Posted on Leave a comment

Novaerus NanoStrike Airborne Disinfection Technology

Novaerus NanoStrike Airborne Disinfection Technology

  • Table Top for Smaller Rooms ~120 sq. ft., NV200 delivers 50 CFM(Cubic Feet per Minute) airflow.
  • Wall Mountable, Pedestal Mounted or Roll Stand Mounted options for Medium Rooms ~900 sq. ft., NV900 delivers 150 CFM(Cubic Feet per Minute) airflow at fan speed 1 and 180 CFM at fan speed II.
  • Standalone for rapid remediation for larger common areas with a triple-stage Camfil filter, ~3,000 sq. ft., NV1050 delivers 533 CFM(Cubic Feet per Minute) airflow.
  • Novaerus NanoStrike Airborne Disinfection Technology protects against airborne viruses and bacteria. Nanostrike is the core, patented technology that uses Novaerus plasma-based technology killing all airborne microoganisms on contact providing protection against viruses and bacteria.

NanoStrike patented technology destroys viruses, microorganisms and bacteria at the DNA level:

  • Plasma coils create energy field that kills ALL germs and pathogens in sub-second time.
  • 99.9+% effective at eliminating Influenza pathogens, SARS-Cov-2(Covid-19), and MRSA
  • Kills ALL airborne microorganisms at the DNA level as small as 1 nanometer!
  • Total cell destruction ensures cells do not become viable as an infectious agent ever again.
  • Continuous 24/7 air disinfection and odor control with no disposables
  • Lowest cost of ownership operating 24/7 with no supplies needed for NV200 or NV900.
  • Plugs into standard power outlets plus wall mounts, pedestal stand or roll stand options
  • Independently tested and proven for use in ORs, ICUs, ED, Offices, Restaurants, etc.

 How does NanoStrike Protect?

NanoStrike utilizes an atmospheric plasma discharge like a lightning strike to kill and deactivate harmful airborne microoganisms.  NanoStrike plasma coils provide a deadly strike made up of multiple concurrent processes that work to rapidly destroy airborne pathogens.  The result is total destruction of all airborne pathogens! 

NanoStrike plasma coils create an electrostatic field bombarded by electroporation and electromagnetic field radiating heat and UV radiation in sub-second time to force cells down to one nanometer to explode with osmotic pressure resulting in total destruction of airborne pathogens. 

Novaerus does not filter virus and bacteria cells from the air it destroys them to the point of total destruction with no chance of reactivation or self-healing. 

NanoStrike can protect humans in hospitals, senior living facilities, long term care facilities, schools, locker rooms, casinos, railway stations, residences, hotel common areas, offices, manufacturing, meat processing plants and virtually any indoor environment where people gather.   

Breathe easy with Bell Medical and NanoStrike Technology.

Posted on Leave a comment

The Eyes are the Window to Your Soul

We all know this quote, but its origin is a little unclear. It has been attributed to William Shakespeare, Leonardo Da Vinci, the philosopher Cicero and even the bible.

Whatever the origins of this well-known quote, throughout history we have been aware that our eyes are incredibly precious organs. Not only do they allow us to see the world around us but through them we can tell what a person feels and thinks.

However, despite being aware that somehow our eyes are special, we have been a bit blasé about protecting them. Eye protection has evolved over time(1) via several different routes including:

  1. Combat – To lose an eye in battle and wear an eye patch was once considered an honour. The use of helmets did offer some protection. The use of gas during World War 1 resulted in gas masks with glass windows to protect the eyes from the deadly gas. More recently the rise of IEDs resulted in the percentage of combat causalities hospitalised due to ocular trauma increasing from 2% in 1914 to 13% in the 1990s Desert Storm conflict. In modern armies today eye protection is mandatory.
  2. Sports and Recreation – Jousting required the riders to wear helmets with visors, but eye injuries were common. King Henry II, the French-born King of England, suffered an eye injury during a jousting tournament in 1559.  The king had not fastened his visor upon returning to the arena and a splinter from his opponent’s lance entered his right orbit. Complications resulted in the death of ‘the young lion’ from his eye injury. His death significantly changed the respective roles of France and England and the course of Western civilisation and history. Recently, ice hockey, Baseball and Basketball were the first sports to embrace eye protection followed by Squash, Cricket Hockey and Lacrosse.
  3. Occupational Eye Injuries – The rise of industry in the late 19th century resulted in a huge increase in mining and metalwork. This led to a surge in corneal abrasions in miners, heat cataracts in foundry workers and arc eye in welders. Gradually, visors and goggles. . Gradually, improved understanding of the impact resistance of materials and the nature of hazards brought about improvements in visors and goggles in the workplace

