The Operating Theatre Journal November 2020

£2.00

November 2020 Issue No. 362 ISSN 1747-728X

The Leading Independent Journal For ALL Operating Theatre Staff

HILLROM’S PRECISION POSITIONING PORTFOLIO

LEADING THE WAY IN SAFE PATIENT POSITIONING

Contact UKI.surgical@hillrom.com for further information

www.OperatinggTheatreJobs.com

A one-stop resource for ALL your theatre related Career opportunities

View the latest vacancies online !

Theatre Practitioners Recovery Nurses Anaesthetic Nurses ODPs

Scrub Practitioners Nurse Practitioners Medical Representatives

and Clinical Advisers

2 THE OPERATING THEATRE JOURNAL www.otjonline.com

November 2020 Issue No. 362 ISSN 1747-728X

The Leading Independent Journal For ALL Operating Theatre Staff

Hillrom®

If you know Trumpf Medical and Allen Medical®, then you

know Hillrom®. The exciting acquisition of these trusted,

industry leading brands has further cemented our dedication

and commitment to provide you with the unique solutions

in patient positioning. Our commitment to both the patient

and the caregiver at Hillrom® means we are always striving

to deliver the very best possible patient outcome whilst

also enhancing our customer’s efficiency in the OR. We find

inspiration in immersing ourselves in our customers world to

effectively address and resolve our customers most pressing

needs. Whether it be developing a solution to address the most

challenging aspects of patient positioning or creating a system

to offer safe and effective surgical site access for the surgical

team, we pride ourselves on providing products of exceptional

quality and value.

Nowhere in our portfolio is this more evident than in our

industry leading Yellofin stirrups®, our latest advancement in a

field where we have had 25 years proven success in overcoming

challenges faced with lithotomy positioning, giving your patient

the upmost comfort and protection from associated nerve

injuries.

Hillrom® is proud to offer our Hug-u-vac® system, its unique pliable design immerses and envelopments the

patent’s complete supine anatomy during lengthy steep Trendelenburg cases. This in turn protects essential

nerves in the shoulders.

Partner with Hillrom® for your orthopaedic positioning needs. Our extensive orthopaedic portfolio is tailored

to suit multiple procedural requirements keeping you and your patients comfortable throughout. The Beach

Chair® gives your clinical team an efficient, easy to use positioning system with removable back panels and

lateral side positioning for optimal surgical site access. The Beach chair® has the ability to attach to both UK

and EU side rails offering a cost effective, versatile solution for shoulder surgeries.

Hillrom® is proud to be the optimal partner for spinal surgery, with versatility and safety across a trusted

and established portfolio. Both our Allen Bow Frame® and Allen 4 post system® give you an easy to store

and easy to use positioning aid for various spinal procedures. Both attachable to a multitude of tables,

these innovative designs allow the patients abdomen to hang free and are completely radiolucent to allow

uninterrupted intraoperative imaging and C -arm access.

In more recent times our innovative solutions have tackled more challenging patient positioning requirements

commonly seen in robotic procedures. Our latest innovation is the ultimate collaboration between clinicians,

Hillrom® and our robotic partners.

For further information about any of our products please send an enquiry to uki.surgical@hillrom.com and a

member of our team will be delighted to help you.

Advice for pregnant members of the anaesthesia and

intensive care workforce during the COVID-19 pandemic

Updated guidance from the Royal College of Obstetricians and Gynaecologists

Version 3.5 - updated Friday 30 October 2020

When responding to articles please quote ‘OTJ’

At the peak of the first Covid-19 Pandemic, we included links to the RCOG and Faculty of Occupational

Medicine’s guidance for pregnant healthcare workers on our joint website. These bodies have now archived

this guidance, due to the end of the official “shielding” period and the regional variation now seen both in

terms of virus prevalence and local social distancing restrictions. They highlight that the RCOG’s clinical

advice on Coronavirus in pregnancy is still relevant, and the particular importance of observing social

distancing measures for those > 28 weeks gestation. The importance of individualised risk assessments,

which are the responsibility of employers to carry out, is emphasised, and for our members this will include

consideration of the nature of our work and working environments.

We include links to the statement produced by RCOG and the FOM - http://bit.ly/OTJ2GdAwOX the most

recent RCOG Clinical Guidance on Coronavirus infection and pregnancy - http://bit.ly/OTJ3e7Kyh2 the RCPs

guidance on working during pregnancy - http://bit.ly/OTJ3mDtYZu NHS Employers advice on risk assessment

- http://bit.ly/OTJ3ecF7xk and the PHE infection control guidance - http://bit.ly/OTJ37W72QU .

Inside this issue

Orbis International Training

Tool Sets Gold Standard

P4

Be the Face of AfPP’s Social

Media in 2021

P6

A Practical Guide to the

Law of Medical Treatment

Decisions

P6

Covid-19 What have

we learned about the virus

P7

Perfect Week restores health

and mobility to 250 patients

P8

New accommodation scheme

for NHS and Government

key workers

P8

Spine study highlights risk

factors of prolapsed disc

post-surgery

P10

Chelsea’s Story

P14

New insight into neovessel

formation shows promise

in future treatment of

cardiovascular

diseases

P14

Infection Prevention

Society New Board

of Trustees

P16

Late stage cancers

increase as Covid

fall-out bites

P16

A new technique could

make more livers available

for transplant

P18

Royal Free surgeon says

‘hospital came together’

P21

Digital health is on the rise

due to COVID-19 and is in the

spotlight at virtual.MEDICA

P24

Bassetlaw hospital worker

recognised for Covid-19

documentary photos

P26

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 362 November 2020 3

New Orbis International Training Tool Sets

Gold Standard to Prepare Ophthalmic

Nurses for the Operating Room

Scrub Nurses Play a Critical Role in Ensuring Positive Outcomes for

Patients Undergoing Surgery

Today, Orbis International, a leading global nonprofit that has

trained eye care teams in places with the greatest need for nearly

four decades, announced the publication of the Orbis Ophthalmic

Nursing Competency Assessment Rubric (ONCAR) for scrub nurses and

technicians in Insight, the American Society of Ophthalmic Registered

Nurses’ peer-reviewed clinical journal. The ONCAR is the first

published tool of its kind for ophthalmic nurse training.

The new tool fills a critical gap

by providing a gold standard

from which to assess early

career ophthalmic scrub

nurses’ readiness for the

operating room and outlining

the specific skills nurses must

demonstrate to progress from

novicehood to competency

during training. The ONCAR

covers 19 core competencies,

including equipment set-up,

pre-surgical handwashing,

setting up a sterile field,

handling of sharp equipment,

prepping the operating room,

proper care of sutures and

steps to safely wrap up the

operation. The rubric was

modeled after the International

Scrub Nurses in Vietnam receive

training on how to prepare and

sterilize surgical stations.

Photo: Geoff Oliver Bugbee

Council of Ophthalmology’s Ophthalmology Surgical Competency

Assessment Rubric (ICO-OSCAR), the accepted standardized rubric for

both teaching and assessing the surgical skills of ophthalmologists-intraining.

“It is our hope that the ONCAR is adopted globally in the training of

ophthalmic scrub nurses and technicians,” said Angela Purcell, RN,

coauthor of the ONCAR and Head Nurse of Orbis’s Flying Eye Hospital.

