the needle attached to the syringe reaches the correct anatomical position. The syringe plunger

is automatically depressed by the spring giving a visual confi rmation to the clinician. This automatic device

therefore frees both hands to manipulate the needle through the tissues in one smooth movement without

requiring frequent stops to attempt to depress the syringe manually.

Product details:

Product Pack Size Pip Code EAN Code (Bar Code)

AutoDetect Syringe 10 per box 680 8331 5021691 107309

The AutoDetect™ Syringe can be ordered direct to hospitals from UDG at the following address:

UDG Ltd, Amber Park, Berristow Lane, South Normanton, Alfreton, Derbyshire, DE55 2FH.

Tel: 01773 510123, Fax: 01773 810644.

The AutoDetect™ Syringe can also be ordered at all branches of AAH.

Should you require further information, please contact Goldshield Hospital Europe

on tel: 0208 410 2134 or 0208 410 2161. Fax: 0208 410 2165.

or E-mail at [email protected]. When responding to articles please quote ‘OTJ’

12

Lemonchase announce exclusive

distribution of Designs for Vision

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Hitchin, 11th November 2005. King’s College Hospital NHS Trust, a major London teaching hospital, has recently installed 12 hand-carried ultrasound (HCU) systems from leading innovator, SonoSite Inc. These revolutionary SonoSite iLook 25’s are specifi cally designed to aid vascular access. They will also enable units in the Trust to comply fully with the recent NICE guidelines which recommend the use of ultrasound guidance in the insertion of CVCs.

The Trust, which has 5110 staff, 936 beds, 18 operating theatres for in-patients and seven for out patients carried out 190,011 CT, MRI and ultrasound scans last year. The hospital provides local hospital services for more than 700,000 people in the London boroughs of Lambeth, Southwark and Lewisham. As well as being a major London teaching hospital, the Trust is also recognised nationally and internationally for its work in liver disease and transplantation, foetal medicine, neurosciences, cardiology and haemo-oncology.

Dr. Peter Thompson, a consultant at King’s College Hospital’s

KINGS COLLEGE HOSPITAL NHS TRUST INSTALLS TWELVE OF SONOSITE’S ILOOK®25HAND-CARRIED

ULTRASOUND TOOLS

System Mobility Backed with Training and Support are Key Factors in Purchase Decision

The SonoSite iLook 25 offers users true mobility at just under 1.5kg, rapid boot-up -- about 5 seconds, intuitive interface with a PDA-like touch screen, AC or battery operation (30-60 minute battery life), high quality digital imaging modes: 2D, CPD and Tissue Harmonic Imaging. It can store up to 74 images with easy download through docking station to provide documentation capabilities to a printer or an electronic storage medium.

The system enables users to better visualize veins and arteries, increase effi ciency, raise user confi dence, improve patient care, minimize hospital risk and maximize departmental uptime.

For more product information please E-mail: [email protected] Telephone: 01462 444 800 or visit www.sonosite.com

Emergency Medicine Department and who was on the steering committee that helped implement the NICE guidelines in the hospital said; “We invested in the SonoSite iLook 25s for vascular access procedures to make Point-Of-Care use quicker and easier for doctors and safer for patients. The SonoSite equipment was selected on account of it being widely available and respected within the marketplace. Another important factor in the purchasing decision was the comprehensive training and support programme that comes with SonoSite’s systems.

We believe that SonoSite’s iLook 25 is the standard vascular access tool”.

Dr Peter Thompson

Radiologist Justin Wilkins training

with the revolutionary SonoSite



l

Tourniquets – Stone Age to Space Age

The history of tourniquets is one that stretches back,

possibly as far as the Neolithic age. By Roman times, the practice was well documented as a way of preventing blood loss when performing amputations.

The concept of creating a bloodless operating fi eld seems not to have appeared until the work of pioneering surgeon Joseph Lister in the 1860s.

Today, this aspect of the tourniquet is almost taken for granted, as the equipment’s development keeps pace with our technological age – current models being touch-screen, computerised electronic tourniquet systems, complete with automatic leak compensation and automatic alarm signals to ensure that good practice guidelines about the duration of use can be followed and monitored effectively.

Less well known perhaps is the part that tourniquets play in other techniques including intravenous regional blocks and pain relief.Renowned orthopaedic surgeon Professor Leslie Klenerman has written extensively about the tourniquet in his long career,

which has seen him hold the posts of President of the European Foot and Ankle Surgery Society, and President of the British Orthopaedic Research Society.

