EBME Forums Forums Management Professional Issues Nursing Issues O2 cylinder cradles/bracket for hospital beds

In the wake of reports of O2 cylinders igniting & a fire in an ITU, as a result new updated recommendations have been issued from various bodies that include ensuring O2 cylinders are not left on bedclothes but housed in a suitable cradle/bracket - given the variety of makes of hospital beds that can be in use in a large Trust what are your solutions to this issue?

You'll be referring to this and possibly this!

There's been quite of lot of guidance issued on cylinders from both the HSE and the MHRA and most cylinders should already be in a cradle/bracket/trolley due to their possible damage to valves or larger cylinders injury to staff. At least it's policy at our Trust as it went through Trust health & safety committee sometime ago. Along with the issuing of fire extinguishers in vehicles used to transport cylinders.

This was a later news story from the inquest which reported the incident was due to a faulty cylinder.

A tragic incident for sure ... but let's hope that when the inquest finally reports we will hear something a bit more definitive (and technically correct) than "an oxygen cylinder exploded"!

Presumably the cylinder was laying flat on the bed (not good). But for all we know it may have even been slightly inverted (even worse). Let's hope that the "expert witnesses" (if any) really dig out the full facts of the case.

It would be interesting to learn what really happened. I'm sure we could all hazard a guess (or two). Mine would include the regulator not being fully tightened onto the cylinder valve; or maybe a ruptured regulator diaphragm. But how come the gas ignited, I wonder? Grease (on the bed clothes, maybe)?

Meanwhile ... this stuff is nothing new. After all, oxygen cylinders haven't changed much (if at all) during my lifetime. Valves, regulators and flowmeters haven't changed that much, either. They are all potentially hazardous, and need to be treated with respect. Not to mention Common Sense.

Cylinder stands and such have also been about for Donkey's Years. It's a pity that the staff don't always use them. Although to be clear (and fair) it should be noted that in the case cited, the patient was about to be transported (and we are not told what type, or size, of cylinder was being used).

Oxygen cylinders have ignited in various places - hospitals, GP surgeries, fire stations - it's not common & the advice is that they are safe to use but renewed common sense/caution needs to be exercised when using. I've look not just in the UK but I've seen similiar reports from the USA & one where the fire station burnt down when a fireman was checking his equipment. So moving on from the scary bit well medical gas cylinders have changed in design - lightweight materials, integrated regulator & flowmeters but even what should have been an inocuous change in the traditional design - BOC changing the supplier of the neck valves has resulted in (certainly for us) a lot of problems & headaches. But specifically I was asking if there is a safe & elegent way to house an O2 cylinder upright in cradle attached to a hospital bed - for example a common make of crade attached to the footend of a bed makes it too long to fit the bed lift.

Beds (and patients) getting bigger and bigger ... bed lifts (elevators) too small (due to lack of foresight by the architect) - where does it all end?

Meanwhile (and as we all know) almost all decent patient trolleys have a sloped oxygen cylinder holder (or have one available as an option). That is:- under-slung.

Other than that (when a patient needing oxygen is being moved in a bed), someone will just need to walk alongside with a (wheeled) cylinder trolley or some such thing (depending on the specific circumstances of the route to be taken).

Does anyone know who the manufacturer (BOC??)and what type of the cylinder it was? Steel that required a regulator or was it composite with an integral regulator?
What caused the O2 to ignite? Static??

Could have been a static discharge from the bed sheets or cover.

But somehow I suspect that we'll never know.

On the other hand, how can "lessons be learned" if no-one knows (or admits) what the real cause was?

All the large bed manufacturers make cylinder holders for their beds.
Or you can get generic ones from people like Therapy Equipment.
Robert