“Evidence shows that well-trained ophthalmic scrub nurses play a

critical role not just in preventing complications during surgery,

but also in ensuring positive outcomes for patients overall. These

nurses are often patients’ first line of contact for understanding the

procedure they are about to undergo as well as follow-up care.”

Released during the World Health Organization’s Year of the Nurse,

the paper underscores Orbis’s commitment to training every member

of the eye care team – not only ophthalmologists, but also nurses,

anesthesiologists and biomedical engineers. Empowering and

supporting all local practitioners is critical for ensuring that patients

get the best possible care and a meaningful step in democratizing and

strengthening eye care systems.

Even though Orbis’s Flying Eye Hospital has been temporarily

grounded due to the COVID-19 pandemic, Orbis’s staff nurses continue

to contribute to the field with peer-reviewed publications like the

ONCAR, conducting virtual trainings for nurses, and developing new

courses to be offered when in-person training can safely resume.

Moving forward, Orbis plans to conduct additional research to

measure outcomes of using the ONCAR in training. Orbis also plans to

create rubrics for other sub-specialties of nursing, such as sterilization

and circulating nursing.

To learn more, please visit orbis.org

When responding please quote ‘OTJ’

CS Medical is now Care Surgical

CS Medical have now completed our rebrand to Care Surgical.

Over the past 5 years CS Medical has become

a trusted name in the operating theatre

and is widely known for our outstanding

product quality and customer service.

Our first positioning solution, the

Prone Plus Helmet and Face cushion

has now helped protect over a

quarter of a million prone patients

worldwide. Although the CS name is

well known and respected among our

many customers, we felt that it didn’t

fully represent our purpose and company

philosophy.

So why Care Surgical?

Simple, our mission is to advance and improve patient Care in the

Surgical environment.

Our commitment to enhance patient outcomes is our prime focus

as well as the driving force behind everything that we do. Correct

positioning is essential for a positive surgical outcome and nowhere is

this truer than during prone procedures. From pressure related injury

to nerve damage and even blindness prone positioning poses a serious

risk to the patient. For these reasons Care Surgical have not just

developed single products but full positioning solutions.

Our latest innovation, the CS Spine Frame, provides a comprehensive

tabletop solution for prone positioning. From the head to the arms,

chest, hips, knee’s and feet we strive to ensure that the patient’s

whole anatomy is correctly and safely supported. The system gives

you a patient position comparable to that of a specialist spine table

but at a fraction of the cost.

So what’s changed?

We’re the same company with the same experienced team, just with a

new face! We feel our fresh new brand better represents who we are

and our position as innovative product engineers and reliable suppliers

of high quality, affordable positioning solutions.

Visit our new website at www.care-surgical.com

We are pleased to accept

clinical articles for publication

within the pages of

The Operating Theatre Journal

Please send for the attention of the

Editor at:

admin@lawrand.com

The next issue copy deadline, Monday 23rd November 2020

All enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51, Pontyclun, CF72 9YY

Tel: 02921 680068 Email: admin@lawrand.com Website: www.lawrand.com

The Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, www.otjonline.com

and in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.

Neither the Editor or Directors of Lawrand Ltd are in any way responsible for the statements made or views expressed by the contributors.

All communications in respect of advertising quotations, obtaining a rate card and supplying all editorial communications and pictures to the Editor

at the PO Box address above. No part of this journal may be reproduced without prior permission from Lawrand Ltd. © 2020

Operating Theatre Journal is printed on paper sourced from Forest Stewardship Council (FSC) approved paper mills and is printed with vegetable based inks. All paper and ink waste is recycled.

Journal Printers: The Warwick Printing Co Ltd, Caswell Road, Leamington Spa, Warwickshire. CV31 1QD


Introducing the new

CS Spine Frame

+ Fits all standard

operating tables

+ 250kg patient

weight capacity

+ Crescent shape allows

for easier positioning

of the breastsAVAILABLE

FOR SHORT

TERM HIRE

More space for the abdomen

to reduce venal pressure.

CS Supports are compatible with

all Allen and Jackson style tables.

Call now to arrange a free trial

www.care-surgical.com 01704 336671

Do you want to be the Face of

AfPP’s Social Media in 2021?

Does your perioperative team go above and beyond to encourage and

develop a supportive and positive culture within your immediate team

or with the department as a whole?

If yes, you could be in with the chance of becoming the 2021 Face

of The Association for Perioperative Practice (AfPP), the UK’s leading

membership organisation for theatre practitioners.

As part of its Caring for those who Care campaign, the Association

is giving eight perioperative teams the chance to represent what a

supportive culture within the perioperative environment means, by

being the face of their online brand.

Louise Ashton, marketing lead at the Association explains: “This year’s

Face of AfPP competition was so successful that we’ve decided to rerun

it for 2021.

As part of our Caring for those who Care campaign, we have carried out

two surveys with perioperative professionals to find out more about

culture and behaviours within operating theatres and the impact it has

on staff wellbeing. Responders to both surveys highlighted concerns

about the culture and behaviour within operating theatres. They

expressed concerns about the impact a negative culture and bullying

were having on staff wellbeing and patient safety.

We’d like to know how teams across the country have addressed issues

like these, including any initiatives they’ve put in place”.

The teams who submit the best initiatives will become the cover photo

for The Association for Perioperative Practice’s social media accounts

for one month in the run up to the 2021 AfPP Annual Conference in

August. One overall winner will be announced at the conference and

their image will then become the face of AfPP for the rest of the year.

What’s more, each of the winning teams will receive a Betty’s tea and

biscuit bag to enjoy together.

Dawn Stott, CEO of the Association added: “AfPP takes patient outcomes

and the wellbeing of all perioperative practitioners very seriously.

Our experience shows how invaluable the wellbeing of healthcare

professionals is to patient safety. AfPP is all about networking and

sharing best practice and this project is a fantastic way to showcase

great initiatives that make teams stand out.

“Whether you’ve introduced a ‘thumbs up’ board to highlight

great practice; or helped to create a happier and more productive

environment through finding and developing ways to engage and

communicate positively with colleagues. Maybe teams or individuals

have been empowered to develop solutions to issues that have

challenged team performance in the past. Whatever it is that you’ve

done to create a more positive working environment, we’d like to hear

about it! “

To find out more, including terms and conditions, and how to enter go

to https://bit.ly/3kDlGjC or email marketing@afpp.org.uk.


A Practical Guide to the Law of Medical Treatment Decisions

Ben Troke is a solicitor and a mediator with 20 years’ experience working in health and social care, acting for the NHS and private sector providers

all over the country. His particular interest is in decisions about medical treatment and he regularly deals with urgent applications to court in

emergency situations. Ben currently sits on the Law and Ethics Policy Unit of the Faculty of Intensive Care Medicine and has a decade of experience

of sitting on the ethics of clinical practice committee of a large acute NHS Trust. Ben is a partner in the healthcare team at Hill Dickinson solicitors.

The murky area where medicine, law and ethics rub together has always fascinated me. The more we can do, as medicine and science take great

strides, the more questions arise about what we should do, and the greater the need to tread carefully.