He explained: ‘There are times when it is preferable not to give a general anaesthetic – if the patient has particular risk factors, or the procedure is relatively minor.

It was August Karl Gustav Bier back in 1908 who fi rst developed the method of using a tourniquet to bring about complete anaesthesia and motor paralysis of a limb. Today, a more refi ned version of his procedure is widely used – although great care must always be taken to ensure that the local anaesthetic does not leak prematurely into the general circulation.’

A similar method of local blockade is also used in patients suffering from complex regional pain syndrome. With a suitable solution, pain relief can be induced for up to four days allowing for active physiotherapy.

Professor Leslie Klenerman has recently written a book on the preparation, use and care of tourniquet systems. It was produced in collaboration with UK tourniquet manufacturer Anetic Aid Limited as part of the company’s commitment to promoting tourniquet good practice.

Further information available from Anetic AidTelephone: 01943 878647

Q-Med is a rapidly growing biotechnology and medical device company that develops, produces and markets medical implants. The company has now published a new clinical Case Study, based on the use of it’s Zuidex™ injectable gel for stress urinary incontinence (SUI) in women, attending the Royal Berkshire Hospital in Reading.

The Case Study is based on the experiences of Mr Steve Foley, a Consultant Urologist at the hospital, who has treated over 100 patients with SUI successfully in the past three years. It reveals how commonly the condition occurs in up to one quarter of women in the 35-70 years

of age group, two thirds of whom fi ndrine leakage to be embarrassing,onfi dence sapping, and troublesome.

he various pros and cons of existingreatments are covered before Mr Foleyiscusses the Zuidex system, whichan show effectiveness for periods inxcess of seven years. Commentingn his results he says, “This is anutpatient procedure where the speedf returning to normal is remarkablyuick. The sense of relief and joy from

my patients is there for all to see.”

he Case Study then goes on toescribe the experiences of an

ndividual patient (Denise), and howMr Foley wants to raise the doctor awareness level of the value of Zuidex treatment, in conjunction with Q-Med. As a result, programmes of clinical workshops and ‘hands on’ training sessions have been initiated, with the assistance of Mr Foley and other clinical experts.

These programmes help to emphasise the benefi ts of Zuidex, which include longevity of action, ease of use and lack of complications. For details on Zuidex, or the User Support Programme, or for a copy of the new Case Study on SUI treatment, please telephone Q-Med on 01737 735503.Q-Med: The NASHA Technology Company.

New Case Study from Q-Med reveals ‘a sense of relief and

joy’ from SUI patients

When responding please quote ‘OTJ’

‘au Naturelle’ – feel The difference with Biogel EclipseRegent Medical meets customer demand with increased customer satisfaction

Launched in June 2005 at the London Planetarium, Biogel Eclipse has proved extremely popular as the fi rst powder-free, Deproteinised Natural Rubber Latex (DPNRL) surgical glove. With potentially reduced risk of latex allergy, Biogel Eclipse offers theatre staff a more comfortable and affordable solution to moving completely latex free.

Recent customer feedback has been consistent focusing primarily on the gloves supreme comfort, fi t and feel. Comments have included “extremely comfortable”, “superb fi t” and “feels like a second skin”. Biogel Eclipse has additionally allowed non-sensitised wearers to feel the comfort of latex with reduced concerns of acquiring allergy.

Biogel Eclipse is 20% thinner than standard Biogel and 30% softer than Biogel SuperSensitive. It not only allows users improved usability and dexterity but importantly, offers increased durability and protection. In a UK trial 80% of users preferred Biogel Eclipse over their current glove.

Regent Medical is a world leader in surgical glove technology and glove barrier protection, producing the market-leading Biogel range of gloves. Regent has become the successful company it is today by investing heavily in research and education on the issues and problems facing the modern theatre team.

Whilst Biogel Eclipse has a low potential for the development of latex allergy and allergic contact dermatitis, they should not be worn by latex-sensitive individuals.

Please call 0161 777 2600, E-mail: [email protected], or write to Regent Medical, Two Omega Drive, Irlam, Manchester, M44 5BJ to request samples or arrange for a representative to visit.www.regentmedical.com

Regent Medical, the Regent Medical logo, Biogel and Biogel Eclipse logo, are trademarks of Regent Medical Ltd and are registered in the US, UK and elsewhere globally. Please quote ‘OTJ’


The steady increase in surgical procedures is set to trigger more opportunities for minimally invasive techniques. With the potential for fewer complications, less complex procedures and reduced average lengths of hospital stay, minimally invasive surgeries (MIS) will hold particular appeal to cost conscious health care authorities. Therefore, the long-term cost effi ciencies may encourage uptake of MIS devices despite their higher capital costs, boosting the prospects of European MIS device manufacturers.