Thankfully, mainly due to the rise of Health and Safety, eye protection is now mandatory in many workplaces. There is good reason why this is necessary. Thousands of workers suffer painful eye injuries each year around the world. Many are minor but around 10-20% result in partial or full blindness. Equally, we only have two eyes and whilst some parts of the eye can be transplanted, a complete eyeball transplant is not yet possible. So, we need to do everything we can to protect our eyes as much as we can.

The most common types of injuries are:

  • Invasion of foreign bodies – The eye/s may sometimes be invaded by small foreign particles (e.g. dust from manufacturing activities) which can cause irritation and inflammation. Chemical Eye Burns – Both highly acidic (pH <4) and highly alkaline (pH >10) substances are toxic to the eye and cause chemical eye burns if they come into contact with the surface of the eye. Such substances are commonly found in the workplace, for example in laboratory chemicals or industrial cleaning products.Penetrating Injuries – When an object pierces the eye, penetration occurs, and this can lead to loss of vision or blindness. Staples, nails and flying debris commonly cause this type of injury.Blunt trauma injuries – These are injuries which do not penetrate the skin and do not result in external bleeding.  The eye is struck by a heavy object and this can cause the eye to bleed internally.Allergic conjunctivitis – Is common amongst workers in the food handling and agricultural sectors who are regularly exposed to spices, fruits, and vegetables. Eye diseases associated with ultraviolet radiation exposure – Outdoor workers are often exposed to ultraviolet radiation (in the form of sunlight) in excessive quantities. Artificial sources of ultraviolet radiation are also found in a range of workplaces and can damage the eyes. These include welding arcs, germicidal lamps, and lasers. Computer use disorders – Using a computer for extended periods of time is associated with a range of temporary eye disorders including pain and altered vision.

Of course, when we go about our daily lives, we meet all sorts of people wearing eye protection. These can be construction site workers, the mechanic fixing your car, the gardener mowing your lawn, the person mending your shoes. Many jobs now take eye protection seriously.

Eye protection is also taken seriously even if you are unfortunate to be here –

However, can you guess by looking at these photographs what the problem is?

Where is the eye protection for the patient? Everyone else in theatre has eye protection so why not the patient? A nurse will take a roll of non-sterile tape that has been lying in theatre and tape your eyes. A piece of equipment could hit you in the eye or even someone’s elbow. You are the most vulnerable person in the room and yet nothing is done to protect your eyes from an infection, a corneal abrasion or even a trauma blow. Surely, if a gardener or a cobbler has eye protection then patients undergoing surgery should equally have their eyes protected.

References:

  1. Hoskin A.K, Mackey D.A, Agrawal R, Watson S. (2019). Eye Injuries across history and the evolution of eye protection. Acta Ophthalmologica, 97: 637–643.

Author: Niall Shannon, European Business Manager, Innovgas

This article is based on research and opinion available in the public domain.

Posted on Leave a comment

Increased PACU Length of Stay – A Costly Matter

Postoperative residual curarization (PORC), also known as residual neuromuscular blockade, refers to the residual muscle paralysis that occurs after emergence from general anesthesia. PORC stems from the use of neuromuscular blocking agents (NMBAs). It is defined as a Train-of-Four (TOF) ratio of <0.9 and may occur in around 41% of patients who receive intermediate-acting neuromuscular blockers.1 PORC has been associated with critical respiratory events and impaired postoperative respiratory functions.2 It is also independently associated with an increased length of stay (LOS) in the post-anesthesia care unit (PACU). The increased PACU length of stay in turn impacts operating room throughput and results in prolonged waiting time for new PACU admissions.3

The Use of Quantitative NMT Monitoring to Avoid PORC

Subjective tests of NMT monitoring are not sensitive enough to detect residual weakness

