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Independent audit of oxygen management in all govt hospitals a must

Hospitals not only need to maintain a constant and uninterrupted supply, but also ensure that patients get this life saving gas in correct concentration and pressure

columns Updated: Aug 19, 2017 22:11 IST
oxygen,govt hospitals,gorakhpur deaths
Hospitals not only need to maintain a constant and uninterrupted supply, but also ensure that patients get this life saving gas in correct concentration and pressure(AP)

The large number of infant deaths at the Baba Raghav Das Medical College Hospital in Gorakhpur, Uttar Pradesh has once again brought into the limelight, the appalling state of affairs in our health care system. But more specifically, it has focused attention on the low priority given to one of the most critical components of patient care — oxygen supply — at government hospitals.

Given the importance of oxygen in treating a wide variety of acute, critical and chronic conditions (and its use in surgery), hospitals not only need to maintain a constant and uninterrupted supply, but also ensure that patients get this life saving gas in correct concentration and pressure. Since even a slight slip-up could lead to serious complications and even death, oxygen management not only requires a fool-proof system of delivery and supply of the gas, but also proper procedures in place to ensure that hospitals order appropriate amounts and well in time. It also requires standard apparatus and procedure for maintenance of the system by qualified and trained technicians. Hospitals are also expected to have contingency plans to eliminate any interruption in supply.

Yet, going by the initial media reports, the hospital management in Gorakhpur ignored patient safety and put the lives of infants at risk by disregarding repeated warnings by the oxygen supplier that he would stop supply if the payment due to him was not made. From what the chief minister told a press conference last week, even after the government released the funds on August 5, there was a delay of six days in paying the supplier. This was sheer negligence and those responsible should be held accountable.

Having said that, I must point out that this is not the first time a government hospital has ignored patient safety in respect of oxygen supply and this is a matter of great concern. In May 2016, for example, two infants died at the Maharaja Yeshwant Rao hospital in Indore, because they were wrongly administered nitrous oxide instead of oxygen after surgery. Investigations by the hospital had shown a mix-up in the gas lines at the newly constructed pediatric unit.

Prior to that in September 2015, four women on ventilators at the ICU of Darbhanga Medical College and Hospital, Darbhanga, died on account of lack of oxygen supply. According to the superintendent of the hospital, this was caused by the oxygen supply attendant leaving the hospital before his reliever turned up and two more persons in-charge of oxygen supply also turning up late.

Earlier in December 2012, five patients on ventilators at the Sushruta Trauma Centre in North Delhi had died due to a break in the oxygen supply. Here again, shortage caused by delayed payment to the supplier, an untrained person in-charge of the oxygen supply system and the failure of the hospital staff to follow up on the sudden fall in oxygen pressure noticed the previous day were blamed for the tragedy.

Similarly in July that year, the nurses union of the Kochi Co-operative Medical College hospital had alleged that three patients in the ICU had died on account of shortage of oxygen. Even though two committees that probed the allegations discounted it, their investigations had shown gross deficiencies in the oxygen supply system in the hospital. Around the same time, Sri Venkateswara Ramnarain Ruia Government General Hospital in Tirupati had come under attack for the absence of trained and qualified technicians to ensure efficient and continuous supply of oxygen.

It’s time the state and the central health departments called for independent audit of oxygen management in all government hospitals in the country and ensured that robust and foolproof medical gas pipeline systems are put in place to prevent oxygen-related traumas and deaths.

First Published: Aug 19, 2017 22:10 IST