Over time, MIS procedures will outnumber traditional open surgery with the market for related MIS devices set to soar from its current size of USD 779.0 million to USD 1,164.0 million in 2011. Therefore, the immense potential of the market is likely to offer considerable opportunity to new participants with regional markets in Italy, Spain and the United Kingdom forecast to experience high growth despite intensifying competition.

Growing awareness about minimally invasive modalities and their benefi ts among health care practitioners and patients is likely to trigger demand for technologically advanced MIS devices. Such acceptance is also being supported by the emergence of several clinical conditions that lend themselves to MIS techniques.

Clinical specialties such as prostate resection, nephrectomy, ureteric surgery (urology), lap. ablation, endometriosis, fi broids (gynaecology), carpal tunnelling, shoulder and knee surgery, mandibles surgery (orthopaedics), gastric bypass, splenectomy, bowel surgery as well as gastrectomy (general surgery) are included in the potential niche applications that MIS device manufacturers can target.

Moreover, novel MIS procedures in paediatrics, oncology and cardiology are set to widen the adoption of MIS devices. Trends such as miniaturisation and instrument development will also reinforce the expanding scope of MIS devices.

In this context, companies with product lines catering only to a particular niche segment can focus on application expansion. Ms. Aarti Ajay, Research Analyst

Increase in Minimally Invasive Surgeries Set to Spur Adoption

of Related DevicesPrice Erosion Remains Area of Concern for Minimally Invasive Surgical Devices Market

with Frost & Sullivan (http:frost.healthcare.com) advises, “Such companies need to identify newer surgical procedures that have potential for use of MIS and they should focus more on organ specifi c studies than on system specifi c studies.”

The strategy to concentrate on product line development will be effective for companies providing a complete range of instruments and devices that cover all specialities. “Upgrading options and enhancing features will be an aspect of developing a complete product line. Companies also need to build a ‘one-stop shop’ strategy by bundling products customised to suit the specifi c needs of customers,” adds Ms. Ajay.

More immediately, manufacturers have to contend with cost containment schemes that can stifl e revenue growth. Given the limited budgets, volume purchase by local or national purchasing groups has become common. Even at the micro level, groups or individuals are joining together to purchase common equipment. In addition, as private clinics try to attract more patients with discounted treatments, they demand price cuts from manufacturers.

Escalating competition is contributing to price erosion within the market. Foreign manufacturers are being compelled to reduce prices to match local manufacturers that offer cheaper endoscopes. This is leading to overall price erosion within the market. The repair and exchange of endoscopes by companies at a lower price is resulting in further price undercutting.

Such developments are creating tremendous price pressures in the market. While manufacturers need to bring pricing in line with cost containment plans in Europe, they can also adopt various strategies to maintain their profi t margins. These include forging relations with managed care providers to increase volume sales. Developing high quality, enhanced product features and continuously improving product technology will enable companies to charge premium prices and would also be essential to gaining the acceptance from surgeons that play an important role in purchase procedures.

In this highly competitive setting, technological innovation and new product development are poised to be crucial to retaining profi tability. For instance, sophisticated endoscopes catering to niche segments will demand premium prices. Indeed, surgical endoscopes (already the largest revenue contributor to the market) may be the fastest growing segment due to the rapid adoption of technologically advanced, high-end products catering to specifi c surgical applications that command premium prices.

If you are interested in a research overview, which provides manufacturers, end-users and other industry participants with a synopsis of the latest analysis of the Minimally Invasive Surgical Devices Market (B489-54) – then send an e-mail to Katja Feick – Corporate Communications at [email protected] with the following information: your full

name, company name, title, telephone number, e-mail address, city, state and country. We will send you the information via e-mail upon receipt of the above information.

Minimally Invasive Surgical Devices Market (B489-54)

BackgroundFrost & Sullivan, a global growth consulting company, has been partnering with clients to support the development of innovative strategies for more than 40 years. The company’s industry expertise integrates growth consulting, growth partnership services and corporate management training to identify and develop opportunities. Frost & Sullivan serves an extensive clientele that includes Global 1000 companies, emerging companies, and the investment community, by providing comprehensive industry coverage that refl ects a unique global perspective and combines ongoing analysis of markets, technologies, econometrics, and demographics.