Quantitative neuromuscular transmission (NMT) monitoring can help reduce the incidence of PORC. Neuromuscular monitoring is recommended when neuromuscular blockers have been administered as a part of general anesthesia. It can be carried out through subjective techniques, such as clinical assessment or peripheral nerve stimulation (qualitative monitoring), or with the help of objective or quantitative NMT monitors that provide a numeric value representing the depth of neuromuscular blockade. There is mounting evidence that clinical or subjective tests of NMT monitoring are not sensitive enough to detect residual weakness and do not predict adequate neuromuscular recovery. Quantitative or objective neuromuscular monitors should therefore be used whenever non-depolarizing NMBAs are administered.4,5,6

The Stimpod NMS 450X is a quantitative neuromuscular monitor that uses a 3D acceleromyography (AMG) transducer which is effective in detecting the full force of muscle contraction. It minimizes the risk of residual neuromuscular blockade and associated adverse respiratory events.7 As discussed below, this leads to a decrease in the average length of stay in the PACU and substantial cost savings for the hospital.

Reduction in the PACU Length of Stay as a Cost-reducing Measure

The economic structure of the PACU determines whether a cost-saving measure such as reducing the PACU length of stay is likely to reduce hospital costs. Hospital costs can be divided into fixed and variable components. Fixed costs are one-time costs that do not change in relation to the number of surgical cases. These include capital expenditures, such as gurneys, monitors, and the physical plant of the PACU. On the other hand, variable costs are directly related to the number of surgical cases, and include X-ray films, pharmaceuticals, dressings, and laundry.

The only real way of reducing PACU costs is to increase the productivity of the PACU and the staff

It is important to bear in mind that reducing the PACU length of stay will only affect variable costs. Small reductions in the length of time that patients stay in a PACU are unlikely to impact fixed costs at ambulatory surgery centers, which include the labor costs of staffing the PACU with full-time nurses.8 This means that reducing the length of stay of a patient in the PACU by one minute is not equivalent to saving one minute of PACU costs. Therefore, the only real way of reducing PACU costs is increasing the productivity of the PACU and the staff working in it.

Reduction in the Peak Number of Patients Improves Productivity and Reduces Costs

A reduction in the peak number of patients in the PACU is the most effective way to increase the productivity of the PACU and its staff. One way of doing this is to use anesthetic agents that permit a quicker discharge of patients from the PACU. However, if for example the average total time a patient stays in the PACU is 120 minutes, then for a modern anesthetic drug to reduce the peak number of PACU patients by 25%, the drug would have to reduce the mean time to discharge from a total of 120 minutes to just 34 minutes. Such a drastic change is unrealistic and therefore this method is limited in its effectiveness to achieve a substantial increase in PACU productivity.8

Optimization of the time of arrival of patients into the PACU is the single most important measure

For a PACU with salaried or full-time hourly employees, optimization of the time of arrival of patients into the PACU is the single most important measure that can reduce the peak number of patients in the PACU and decrease the peak requirements of nursing staff. This increases PACU productivity and results in PACU cost savings.8 According to a study conducted by Butterly et al., the mean length of stay in the PACU for patients with PORC was found to be 323 minutes whereas the length of stay for patients without PORC was 243 minutes.3 This shows that using the Stimpod NMT monitor for performing objective monitoring and avoiding residual neuromuscular blockade can save up to 80 minutes of the PACU time per patient. The Stimpod thus makes possible the “unrealistic” change that results in a significant reduction in peak patient numbers in the PACU.

Decrease in Operating Room Holding Time Results in Cost Reduction

Postoperative residual curarization results in delayed discharge of the patient from the PACU. If the PACU gets filled up with patients, the next patient has to wait before leaving the operating room resulting in operating room holds. The operating room/PACU system becomes congested. This has debilitating financial fallout as it increases the operating room costs. For instance, if all the operating rooms are filled up with patients waiting for PACU beds, some surgical cases may be delayed or cancelled. Also, in some situations, incentive salaries may have to be paid to the nurses and anesthetists for the extra time that they monitor patients in the operating rooms.3,9,10

The Stimpod quantitative NMT monitor provides an excellent solution to this problem—it minimizes the incidence of PORC and with it PORC-induced delay in PACU discharge. The increased availability of beds in the PACU allows for a quicker release of patients from the operating room. This cuts down operating room costs.

