Coronavirus: Hospitals warned to have oxygen cylinders on standby as Covid-19 pushes systems to the limit

‘Some hospitals are drawing more oxygen from their tanks than the maximum flow for which they were designed’ amid coronavirus pandemic

NHS hospitals have been warned not to exceed the safe limits of oxygen units (AP)

The number of coronavirus patients now needing oxygen is pushing hospital infrastructure across the country beyond its limits – with supply pipes at risk of permanent damage from the strain on the system.

Hospitals have been told to have portable oxygen cylinders on standby in case piped oxygen is cut off, and to consider how they would move patients out of hospital if they run out of capacity.

With a week to go before the expected peak in patient numbers, incidents have been reported at multiple hospitals across London and elsewhere in the UK, with NHS trust bosses told on Monday not to try to push oxygen systems beyond their limits, saying “unapproved procedures may cause permanent damage”.

The demand has been described as “exceptionally high”, raising fears that the problem could be exacerbated by a predicted rise in patients, and could lead to systems breaking down.

While there is no shortage of oxygen supply for hospitals, the sheer demand for the gas is more than hospital pipes can physically deliver to wards.

On Saturday, Watford General Hospital was forced to close its A&E department after its oxygen supply was cut off. The trust declared a critical incident and asked people to go to the next nearest hospital.

A small number of patients needing oxygen were transferred to other hospitals in the area.

On Monday, a message to hospital bosses from NHS England said: “Every patient requiring O2 on wards draws on the oxygen storage tank. With hospitals now treating a large proportion of their inpatients for Covid-19 infection, the draw is exceptionally high.

“The result is that some hospitals are drawing more oxygen from their tanks than the maximum flow for which they were designed.”

It said this could lead to unexpected drops in the flow of gas “compromising supply to patients”.

NHS regional bosses have been told to “manage the location of care for patients that require oxygen” when considering how to transfer Covid-19 patients between hospitals as cases start to rise. The alert to hospital chiefs said: “This will help to ensure that critical oxygen systems are not damaged, compromising patient safety and the whole hospital.”

In normal times, most hospital patients are receiving normal air or low-flow oxygen, but during the coronavirus outbreak a much larger number of patients need oxygen therapy to support their breathing.

Coronavirus attacks the lungs and can cause severe pneumonia and difficulty in breathing. Many patients require a form of ventilation including full sedation and a tube passed into their windpipe.

A number of hospitals in London that have been forced to rapidly increase their numbers of critical care beds to cope with coronavirus patients are being given engineering support to increase their oxygen supplies.

Liquid oxygen supplier BOC, which serves most UK hospitals, said it was “receiving high volumes of requests to increase the flow capacity”, adding: “Some of the suggestions/requests that have come through would not be advisable and could impact the capacity of the supply or result in supply interference.”

The company has agreed to increase the pressure for some units, but warned hospitals not to exceed the level set or it would set off alarms and safety valves that would mean cutting off supply to wards.

But the company warned it may run short of engineers to send out to hospitals if there are too many requests or too many staff are forced to self-isolate.

Health secretary Matt Hancock said earlier this week that the government was focused on the “quantity and supply of oxygen”, adding he had a “very high degree of confidence in the supply”.

A spokesperson for NHS England said: “Hospital oxygen tanks are fuller than normal, having been filled more frequently in recent weeks as part of preparations for patients with coronavirus, so there is sufficient oxygen supply available. Individual hospitals received guidance in February and again this week on how to safely manage engineering and their increased oxygen usage.”