Formula 1 Inspires New Invention to Halt Spread of MRSA in Hospitals

Changing aprons between patients, a current strategy to combat MRSA and other hospital-acquired infections (HAI), is impractical for healthcare professionals working in busy wards and therefore seldom rigorously adhered to.

This is the claim made by London based Kuldeep Kaur Bhangal, a specialist registrar in orthopaedics and a nominee for the 2005 Medical Futures Innovations Awards. Ms Bhangal’s solution to the problem ‘The Multi-layered Disposable Apron’ was inspired by watching Formula 1 drivers tear of their disposable, see-through visors during the race.

Kuldeep’s novel invention comprises: - A base which is tied just once - 10 detachable layers, which can be torn off and discarded after every patient contact.

The Bhangal Apron, which was developed specifi cally for nurses, doctors, physiotherapists and any other NHS employees who have regular contact with patients, will also benefi t other industries where cross-contamination is an issue, such as catering and the food industry.

Commenting on why her radical new design will combat MRSA and HAI, Kuldeep Kaur Bhangal said, “Whilst changing aprons between patients is an important step in theory, the truth is that most healthcare workers simply don’t do it as it is totally impractical. It takes almost a minute to change one of the existing aprons, whereas mine just takes seconds.

“The real benefi t will be to patients because my simple solution is practical and will hopefully minimize cross-contamination between patients.”

Kuldeep Kaur Bhangal is one of 32 nominees in this year’s Medical Futures Innovation Awards. The winners will be announced on the 3rd November 2005.

The Awards, which were set up in 2001 by a practicing NHS doctor, Dr Andy Goldberg, are designed to encourage and promote a culture of creativity, innovation and leadership amongst healthcare professionals and facilitate the successful commercialisation of these ideas.

PR Newswire - Source: Medical Futures Innovation Awards


l

22 sixth form BTEC National students from around the region have visited Anglia Ruskin University’s Institute of Health and Social Care for a ‘taster’ day to fi nd out more about potential careers within a simulated operating theatre environment.

The young student ‘volunteers’ from Braintree College and Palmer’s College, Grays focused on anaesthetics, surgery and recovery as part of a closer look at the work of Operating Department Practitioners (ODPs) and theatre teams in general. As part of the day the visitors were given an introduction to the various clinical skills involved in the work such as the preparation of a wide range of equipment and drugs. They spent some time looking at anaesthetic machines and vital signs monitoring equipment and learned some basic information about surgical attire and methods of infection control. This involved student participation enabling the students to ‘scrub up’ and simulate a surgical experience. The were also given a short introduction on basic life support and instruction on how to manage an individual’s airway.

Commenting on the taster day, John Redmond, Programme Leader from the Department of Allied Health, said: ‘When people think of hospital careers, most will concentrate on the role of doctors and nurses. The purpose of this taster day for sixth form students is to open their eyes to other career possibilities within the health service, such as theatre work.’

‘Operating Department Practitioners are a vital part of the multidisciplinary operating theatre team. They provide high standards of patient care and skilled support alongside medical and nursing colleagues during the anaesthetic, surgical and recovery phases. It is a career that is interesting, often demanding, but

Students get to grips with life in an operating theatre at Anglia Ruskin ‘taster’ day

St John’s Hospital Theatre Nurse Alison Adam shows the following Palmers College students various operating procedures: Jonathan Spry, Hanna Leavold, Terence Livingstone, Ben Murphy and Lauren Cole.

also hugely rewarding. It is for people who want to do something important every day of their working lives.’

Anglia Ruskin’s Institute of Health and Social Care offers pre-qualifying degree and diploma courses on subjects including Operating Department Practice, Nursing, Midwifery, Social Work, Health and Social Care, Radiography, Occupational Therapy and Physiotherapy. Start dates are available in January April and September.

The University’s nursing courses were rated ‘excellent’ by both the Guardian and the Times Education Guide 2005.

For a copy of the new Institute of Health and Social Care Prospectus from Anglia Ruskin University, call 0845 271 3333.

Lawrand LtdLawrand Ltd

Would like Would like

to wish our to wish our

readers and readers and

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a Happy a Happy

Christmas Christmas

and a and a

Prosperous Prosperous

New Year !New Year !



Guy’s and St Thomas’ NHS Foundation Trust is pleased

to announce the opening of its brand new Evelina Children’s Hospital. The Evelina, which has cost £60 million, is London’s fi rst new children’s hospital for more than 100 years. The 140-bed hospital, which is based on the St Thomas’ Hospital site, brings the majority of Guy’s and St Thomas’ children’s services together under one roof.