Stimpod NMS 450X—The Ultimate Cost-Saving Option

Stimpod NMS450X Neuromuscular Monitor

The Stimpod NMS450X Neuromuscular Monitor reduces the incidence of residual paralysis in 97% of patients

The Stimpod NMS 450X is a fully-automated neuromuscular monitor that supports Train-of-Four (TOF), Double Burst (DB), Post-Tetanic Count (PTC), Tetanus and Twitch Stimulation modes to perform accurate, real-time neuromuscular monitoring. It uses OneTouchTM technology that allows an entire case to be monitored—starting from automatic electrode placement to extubation—with the press of a single button. The Stimpod begins TOF monitoring and moves to PTC when a deep block is achieved. It detects the depth of neuromuscular blockade throughout the procedure and automatically reinitiates TOF monitoring when the patient begins the reversal process. The monitoring continues until the patient is more than 90% recovered.

The Stimpod NMS 450X is an all-in-one solution for quantitative NMT monitoring that can

  • minimize the incidence of PORC
  • reduce the length of stay in the PACU
  • increase the PACU productivity by decreasing the peak number of patients
  • decrease the operating room hold time

In short, it’s the perfect cost-saving measure for any PACU.

References

  1. Naguib M, Brull SJ, Johnson KB. Conceptual and technical insights into the basis of neuromuscular monitoring. Anaesthesia 2017; 72: 16–37.
  2. Boon M, Martini C, Dahan A. Recent advances in neuromuscular block during anesthesia. F1000Res. 2018;7:167. Published 2018 Feb 9. doi:10.12688/f1000research.13169.1
  3. Butterly A, Bittner EA, George E, Sandberg WS, Eikermann M, Schmidt U. Postoperative residual curarization from intermediate-acting neuromuscular blocking agents delays recovery room discharge. Br J Anaesth 2010; 105: 304–9.
  4. Duţu M, Ivaşcu R, Tudorache O, et al. Neuromuscular monitoring: an update. Rom J Anaesth Intensive Care. 2018;25(1):55–60. doi:10.21454/rjaic.7518.251.nrm
  5. Abdulatif M. Neuromuscular transmission monitoring: Beyond the electric shocks and the shaking hands. Saudi J Anaesth. 2013;7(2):115–117. doi:10.4103/1658-354X.114045
  6. Naguib M, Brull SJ, Kopman AF, et al. Consensus statement on perioperative use of neuromuscular monitoring. Anesth Analg 2018; 127: 71–80.
  7. Murphy GS, Szokol JW, Marymont JH, Greenberg SB, Avram MJ, Vender JS, Nisman M. Intraoperative acceleromyographic monitoring reduces the risk of residual neuromuscular blockade and adverse respiratory events in the postanesthesia care unit. Anesthesiology 2008;109:389–98.
  8. Macario A., D. Glenn and F. Dexter, 1999, What can the postanesthesia care unit manager do to decrease costs in the postanesthesia care unit?, J Perianesth, vol 14, pp. 248-93.
  9. McLaren JM, Reynolds JA, Cox MM, et al. Decreasing the length of stay in phase I postanesthesia care unit: an evidence-based approach. J Perianesth Nurs. 2015;30:116-123.
  10. Cammu G. Sugammadex: Appropriate Use in the Context of Budgetary Constraints. Curr Anesthesiol Rep. 2018;8(2):178–185. doi:10.1007/s40140-018-0265-6
Posted on Leave a comment

Anesthesia Hygiene – Infectious Control

Anesthesia Machine Covers Prevent Infections!


Guidance issued by Society for Healthcare Epidemiology of America (SHEA): “…explore the use of disposable covers”

Anesthesia Hygiene machine covers have tear away pouches that hold and contain contaminated supplies such as laryngoscopes and yankauer suction! The use of disposable covers is endorsed by SHEA and ASPF.

Anesthesia Hygiene Covers protect your patient and your anesthesia machine from pathogens and infectious diseases. To view videos and more information on our webpage Anesthesia Hygiene Covers and anesthesiahygiene.com .