Decisions about medical treatment can be about life and death, such as withdrawal of treatment or (not) providing CPR; or they can be about

quality of life, liberty and independence, which can be just as important. However, the legal (and ethical) framework around these decisions is

often misunderstood, leading to distress and disputes at the very worst of times, as we have seen in a few very high-profile cases, and there will

have been untold others in private.

Should a patient always get what they want, or does “doctor know best”? When a patient cannot make a decision for themselves, who gets to

decide, and how should these decisions be made? What is the role of so-called “next of kin”? (and did you know that there’s actually no such

thing?). Can family insist on treatment when doctors think it futile? How are disputes in this context resolved and, better yet, how are they

avoided? And how can we act now to control what happens to us in future, when we may not be able to decide for ourselves?

For our most life-changing decisions, I felt that there was a need for a practical guide to the law and how it really works, written to not only be

accessible for lawyers, but also for clinicians, patients and anyone concerned about them, covering:

• Treatment options and resource allocation (including DNACPR, and what to do if healthcare demand outstrips resources, such as in a pandemic)

• Consent, autonomy, communication and how medics can minimise their chances of being sued

• Mental capacity and best interests decisions

• Dispute resolution, including when you need to go to court, and practical advice on preparing statements and giving evidence.

It has been my privilege to build a career in this field, supporting professionals dedicated to providing treatment and care. I have always been

immensely proud to work alongside the NHS, and especially now when, more than ever, the NHS is stepping up to the plate to look after us all,

and desperately difficult decisions may be needed.

The least we can try to do is be clear and open about the legal and ethical framework in which those decisions about medical treatment are made.

I hope that this book (all author’s proceeds of which are going to the Alzheimer’s Society) is helpful.

You can purchase a copy of ‘A Practical Guide to the Law of Medical Treatment Decisions’ by Ben Troke here: http://bit.ly/OTJ37RLwgn


Covid-19 What have we learned about the virus, so far?

Author: Adrian Gee-Turner

Summary

As the pandemic progressed,

our understanding of the virus

that causes Covid-19 grew, and

this has influenced the guidance

on transmission prevention

measures such as face masks,

social distancing, hand washing

and disinfection. Whilst a few

grey areas persist, such as the

degree of challenge presented

by aerosolised virus, a number

of conclusions are emerging. For

example:

• Fomite transmission (from

objects and surfaces) is highly

likely given the extended

periods (days) that SARS-CoV-2

is able to remain viable on a

variety of surfaces, including

glass and plastic. This is

important because people

generally touch mobile phones

and keyboards many times

per day, so as well as hand

washing, ‘touch points’ will

need frequent disinfection

with an antiviral disinfectant

(caution: some ‘antibacs’ are

not antiviral).

• It appears that the viability

of SARS-CoV-2 is significantly

reduced by sunlight or high

temperatures. This conclusion

would appear to be borne

out by the outbreaks that

have occurred in chilled food

packing facilities.

• SARS-CoV-2 can remain

infectious as an aerosol for

at least several hours. This is

important because pathogens

predominate in small particles

of less than 5 microns (<5 μm)

which do not settle in the way

that larger particles do.

Virus survival on surfaces

The emergence of a novel

human coronavirus, SARS-

CoV-2, prompted a review

of the available data on the

persistence of coronaviruses on

inanimate surfaces and their

inactivation with biocidal agents.

Published in January 2020 in the

Journal of Hospital Infection,

the review examined 22 studies

that evaluated the persistence

of human coronaviruses such

as Severe Acute Respiratory

Syndrome (SARS or SARS-CoV-1)

coronavirus and Middle East

Respiratory Syndrome (MERS)

coronavirus. The assessment

detailed the persistence of

coronaviruses on inanimate

surfaces such as metal, glass

and plastic for up to 9 days,

but found that they can be

efficiently inactivated by surface

disinfection procedures.

It proposed, therefore that such

procedures should be adopted

to curtail the further spread

of SARS-CoV-2. Interestingly,

whilst the Paper concluded that

human coronaviruses can remain

infectious on inanimate surfaces

at room temperature for up to

9 days; it also mentioned that

temperatures of 30 DegC or

higher reduce the duration of

persistence.

Is SARS-CoV-2 different?

In general, the health effects

of infection by SARS-CoV-1 are

more serious than by SARS-CoV-2,

but as a contagion, SARS-CoV-2

is more important because it

appears to transmit more easily

than its predecessor. This is likely

to be because the viral load is

highest in the nose and throat

of people with COVID-19 shortly

after symptoms develop, whereas

with SARS, viral loads peak much

later in the illness. Consequently,

people with COVID-19 may be

transmitting the virus even

before their symptoms develop.

According to the Centers for

Disease Control and Prevention

(CDC), some research suggests

that COVID-19 can be spread by

people with no symptoms.

In March 2020, at about the same

time that the UK lockdown was

first announced, van Doremalen

and others published a Paper

in the New England Journal of

Medicine, which compared the

aerosol and surface stability of

SARS-CoV-2 in comparison with

SARS-CoV-1. The work assessed

the viability of the viruses in five

conditions: in aerosols, and on

plastic, stainless steel, copper,

and cardboard. All of the trials

were conducted at 40% relative

humidity and 21-23 DegC, and

found that the stability of SARS-

CoV-2 was similar to that of SARS-

CoV-1 under the experimental

circumstances tested.

The research showed that SARS-

CoV-2 was more stable on plastic

and stainless steel than on copper

and cardboard, and viable virus

was detected up to 72 hours after

application to these surfaces,

although the virus titer (viral

load) was greatly reduced. The

results indicated that aerosol and

fomite transmission of SARS-CoV-2

is plausible, since the virus can

remain viable and infectious in

aerosols for hours and on surfaces

up to several days.

Airborne transmission

Clearly, more work is necessary

to better understand the airborne

behaviour of the virus.

However, a study of the particle

sizes of infectious aerosols (July,

2020) published in the Lancet,

found that humans produce

infectious aerosols in a wide range

of particle sizes, but pathogens

predominate in small particles

(<5 μm) that are immediately

respirable by exposed individuals.

Also, evidence is accumulating

that SARS-CoV-2 is transmitted

by both small and large particle

aerosols. It would appear

therefore that masks should be

capable of intercepting even

ultrafine particles and given the

persistence of viable virus in

aerosols, facemasks represent an

important means with which to

limit transmission of the virus.

The effects of temperature and

light

In October 2020 the Virology

Journal published work by Riddell

and others in Australia, in which

the effect of temperature on the

persistence of SARS-CoV-2 was

evaluated on surfaces including

glass, stainless steel and both

paper and polymer banknotes.

These surfaces were chosen

because they represent most of

the major ‘touch points’ such

as mobile phones, money, bank

ATMs, supermarket self-serve

checkouts etc.

All experiments were conducted

in the dark, to negate any effects

from UV light; SARS-CoV-2 has

been shown to be inactivated

by simulated sunlight (Ratnesar-

Shumate S, et al. (2020), and

Schuit M, et al. (2020)). Inoculated

surfaces were incubated at 20

DegC, 30 DegC and 40 DegC and

sampled at various time points.