The new Evelina, which was designed by Hopkins Architects and has been dubbed ‘a hospital unlike any other’, has been funded by a grant of £50 million from Guy’s and St Thomas’ Charity and £10 million from the NHS.

Serving children in the boroughs of Lambeth and Southwark, as well as offering specialist care for children from across south east England and further afi eld (including internationally), the Evelina Children’s Hospital is, quite simply, unique.

The Evelina is a hospital created by children for children. Young patients and their families have been involved in shaping its environment and architecture from the earliest stages of design, resulting in a state-of-the-art hospital that redefi nes expectations.

Sir Jonathan Michael, Chief Executive, Guy’s and St Thomas’ NHS Foundation Trust, says: “We wanted the new Evelina Children’s Hospital to be much more than a landmark building on a landmark site. Our aim has been to createa hospital that does not feel like a hospital by involving children, their families and our staff in every stage of the design process.

“The result is truly inspirational. The new Evelina is a supremely practical, state-of-the-art hospital, but one that is full of imagination, warmth and fun. It redefi nes the concept of a children’s hospital and will undoubtedly infl uence the building of new hospitals in Britain and across the world.”

Hopkins Architects won a Royal Institute of British Architects (RIBA) approved competition to design the new Evelina and work started on the hospital in March 2002.

Geoff Shepherd, Chief Executive, Guy’s and St Thomas’ Charity, says: “I am delighted that the Charity could provide a £50 million grant for the new Evelina Children’s Hospital. The Trustees’ decision to fund the fi rst ever RIBA architectural competition for an NHS hospital has been key to the magnifi cent design of this amazing children’s hospital. Hopkins have created a building which will be recognised internationally for its innovation and child-centred approach”.

The new Evelina is full of ideas suggested by the very youngest ‘customers’ and their families who wanted colour, light and fun. A Children’s Board of patients and local school children was established and their views on everything from the menus and furniture to the design of the building itself were noted and assimilated.

Bright red rocket lifts, clearly visible from inside and outside the hospital, carry people to a four-storey central conservatory. Throughout the hospital, lively artwork, funded by Guy’s and St Thomas’ Charity, creates a welcoming, friendly atmosphere, whilst each fl oor of the hospital has been given a colour and a symbol taken from the natural world - from Ocean and Beach through to Savannah and Sky. Crucially this also avoids the need for a complex multi-lingual direction system to deal with the 140 languages spoken by local patients.

The hospital also has many play areas, as well as a 17-foot high helter skelter in the outpatients department for children to enjoy whilst they wait for their appointment.Refl ecting the pioneering design spirit that has shaped the structure of the new Evelina, the hospital is also exploring new ways to improve the patient experience.

Staff at all levels are experimenting with new ways of working, taking their cue directly from patients and their families to establish what makes their visit to the Trust good and what could make it better. The project has been called Improving the Patient Experience.

New methods of recruitment, which better match applicants

to job descriptions that refl ect the needs of children and their families, have been used to recruit new staff working in the Evelina. To date, specialist assessment centres have been used to recruit more than 50 people to the new Evelina’s environment team, making sure that staff recruited have the attitude and behaviour expected within a children’s hospital, as well as the technical skills.

Dr Frances Flinter, Clinical Director, Children’s Services, Guy’s and St Thomas’ NHS Foundation Trust, says: “Entering a hospital can be an intimidating experience for anyone, but for children and their families it can be especially diffi cult. That’s why we have worked so hard at the new Evelina to create an environment as far removed from the traditional institutional atmosphere as possible.

“We have been working with children, parents and their carers through the Evelina Children’s Board and the Pride of Guy’s (a teenage patient support group), to encourage them to ‘tell their stories’ about their time in hospital. This helped us to plan a ground-breaking training and induction programme to support the 900 staff who will be working in the new Evelina, ensuring we offer the best experience for current and future patients.”

The training, which uses ‘scenes’ from children’s real life experiences played by actors, allows staff to refl ect on what makes the experiences of children and their families the best they can be.

It is planned that the valuable lessons learnt from Improving the Patient Experience will eventually be rolled out to other areas throughout the Trust.

The Evelina Children’s Hospital Appeal formally launched a £10 million campaign in March 2004 to ensure that the new hospital has the very best and most modern medical equipment and facilities. So far the campaign has raised more than £8 million - which has covered the costs of new equipment needed, including a state of the art MRI scanner, in time for the opening.

For more information visit www.evelinaappeal.org

The Evelina Children’s Hospital, London’s

fi rst new children’s hospital for more than

100 years, opens for business.

First gastric pacemaker

operations for obesity

treatment occur in the UK

Harehill Park announces that the fi rst implants of a new form of surgery in the UK for the treatment of obesity occurred at the Princess Grace Hospital, London using an Implantable Gastric Stimulator (IGS) called the Transcend .

Working with The Healthier Weight Centre, two patients each received an IGS for weight management. Currently weight loss surgery involves putting tight bands around the stomach to reduce its size, or radical surgery, in which the stomach is stapled or by-passed to limit the amount of food that can be eaten. However these procedures can carry risks including infection, wound problems, band erosion, blood clots or in extreme cases, death.

In contrast the implantable gastric stimulator (IGS) has been shown to be very safe, with no reports of death or serious consequences. It does not involve any cutting or restrictive approaches affecting the integrity of the stomach and offers a marked improvement upon the quality of life for patients following obesity surgery.

According to Scott Shikora, MD of Tufts-New England Medical Centre, Boston, Massacheusetts, USA,’It’s remarkably complication free’. Weight is lost and kept off with the help of a follow-up programme.

The IGS consists of a small battery operated device implanted into the abdomen. A small wire connects the device to the stomach wall. Rather like a cardiac pacemmaker, which sends electrical impulses to the heart, the gastric stimulator delivers a small current to the stomach wall. The current is adjusted through a hand held computer by the doctor, which ‘talks’ to the pacemaker through a radio signal. Patients usually do not feel anything when the pacemaker is working. The key-hole surgery takes just about one hour and patients can be admitted as day cases.

‘The gastric stimulator is an exciting new surgical development that offers quality of life to people following surgery. It is probably the most gentle and safest form of obesity surgery currently available’, said Denise Rankin, Company Development Manager of Harehill Park ,which deals exclusively with obesity treatment.

In the UK, the incidence of obesity has trebled in the past twenty years with 21% of men and 24% of women considered to be clinically obese. It is estimated that if the current trend continues, 35% of the population will be obese in 6 years time.

The IGS is only available from Harehill Park . For further information contact : Denise Rankin Company Development Manager, Harehill Park Ltd. Tel: 01625 666932 E-mail: [email protected] Website: www.harehillpark.com

Source: Response Source

16

MAPRON PRODUCTS LTD

Specialists in

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manufacture

of hospital

equipment

FREEPHONE

0808 1001 353

We look forward

to your call

For further information, catalogue and price list please contact Pam on:

FREEPHONE/FAX: 0808 1001 353, or write to: Mapron Products Ltd

UNIT 9, PENALLTA INDUSTRIAL ESTATE, YSTRAD MYNACH, HENGOED, MID GLAMORGAN CF82 7QZ

TEL: (44) 01443 862450 FAX: (44) 01443 862454

E-mail: [email protected] http://www.mapronproducts.co.uk

Wish all our customers avery Merry Christmas


The medical sector is among the key innovation and growth drivers – as was impressively confi rmed by the world’s largest medical trade fair MEDICA and ComPaMED, the foremost international trade fair for Components, Parts and Raw Materials for Medical Manufacturing. On the four days of the trade fair a total of 137,000 trade visitors from nearly 100 countries came to Düsseldorf (the fi gure for the previous year being 136,152). They were presented with a wide spectrum of systematically arranged and clearly segmented new products, devices, systems and services for out-patient and in-patient care. „The industry with its innovative power has sent out exactly the right signals countering the discussions about health care costs. The interest taken by visitors in more effi cient and higher quality diagnosis and therapy procedures was enormous and therefore spirits among exhibiting fi rms were correspondingly high,“ reports Wilhelm Niedergöker, Managing Director of Messe Düsseldorf, after his numerous talks with exhibitors.

Especially for companies with their sights on new markets MEDICA and ComPaMED 2005 offered a second-to-none basis for business due to the events’ high degree of internationality. Almost 40 % of visitors came from abroad, a particularly high percentage also came from overseas markets such as the USA, India, China or Taiwan and increasingly also from Arab countries. All in all, people from more than 100 nations attended MEDICA, thereby once again underscoring its outstanding importance as the World Forum for Medicine.