The initial viral loads were

approximately equivalent to

the highest titres excreted by

infectious patients, and viable

virus was isolated for up to

28 days at 20 DegC from the

surfaces. Conversely, infectious

virus survived less than 24 hours

at 40 DegC on some surfaces.

Nevertheless, this work indicates

that SARS-CoV-2 survival

rates are considerably longer

than previously believed, so

disinfection strategies should be

adjusted accordingly.

As the manufacturer of Nemesis

eH2O, we have witnessed an

enormous increase in demand

for both sprayable and foggable

product. This is because, whilst

hand washing can help protect

individuals, effective spraying

of touch points is also essential,

coupled with the fogging of large

spaces to decontaminate surfaces

and viral aerosols.

References:

Kampf, G. et al. (January, 2020)

Persistence of coronaviruses on

inanimate surfaces and their

inactivation with biocidal agents.

Journal of Hospital Infection.

van Doremalen N, et al. (March,

2020) Aerosol and Surface Stability

of SARS-CoV-2 as Compared with

SARS-CoV-1. New England Journal

of Medicine.

Ratnesar-Shumate S, et al.

(July, 2020). Simulated sunlight

rapidly inactivates SARS-CoV-2

on surfaces. The Journal of

Infectious Diseases.

Fennelly K P. (July, 2020) Particle

sizes of infectious aerosols:

implications for infection control.

The Lancet Respiratory Medicine.

Schuit M, et al. (August, 2020).

Airborne SARS-CoV-2 is rapidly

inactivated by simulated sunlight.

The Journal of Infectious

Diseases.

Riddell et al. (October, 2020)

The effect of temperature on

persistence of SARS-CoV-2 on

common surfaces. Virology

Journal.

For further information, contact:

Sterling Presentation

Health Limited

Royal Bank Chambers

Melrose

TD6 0PN

Email: info@nemesis-eH2O.com


Perfect Week restores

health and mobility to

250 NHS patients

Practice Plus Group Hospital Ilford and the

Barking, Havering & Redbridge University

Hospital Trust (BHRUHT) have carried out

250 orthopaedic procedures in one week in a

programme designed to reduce waiting times

for orthopaedic surgery across the three

London boroughs.

Nurul Ahad, medical

director at PPG

Hospital Ilford

and the Group’s

national orthopaedic

lead, said: “This

was an incredible

collaboration over

seven consecutive

days, across several

sites including four of

the theatres at Ilford

Hospital.

“As we all know lockdown has led to longer

than usual waiting times for elective surgery,

leaving many in considerable pain for

prolonged periods. By opening up four of our

operating theatres and by collaborating with

BHRUHT, our teams have managed to lift 250

people out of pain, enabling them to go back

to the jobs and the lives they love. Some of

our patients include those working on the

front line of care, and we know they are glad

to be back and serving their communities.”

Operations carried out during the week –

named Perfect Week – included 135 joint

replacements of which 10 managed to

successfully and safely return home on the

same day! Professor Briggs from GIRFT had

attended to give his own seal of approval and

to encourage further collaboration with the

sole focus on serving the local population.

More collaborations are expected between

PPG Hospital Ilford and BHRUHT in the future to

further support the patients within the London

boroughs of Barking, Havering and Redbridge,

and the six Practice Plus Group hospitals and

three surgical centres nationwide are working

hard to support the NHS and patients to tackle

the issue of extended waiting times.

NMC

Caring with Confidence:

The code in Action.

We know that nurses, midwives and nursing

associates have been facing difficult decisions

in unprecedented circumstances over the

last few months. That’s why we’ve launched

Caring with Confidence: The Code in Action.

Caring with Confidence is a series of bitesized

animations about key aspects of nursing

or midwifery professionals’ roles, and how the

Code can support them.

Please share Caring with Confidence in your

organisation, to help us support as many

nurses, midwives and nursing associates as

possible to feel confident about the care they

deliver in these challenging times and beyond.

Find out more: http://bit.ly/OTJ35YHAYC

New accommodation scheme for NHS and

Government key workers launched by

short term rentals industry body

The UK Short Term Accommodation Association

(STAA) has followed up its successful

nationwide NHS Homes initiative with the

launch of a new scheme to offer NHS staff

and key government workers discounted safe

and clean accommodation near their places of

work, to help protect them and their families

as the UK’s COVID-19 infection rates rise.

The STAA, the short-term rentals industry

representative body, is launching the

TrustedStays scheme this week, after close

consultation with Government representatives.

Over the last six months, its NHS Homes

scheme has been hugely successful in offering

NHS workers free accommodation, which has

led to a significant number of professional

short term rental companies collaborating to

launch the Trusted Stays scheme. The new

scheme is offering discounted accommodation

to any government worker, including those

who need to relocate, to support them in the

fight against the second wave of COVID-19.

The association has developed the scheme

to make it more convenient for the UK

Government and NHS to book appropriate

accommodation for its staff. The main

elements of the scheme are:

• It will provide the Government and NHS

with one single website on which to book

accommodation in accredited homes across

the UK

• All bookings will receive discounted rates

on the standard commercial rates

• All TrustedStays member companies follow

the single set of industry cleaning and

safety protocols introduced in June*1

• It is only open to STAA members who have

accreditation from Quality in Tourism’s

Safe, Clean and Legal scheme*2

• Property management companies upload the

information about their available properties

onto the website to enable Government

officials to search for accommodation in

their area or near to specific hospitals

• Enquiries from customers will go directly

to the company responsible for the home’s

rental and payment can be arranged by

invoice or debit/credit card

Around 1,000 properties in London,

Manchester and Edinburgh are available now

for bookings through 11 different short term

rental partners in the UK. The scheme will be

rolled out to towns and cities across the UK in

November.

The NHS Homes scheme, which launched

in March, involved more than 30 property

companies donating accommodation with

a value of more than £20m, providing over

10,000 nights’ free accommodation. The

scheme has experienced a spike in demand in

recent weeks as COVID-19 infection rates rose.

TrustedStays will now effectively replace it

and be available to a wider audience of key

workers on a long-term basis.

TrustedStays has partnered with some of

the major players in the UK short term

accommodation industry including Sykes

Cottages, who represent thousands of

properties around the UK, Guest Ready who

cover Edinburgh, Manchester and London

and UnderTheDoormat who provide luxury

homestays throughout London. The other

partners are Altido, CityRelay, Air Peace of

Mind, A Place Like Home, Way of Life, Seven

Living, Urban Stays and Mason & Fifth.

Merilee Karr, Chair of the STAA, said, “The

huge success we saw with the NHS Homes

scheme illustrated to us that the authorities

needed our support in housing their staff as

they continue to work through this pandemic

and beyond.

“We took many learnings from setting up

that scheme and because we already have

the infrastructure, cleaning protocols and

accreditation in place, the Government

and NHS workers trust us to provide the

appropriate accommodation.

We recognised the need went beyond NHS

workers and we were challenged to produce a

more sustainable version.

“We put a huge amount of effort in over

the summer months to deliver this and I’m

delighted with what has been achieved. This

offer isn’t just confined to NHS workers.

We can also support the Government to

accommodate people who need to shelter from

COVID-19 for health reasons and for other key

workers such as MPs, who have to be at their

place of work, need flexible accommodation

and prefer to stay in a professionally managed

home setting.