A focal theme of MEDICA 2005 was telematics applications and infrastructures revolving around the imminent introduction of the electronic health (patient) card in Germany and the electronic Health Professional Card. Therefore, the Special Show MEDICA MEDIA in Hall 17 virtually served as a point of departure for an „electronic health card“ route. Visitors along this route were able to „network“ with various exhibits covering the card theme. Interested visitors could follow „signposts“ taking them to the various relevant companies to have the functions and procedures associated with this card explained; ranging from card processes and electronic prescription, via legal data-protection issues to the use of digital signatures by the physician consulted. The imminent introduction of the electronic health card therefore acts as a catalyst for new software applications and hardware equipment. Here the MEDICA exhibitors from the IT industry reported many interesting conversations and enquiries, above all from hospitals and doctors’ surgeries.

Other new developments launched during MEDICA 2005 included a heart implant with a built-in transmitter that automatically sends cardiological data to a medical care centre, ultra-sound devices with optimised sound heads for improved 3D imaging as well as more compact laboratory equipment for low-cost rapid tests at doctors’ practices.

Medical Sector confi rms its Reputation as an Innovation and Growth Driver

at MEDICA and ComPaMED

More than 137,000 trade visitors travelled to Düsseldorf to attend the world’s largest medical fair

Apart from these topics with a more domestic focus, the wide area of telematic applications also had plenty of new developments to offer to international visitors. Worth mentioning in this context are innovative solutions for tele-radiology enabling the special expertise of a radiology ward to be made available to a network of other clinics. Just as „up-and-coming“ is tele-monitoring, i.e. the effi cient „distance care“ of chronically ill patients. At MEDICA a new technology platform was presented for monitoring via a standard TV set in conjunction with the fi rst implant capable of automatically transmitting biometric data. The implanted pacemaker or defi brillator comes with a transmitter that sends data to a compact telephony unit from where the cardiac parameters are then passed on to a medical service centre.

Diagnosis improved through higher precision imaging At the same time, the suppliers exhibiting in the medical technology and electro-medicine segment of MEDICA set new yardsticks for the reproduction quality of medical imaging, above all with a view to ultrasound. Here innovations „on all levels“ ensure improved image quality and, hence, more precise diagnostics. This is achieved by a combination of optimised soft and hardware, a new generation of contrast media (e.g. with microscopically small gas bubbles that accumulate in infected areas) as well as an altered design in ultrasound heads with sound emission in a matrix array for more precise 3D rendering.

With a view to the market segment of laboratory technology and diagnostics the focus continues to be on the so-called POCT (point-of-care testing); i.e. tests that can be directly run on the patient and make its possible to conduct a rapid analysis (at the doctor’s surgery). An example of this new approach are modern, compact devices that test blood, plasma or serum (applied to indicator carriers or papers with a view to liver, kidney and pancreas data) and also measure fat metabolism parameters. The benefi t for both physicians and patients: The waiting time for receiving examination results is markedly shortened because the samples no longer have to be transported to a central laboratory. Whereas only a few years back physicians did not really rely on the results of such quick tests, the validity of the parameters examined is now considered acknowledged.

Congress Agenda: Many Topics and Excellent Response This year’s MEDICA Congress again covered a wide variety of subjects ranging from disease prevention and the latest in diagnostics to tele and emergency medicine not forgetting legal issues. A special focal point of the Congress - boasting in excess of 500 speakers and 170 workshops as well as symposiums - were lectures on various types of cancer, worldwide infectious diseases, pain therapy and disease in old age. In addition to these topics relating to everyday medicine, the public was particularly intrigued by the contributions from scientists and researchers.

The presentation of the latest state-of-the-art research in stem cell therapy by experts from the Düsseldorf Heinrich-Heine University was very well received. The pros and cons had already been exhaustively debated in the run-up and now at the event itself the focus was on an exchange of ideas about current options,“ said Gerd Fischer, Secretary General of MEDICA Deutsche Gesellschaft für medizinische Diagnostik (German Society for Medical Diagnostics) rejoicing at the positive response. Just as well attended were the complementary “InfoForums“ for patients addressing issues related to frequently diagnosed clinical patterns such as breast cancer or cardiac infarction.