“By staying in safe and clean accommodation,

key workers won’t have the worry of a daily

commute on public transport and will be

able to protect vulnerable family members

by staying in a separate, self-contained

property.”

Graham Donoghue, CEO of Sykes Cottages:

“Sykes Cottages are proud to participate in

TrustedStays and with our strong network of

properties across the UK, we are in a position

to provide quality accommodation in homes

for NHS and other key workers as their needs

arise.

As a company that works to contribute to the

communities where we operate, this is a great

way for us and our owners to play an active

role in providing homes to the people who are

working so hard to support us all.”

Richard Bridger, COO of UnderTheDoormat:

“NHS Homes demonstrated that there is

a real lack of options when it comes to

accommodation for professionals and key

workers in this current environment.

By opening up the option of safe, clean and

comfortable homes to Government workers

we can provide a long-term sustainable

solution for them in the current environment

as well as in a post-COVID world.”

For more information visit: trustedstays.co.uk


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JUNE Medical launches

male surgical retractor kit

JUNE MEDICAL is expanding its comprehensive portfolio of medical

devices with the upcoming launch of its new pre-packed retractor kits

especially for male procedures. Based on the company’s award-winning

Galaxy II retractor, the Galaxy II Male kit brings the same level of

innovation to male surgeries.

The Galaxy II Male kit is set to revolutionise male procedures by

dramatically improving visualisation during surgery. This straightforward

and easy to use kit is suitable for a wide range of procedures requiring

optimal control over the surgical site, such as scrotal and associated

surgeries, as well as prosthetic testicle implantations. The kit features

a number of different accessories and a novel hammock elevation strap

to manoeuvre the male anatomy, allowing the penis to be held securely

without requiring hooks through the skin, improving patient comfort.

The kit also benefits from all of the characteristics that have made

the Galaxy II system so popular. The retractor’s unique, design

protected cam locks allow simple single-handed adjustment for rapid

re-positioning, while the slots on the retractor ring easily secure the

stays in place. Together with a range of stay hooks designed to enable

high tension without the risk of tissue tearing, this system provides an

innovative, cost-effective and convenient solution for a wide range of

surgical procedures.

Angela Spang, CEO of JUNE Medical, commented: “The Galaxy II frees

up the hands of assistants and nurses that often have to hold the

retractor, sometimes for long periods of time. This improves efficiency

and reduces the numbers of people needed in the operating room,

which is especially useful during the COVID-19 pandemic to help reduce

infection risk.”

Visit the JUNE Medical website www.galaxyretractor.com

to learn more.


One of world’s largest spine study highlights

risk factors of prolapsed disc post-surgery

Data from one of the world’s largest spine study, which analysed the

reoccurrence and risk factors of prolapsed disc post-surgery, has been

presented at this year’s EUROSPINE conference by London Norwich

Spine Clinic.

Collected over a 10-year period, the study reviewed 888 lumbar

discectomy patients who all had a minimum of two years follow-up.

The results revealed that the female sex, smoking, and having a higher

pre-operation disability were all factors for reherniation.

The research was carried out by

Spinal Consultant Mr Am Rai and

his colleagues from the Department

of Orthopaedics and Spinal Surgery

at the Spire Norwich Hospital and

Norfolk and Norwich University

Hospital.

Surgical discectomy is an

effective treatment for lumbar

intervertebral disc herniation but

despite developments in technique,

the incidence of reoperation is

estimated to be between 13% to

25%. Until now robust predictive

metrics and risk factors associated

with recurrent lumbar disc

herniation haven’t been clearly

defined.

The independent study looked at patient demographics and patientreported

outcome measures including back and leg pain. Postoperative

data was also collected from clinical notes and MRI database and the

team checked against all imaging providers in the region. Diagnosis was

confirmed clinically or by operative findings

Mr Rai explains: “The rate of reherniation after lumbar discectomy

varies widely and the role of risk factors has not been fully established.

Equally, among clinicians, the subsequent treatment option in the

management of symptomatic recurrent lumbar disc herniation remains

unclear.

“The aim of the study was therefore to identify the true incidence

and the associated risk factors. It is the largest one of its kind and

the findings are important for healthcare practitioners globally when

developing management strategies.”

The London Norwich Spine Clinic was founded by Mr Rai in 2003 to give

patients with spinal conditions access to the best surgical care.

Headquartered in Norwich, and with state-of-the-art facilities in

London, the clinic specialises in treating a wide range of problems,

including disc herniations in the neck and lower back, spinal

deformities such as scoliosis and kyphosis in adults and children, plus

trauma, infections and tumours. With access to world-class diagnostic

equipment, the specialist clinic offers both conservative and surgical

techniques, providing innovative solutions and personalised care for

patients from across the UK and abroad.

Mr Rai was elected President of the British Association of Spinal

Surgeons by his surgical peers and has been on the BASS Executive

Committee for 6 years. He has also published on national best practice

surgical guidelines, helped develop the British Spinal Registry (over

140,000 patients), and been involved in National Institute for Health

and Care Excellence (NICE) guidelines and government-led regional

variation in surgical practice across England.

Due to COVID-19 restrictions, the research was presented virtually at

EUROSPINE – an international conference hosted by the Spine Society of

Europe. The event shares knowledge and ideas in the field of research,

prevention and treatment of spine diseases and related problems,

and coordinates efforts undertaken in European countries for further

development in this field.

About London Norwich Spine https://londonnorwichspine.co.uk/


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companies. © 2020 Mölnlycke Health Care. All rights reserved. UKSU0136.

Keeping eyes on the patient: Mindray confirms new anaesthesia

machines will launch in the UK

Mindray has announced it will be launching its new A8 and A9

anaesthesia machines in the UK market.

The two systems are the medical device manufacturer’s most advanced

anaesthesia products to date, offering market-leading connectivity

options and innovative patient safety features.

Both the A8 and A9 are the first devices in the industry to have integrated

high flow nasal cannula (HFNC) technology within the anaesthesia

machine.

The feature helps extend the window of therapeutic action for

anaesthetists by prolonging safe apnoeic oxygenation levels, allowing up

to 30 minutes of safe oxygenated apnoea time. Studies by the British

Journal of Anaesthesia found that HFNC can more than double the

average duration of aponea before desaturation.2,3

Data from a wide range of external monitoring modules such as bispectral

index, neuromuscular transmission and intravenous imaging, can be

seamlessly integrated and displayed by the new devices without any extra

monitoring screens.

Enabling anaesthetists to collect more data at a glance, the modular

design also fulfils the need for fewer devices in theatre, allowing

anaesthetists to utilise a larger workspace and spend more time closely

observing their patients.

A study in the Anesthesia & Analgesia journal found that anaesthesiologists

look at their monitor in one to two second glances, therefore displays

should be developed to optimise this short window of information.1

In order to optimise gas usage and quickly provide a balanced response

to changes in patient status without user intervention, the A9 uses

Automatic Controlled Anaesthesia (ACA). Through its precision electronic

vaporiser and ACA platform, the A9 adjusts fresh gas and vaporiser

output to hit patient targets using both end-tidal and inspiratory oxygen

measurements.