For the 14th consecutive time MEDICA was held concurrently with ComPaMED, the international trade fair for suppliers to the medical industry. 302 exhibitors presented raw materials, parts and components for medical manufacturing to the approx. 9,000 trade visitors in the new Hall 8 giving proof of their key role as innovation drivers for the development and marketing of new medical technology processes. The trend towards miniaturisation and ever more compact, yet at the same time ever more complex, systems was the central theme of the joint stand and Forum of IVAM – Germany’s Professional Association for Microtechnology. Using individual products as an example, the complete value chain from development and approval all the way down to serial production of medical technology products was explained. The exhibition highlights included a new sensor technology for respiratory gas analysis that enables physicians to provide extremely precise diagnosis thanks to a breath-by-breath rendering.

www.medica.com

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There is an urgent demand for skilled First Aid instructors as more and more people want to acquire the basic skills that could save lives in an emergency, whether it’s for their own peace of mind or for workplace requirements.

For healthcare professionals, teachers, carers, parents or even just those with an interest in health and some free time available, training to become a skilled First Aid instructor with Emergency First Response can be a rewarding way to increase income.

Emergency First Response has become the fastest growing CPR, AED and First Aid training organisation in the world, educating individuals, companies and groups in the mastery of these all-important skills. The range of highly-regarded courses has been specially created by professionals for the lay fi rst aider, to give them the confi dence and the knowledge to provide care when faced with a medical emergency, whether it involves an adult, child or infant.

Courses take place at a wide network of sites in the UK and abroad, and are supported by a comprehensive and sophisticated range of materials designed by experts in 12 different languages. Independent study packs, practical hands-on training and a fl exible approach to learning make all EFR’s courses highly accessible even for those with busy lives.

Once qualifi ed, instructors enjoy the independence and fl exibility to tap into what has become a billion dollar industry, while enjoying the backing of an established brand. With the freedom to choose where and how often to teach, instructors can tailor their courses to their students’ needs, and set their own pricing structure. Whether full or part time, they are supported every step of the way, as EFR is committed to offering the very best in business support and ensures that the necessary marketing and state-of-the art training materials are both competitively priced and readily available.

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For further information visit the Emergency First Response website at: www.emergencyfi rstresponse.co.uk or telephone 0117-300-7804

Source: Emergency First Response PRNewswire

RCS PRESIDENT CALLS ON PRIME

MINISTER TO RELEASE SURGEONS-IN-

TRAINING FROM EUROPEAN WORKING

TIME DIRECTIVE

Mr Bernard Ribeiro, President of The Royal College of Surgeons of England, has written to the Prime Minister asking him to try to secure an opt-out arrangement from the European Working Time Directive for surgeons-in-training in the UK. Mr Ribeiro has told the Prime Minister that the EWTD’s undue emphasis has had a detrimental impact on the quality of surgical care provided to patients in the UK.

Mr Ribeiro, who became President of the RCS in July, continues to work at Basildon University Hospital. He draws on his personal experience to describe surgical trainees’ feelings at being unable to provide total care for their patients and their frustration at losing training opportunities.

‘Surgery is a craft specialty,’ he tells the Prime Minister, ‘that requires substantial time in which to gain essential operative skills. At the same time, it is about being with the patient on the whole of his or her “journey”, providing the reassurance of continuity.’

The EWTD became law for junior doctors in August 2004. It reduced the working week to a maximum of 58 hours. In 2007 the working week will be further reduced to 56 hours, and possibly to 48 hours by 2009 (this could be extended to 2012).

Before the introduction of the EWTD, most senior house offi cers (SHOs - the junior category of surgical trainee) were either resident on-call (ie they could rest at the hospital in between periods of activity) or non-resident on-call (ie on call from home and only called in to the hospital for emergencies). Now, more than half of them (57%) are working shifts of up to 13 hours, followed by 11 hours’ continuous rest in every 24-hour period. Of these, almost half are working one week of nights in seven (1:7) in this pattern, or more frequently.

In this working period, SHOs are largely providing service work in hospitals rather than receiving the direct training which is vital to their career progression. Little surgical activity takes place at night and so SHOs working full shifts at night lack training opportunities. In addition, they miss out on daytime training (when most surgery is carried out) because they have to take compensatory rest after night work. This results in them spending less time with their trainer(s) and having less training time in theatre.

Full shift night working creates problems with trainees’ concentration and learning, and this is more marked after the fourth consecutive night on call.

Welch Allyn will lighten the load for busy healthcare professionals this New Year, with the launch of an innovative new device, available January 2006.

This new technology will prove that sometimes less is more when it comes to healthcare devices and it will allow clinicians of all skill levels to monitor patients in places they never thought possible.

To fi nd out more about Welch Allyn’s forthcoming new products Tel: 0207 365 6780.

Welch Allyn To Prove Less is More


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