The new systems also utilise a suite of gas reduction tools to minimise

the environmental and economic impact of surgery by preventing leakage

and managing usage, improving patient safety in the process. Both the

A8 and A9 can offer suggestions on optimal fresh gas flow, provide realtime

usage metrics, pause to prevent leakage, and indicate flow rate

abnormalities.

Mindray A9 (in use)

Mindray’s innovative volume exchanger design allows the two devices to

deliver ICU-level ventilation, offering greater precision and protection for

all patients during ventilation. The system has no moving parts and is

supported by a range of protective ventilation tools, offering reliable and

safe ventilation to reduce the occurrence of post-operative complications.

The devices demonstrate Mindray’s commitment to improving connectivity

by easily connecting to existing devices and patient data management

systems, from central workstations to bedside monitors. Both systems can

also be configured for up to 10 individual patient profiles, an industry-first.

This interconnected approach provides greater data visibility throughout

the patient journey, minimising risks and improving patient care.

For more information, please register for the online product launch

https://www.mindray-virtual.com/login

References:

1. Ford S, et al. At-a-Glance Monitoring: Covert Observations of Anesthesiologists in the

Operating Room, Anesthesia & Analgesia 2010; 111: 653 – 658.

2. Gustafsson I, et al. Apnoeic oxygenation in adults under general anaesthesia using

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange, British Journal of

Anaesthesia 2017; 118: 610–177.

3. Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for

management of unanticipated difficult intubation in adults. British Journal of Anaesthesia

2015; 115: 827–48.



Manchester hospitals deploy new remote monitoring

technology to free up beds for the sickest Coronavirus patients

Manchester hospitals implement the Patient Status Engine to monitor Covid-19 patients in hospital and at home.

The surge in Covid-19 patients

in Greater Manchester has

provided the opportunity for

two hospitals to deploy a new

wireless monitoring platform

which they hope will allow

clinicians to identify and predict

deteriorating patients faster

and with less nurse to patient

contact. Originally planned for

use in clinical research, the new

technology holds the promise of

saving many lives in Manchester

and many thousands if rolled out

across the whole country.

Earlier this week Dr Indy Kapila,

intensive care consultant and

chair of the North West Regional

Consultants Committee of the

British Medical Association,

deemed the current situation

in critical care units across the

region as ‘very concerning’. He

said that while units do have

capacity ‘at the moment’, beds

may start to run out ‘over the

next week or so’.

Now, to ensure critical care

beds are available for only the

sickest Covid-19 patients, The

Christie NHS Foundation Trust

and the Manchester University

NHS Foundation Trust (MFT) have

implemented the Patient Status

Engine, a Class IIa CE-Marked and

FDA approved state-of-the-art

monitoring platform to monitor

Covid-19 patients both in hospital

and at home.

The PSE, designed and developed

by UK company Isansys Lifecare

Ltd, automatically collects

continuous physiological data,

including heart rate, respiration

rate, heart rate variability, ECG,

oxygen saturation, blood pressure

and body temperature.

It then uses these measures

together with nurse scored

data such as consciousness

levels to calculate a minute

by minute NEWS 2 score, the

standard early warning measure

of patient deterioration used by

NHS hospitals that enables rapid

identification of those patients

most in need and their clinical

care to be escalated fast.

Professor John Radford, director

of research at The Christie, who is

leading the RECAP project which

is monitoring patients recovering

at home with the PSE, said:

“The technology offers us a way

of keeping a close eye on our

patients while they’re at home.

We hope the PSE will help us

detect when a cancer patient

with COVID-19 is deteriorating

and needs to be reviewed in

hospital. This is the first time

this technology has been used for

patients who aren’t in hospital in

the UK, so it’s truly innovative,

and if successful, could be used in

other areas of medicine.”

The Manchester University NHS

Foundation Trust (MFT) and The

Christie NHS Foundation Trust in

Manchester are using the PSE as

part of the Cosmic (COntinuous

Signs Monitoring In Covid-19

patients) study to monitor Covid-19

patients in hospital. Clinicians aim

to identify in advance patients

who will deteriorate and predict

those who will need intensive

care treatment.

Dr Anthony Wilson, intensive care

consultant at Manchester Royal

Infirmary, part of MFT, where

approximately 10 to 20 per cent of

hospital inpatients with COVID-19

will need to be admitted to

intensive care, said:

“The intensive care team at MFT

has cared for many people with

the COVID-19 infection in the last

few months. This new technology

may allow us to intervene earlier

and give patients a greater chance

of getting better.”

Professor Fiona Thistlethwaite,

medical oncologist at The

Christie, said: “Unfortunately

some patients who are suffering

from COVID-19 on our hospital

wards can become seriously

unwell. By using the PSE, we

hope to be able to identify these

patients early and this means we

can optimise their management

without the need for them to go

to intensive care.

We can also monitor the patients’

vital signs on a screen located in

a different part of the hospital

and we hope that, eventually,

this will mean that as well as

keeping our patients safe, we can

reduce exposure to the virus for

our staff.”

Keith Errey, CEO of Isansys

Lifecare, said: “The situation

across the country and globally

is worrying. All indications are

that Covid-19 infections and

hospital admissions will continue

to rise, so we all need to do what

we can by adhering to safe and

socially responsible behaviours.

At Isansys we are privileged to

be able to support the frontline

clinical teams by providing

our technology and predictive

tools that enable earlier stepdown

and discharge of patients

in hospital whilst at the same

time ensuring Covid-19 patients

at home remain safe. “The PSE

has the capability to expand

overall critical care capacity

by continuously monitoring

patients and establishing higher

dependency beds in lower acuity

areas of the hospital. This allows

hospitals to preserve capacity

for those Covid-19 patients who

need escalated care and is also

enabling healthcare providers

to offer the necessary care for

Covid-19 patients being treated

at home.”

Further information:

www.isansys.com

Non-Limited Life medical cylinder launched by Luxfer, as COVID-19

increases demand for solutions to help millions with respiratory conditions

As COVID-19 prompts the development of new technologies to assist in

oxygen therapy for the millions with respiratory-related illness, Luxfer

Gas Cylinders has launched its first Non-Limited Life (NLL) medical

cylinders to support the healthcare industry.

The new cylinder from Luxfer will help patients affected by conditions

that make breathing difficult, including coronavirus but also Chronic

Obstructive Pulmonary Disease (COPD), which affects 65 million people

globally and results in over 3 million deaths worldwide each year.

As a direct result of supply related to COVID-19 in early 2020, Luxfer

experienced a spike of 8% of its annual medical orders, from its existing

product range.

Mark Lawday, a Director at Luxfer Gas Cylinders, said: “As people

recover from COVID-19 at home, particularly those who have underlying

health conditions that affect their breathing, they may need home

oxygen therapy and that will be something we could see as the

pandemic plays out. While we can’t say for certain how big an impact

this virus will have on home-use portable oxygen delivery systems, it’s

clear that technology has a role to play, and products that deliver safe,

high performance, durable, cost effective, patient-centric solutions,

will be highly prized.

“We’re proud to be one of the world’s most trusted producers of medical

cylinders, and pleased to offer the healthcare industry an innovative,

non-limited life medical cylinder which will optimize performance,

durability and reliability in proven Luxfer lightweight design.”

Luxfer Gas Cylinders, a business unit

of Luxfer Holdings PLC (NYSE: LXFR)

and the world’s largest manufacturer

of high-pressure composite and

aluminium cylinders, already has

more than 15 million of its medical

cylinders in use worldwide.

The new Luxfer 1.0 litre NLL carbon

composite medical cylinder is its

first product offering with a lifespan

beyond the typical 15-year and

20-year oxygen cylinder offerings

available today. The product is

destined for medical institutions and

will go into the hands of healthcare

professionals who can help patients

who need oxygen therapy on the

move.

As with other Luxfer carbon composite medical cylinders, this latest

NLL cylinder uses Luxfer’s proprietary L6X® aluminium alloy as an inner

liner reinforced with an aerospace-grade carbon fibre wrap. The result

is an ultra-lightweight cylinder with improved performance, durability,

capacity and service life expectancy. It will only be available in

countries which approve NLL cylinders.

Further information: https://www.luxfercylinders.com/

Please quote ‘OTJ’


http://bit.ly/OTJtheatreSummit

Getinge takes a significant technological

leap with new Tegris Operating Theatre

Integration platform

www.facebook.com/TheOTJ

For more than 15 years, Getinge has been a global provider of software

solutions for a fully integrated, cable-free operating theatre. Now, a

brand new platform that is taking Operating Theatre Integration to a

whole new level is introduced.

Getinge’s Operating Theatre Integration solution Tegris makes a

significant difference to hospitals across the world when it comes to

improving efficiencies in the operating theatre, reducing costs and

lightening the administrative burden.

“Tegris is a complete solution. It connects everything and gives us

different options to integrate video, manage data and operate various

devices within the operating room,” says Serpil İsabetli, Nursing

Services Manager at Acıbadem Maslak Hospital, Turkey.

Over the years, the Tegris software has evolved significantly to meet

customer requirements and emerging trends. With the latest release,

Tegris comes with a brand-new generation hardware platform that

ensures customers top-of-the-line image quality and unmatched

flexibility for a future-proof and integrated surgical environment.

When patients’ lives are at stake, surgeons should not wait for images to

buffer. The new Tegris is fully dedicated to Video-over-IP and supports

4K ultra-high-definition (UHD) routing and recording, which provides

surgeons with precisely what they need to better assess situations and

perform procedures successfully.

“With the new Tegris platform we have made a significant technological

leap and are optimally prepared for future challenges”, says Maik

Fleischer, Product Manager OR Integration at Getinge. “Our solution

grows with the needs of the facility so that our customers are

guaranteed a safe, reliable and future-proof surgical environment”.

Learn more about the Tegris Operating Theatre integration solution

http://bit.ly/OTJ37SVrlA

Please quote ‘OTJ’


New insight into neovessel formation

shows promise in future treatment

of cardiovascular diseases

A new study by researchers at the University of Eastern Finland provides

novel insight into the previously unknown effects of factors regulating

blood vessel formation. In the study, bone morphogenetic factor 6,

i.e. BMP6, was shown – for the first time - to regulate blood vessel

formation via vascular endothelial growth factor receptor 2 (VEGFR2)

and Hippo signalling pathway. The findings can be used in developing

treatments for cardiovascular diseases.

Cardiovascular diseases are the leading cause of death in the Western

world. In many of these diseases, blood circulation is decreased due

to narrowed blood vessels, leading to inadequate tissue perfusion

and oxygen deprivation. The formation of new blood vessels offers a

novel treatment option for these diseases. The development of this

treatment requires a thorough understanding of cellular signalling

mechanisms that regulate neovessel formation.

Bone morphogenetic proteins, BMPs, are growth factors originally

discovered as regulators in bone formation. Later on, their regulatory

role on the development and maintenance of a wide range of tissues

has become apparent. BMPs have a vital role in the development of the

cardiovascular system. In addition, BMPs have been shown to regulate

This is Chelsea’s story.

blood vessel formation but their exact mechanisms are unknown.

Crosstalk of BMP-signalling with a well-known blood vessel formation

regulator, VEGF, and its downstream effectors is poorly understood.

8 Years This ago Chelsea is lost her Chelsea’s boyfriend in a tragic motorcycle Story

accident. 8 Years She ago chose Chelsea to use lost her grief boyfriend as a driving in force to pursue

The new study now shows that VEGF gene transfer or oxygen deprivation

of the tissue induce the expression of BMPs. Bone morphogenetic factor

nursing a tragic in an motorcycle attempt to accident. support others She chose as the nurses at Royal

to use her grief as a driving force to

6 ligand was further demonstrated, for the first time, to regulate blood

London pursue had nursing done for in her. an attempt She finally to support registered as a nurse after

vessel formation. BMP6 was shown to act in endothelial cells via VEGFR2

studying others at as the the University nurses at of Royal Essex London the had 7 and Hippo signalling pathways by inducing nuclear localization of Hippo

done for her. She finally This registered is as Chelsea’s th anniversary of her

signalling pathway mediator TAZ. Hippo signalling has an important role

loss, with her partner tightly holding her hand.

a story.

nurse after studying at the University

in tissue size control and cell proliferation, and its malfunction has

of Essex on the 7th anniversary been associated with cancer.

8 Years ago

of

Chelsea

her

lost her boyfriend in a tragic motorcycle

g career loss, in ICU with at the her Homerton partner tightly Hospital. holding Within her 6 months of

accident. She chose to use her grief as a driving force to pursue The findings from this research improve our understanding of

e she was hand. thrown in the deep end nursing and in worked an attempt in ICU to support throughout others as the nurses at Royal multifactorial communication of cell signalling pathways in blood vessel

emic. Throughout She began this her period nursing she career London shared in had ICU her done at personal for her. She experiences

finally registered as a nurse formation. after The discoveries related to BMP6 and Hippo signalling can

the Homerton Hospital. Within 6 months

be used in the development of novel treatments for cardiovascular

ucate people about the struggles studying being at faced the University whilst dealing of Essex on with the the 7 anniversary of her

of completing her degree diseases.

loss, with

she

her

was

partner tightly holding her hand.

g days imaginable. thrown in the deep end and worked in

ICU throughout the coronavirus pandemic.

The study, openly accessible in Angiogenesis, was carried out in the

She began her nursing career in ICU at the Homerton Hospital. Within 6 months of Vascular Biology junior research group of Academy Research Fellow,

she never Throughout lost completing her care this her and period degree compassion she was shared thrown for her in others. personal deep There end experiences and are worked so on in ICU social throughout Adjunct Professor Johanna Laakkonen at the A.I. Virtanen Institute for

s that have media been the to coronavirus shared educate about pandemic. people how about Throughout she the supported struggles this period being others. she shared faced When whilst her a personal dealing experiences Molecular Sciences. The main authors of the article, Heidi Pulkkinen,

with the most difficult working days imaginable.

MSc, and Miika Kiema, MSc, are Early Stage Researchers in the Doctoral

d with terminal on social cancer media his to partner educate people locked about herself the struggles in the toilet; being faced whilst dealing with the

Programme of Molecular Medicine at UEF. Understanding how the

Even

most

throughout

difficult working

this she

days

never

imaginable.

door and joined her to comfort her. She lost was her care constantly and compassion checking for up others.

cell types interact in vascular diseases is one of the central research

There are so many fantastic stories that have been shared about how

that had interests of the Laakkonen junior research group. The group’s goal is to

she been Even

supported transferred throughout this

others. to another she never

When a ward, lost her

patient even care and

was coming compassion

diagnosed into for work others. There are so

with terminal

implement these discoveries for improved treatment and diagnosis of

there as cancer they many were his fantastic partner discharged stories locked that back herself have home. been in shared the toilet; about how Chelsea she supported unlocked others. When a

cardiovascular diseases.

door patient and joined was diagnosed her to with comfort terminal her. cancer She his was partner constantly locked herself checking the up toilet;

on previous Chelsea unlocked patients the that door had and been joined transferred her to comfort to her. another She was ward, constantly even checking The up

ospital and moved on to ICU at the Royal London to be able offer

newly published study is supported by the Academy of Finland, the

coming on previous into work patients on her that days had been off to transferred be there to as another they ward, were even discharged coming into European work Research Council, Sigrid Juselius Foundation and the Finnish

d compassion back on home. in her the days place off to that be there her as life they had were been discharged changed back by home. the

Foundation for Cardiovascular Research. The article is part of a project

rking in the that has received funding from the European Union’s Horizon 2020

She hardest left Homerton days of Hospital her life. and Unfortunately moved on to we ICU were at the unable Royal to London

She left Homerton Hospital and moved on to ICU at the Royal London to be able offer research and innovation programme under the Marie Skłodowska-Curie

e things that to be she able was offer capable kindness, of achieving support and there compassion 3 weeks in the after place that her

grant agreement.

life

kindness,

had been

support

changed

and

by

compassion

the incredible

in the place

nurses

that

working

her life had

in

been

the hardest

changed by the

b Chelsea died

days incredible in a tragic

of her life. nurses motorcycle

Unfortunately working in the accident.

we hardest were days unable of her to life. witness Unfortunately the incredible we were unable to

Research article:

things witness that the she incredible was capable things of that achieving she was capable there as of 3 achieving weeks after there starting as 3 weeks after

and family

Pulkkinen HH, Kiema M, Lappalainen JP, Toropainen A, Beter M,

her are starting dream trying her job to dream Chelsea follow job in died Chelsea her in path. died a tragic in She a tragic advocated motorcycle for accident. organ

Tirronen A, Holappa L, Niskanen H, Kaikkonen MU, Ylä-Herttuala S,

nd donated Her to partner, three air friends ambulance and family charities. are trying As a to result follow a in her path. She Laakkonen JP. BMP6/TAZ-Hippo signaling modulates angiogenesis and

Her partner, friends and family are trying to follow in her path. She advocated for organ

has been advocated created to for raise organ much and needed blood donation funds for and the donated Air to three air endothelial cell response to VEGF. Angiogenesis. 2020 Oct 6. doi:

and blood donation and donated to three air ambulance charities. As a result a

ambulance charities. As a result a fundraising campaign has been 10.1007/s10456-020-09748-4. Epub ahead of print. PMID: 33021694.

fundraising campaign has been created to raise much needed funds for the Air

created to raise much needed funds for the Air Ambulance.

Ambulance.

We urge We you urge to you continue to continue to live to live by Chelsea’s by Chelsea’s legacy.

Remember We the urge impact you to continue that you to live by Chelsea’s

legacy. Remember the impact can have that

legacy. on you

Remember someone’s can

the lives impact that you can

have on someone’s lives when have they on someone’s come

through lives when they come

your

through

doors.

your

The

doors.

kindness

through your doors. The kindness and The kindness and

and compassion that you

compassion that you show compassion that you show daily can

show daily daily can can completely

change someone’s path

and provide some solace in

their darkest of days.

many fantastic stories that have been shared about how she supported others. Wh

are There others. for compassion and care her lost never she this throughout Even

Chelsea unlocked the door and joined her to comfort her. She was constantly check

toilet; the in herself locked partner his cancer terminal with diagnosed was patient

on her days off to be there as they were discharged back home.

into

coming even ward, another to transferred been had that patients previous on

This is Chelsea’s story.

accident. She chose to use her grief as a driving force to p

motorcyc

tragic a in boyfriend her lost Chelsea ago Years 8

London had done for her. She finally registered as a nurse

R at nurses the as others support to attempt an in nursing

loss, with her partner tightly holding her hand.

anniversary o

7th

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kindness, support and compassion in the place that her life had been changed by th

witness the incredible things that she was capable of achieving there as 3 weeks aft

un were we Unfortunately life. her of days hardest the in working nurses incredible

starting her dream job Chelsea died in a tragic motorcycle accident.

and blood donation and donated to three air ambulance charities. As a result a

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through your doors. The kindness and

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compassion that you show daily can


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Infection Prevention Society New Board of Trustees

Following our re-structure this year the Infection Prevention Society

IPS are pleased to announce the appointment of three independent

Trustees, Tricia Hart, Ginny Edwards and Andy Leary and two IPS

member Trustees, Tracey Cooper and Paul Cryer, to our Board. We

have been extremely fortunate to recruit such influential leaders

in healthcare who also have a passion for infection prevention and

control.

Tricia Hart is a highly

accomplished Chief executive and

clinical leader with experience

across all sectors of the NHS.

She has had a long term interest

in IPC, was the nurse expert on

the Frances report and has been

a patron of IPS for 7 years.

Andy Leary is a chartered

accountant with 20 years

experience working strategically

and operationally in director of

finance roles within the NHS,

including as Director of financial

resilience at NHE England. Andy

has previously been Chairman

of the Healthcare Financial

Management Association.

Ginny Edwards has been a

director in healthcare for over

thirty years and has both national

and Department of Health and

has considerable experience

as a non-executive director.

Ginny was a director of the HCAI

reduction programmes at the

department of health which were

instrumental in tackling MRSA

and C. difficile.

Paul Cryer is an independent

innovation and solutions

consultant to healthcare

organisation and technology

companies. He was Programme

Manager at the Department of

Health for 10 years, including the

highly successful HCAI technology

innovation programme.

The experience our new board members will bring will be invaluable

in enabling the Society to grow and flourish and ensuring that we

work effectively to meet our vision ‘that no person is harmed by a

preventable infection’.

Our new trustees will be joined on the board by the executive team

of Jennie Wilson (Honorary President), Jo Taylor (Honorary Treasurer)

and Pixy Stradz (Honorary Secretary).

Tracey Cooper is Interim Director

of Infection Prevention & Control

at Worcestershire Acute Hospital

NHS Trust. She has 20 years

experience as a nurse consultant

in IPC, in assistant director of

nursing and DIPC roles leading

high performing teams. Tracey is

a past president of IPS.

Tricia Hart said: “I am delighted to be the Chair of the new Board of

Trustees having been involved with IPS for many years as a Patron.

This is both a challenging and exciting time in the history of IPS and I

feel extremely privileged to be part of the continuing journey.”

Jennie Wilson said ‘I am so thrilled that we have managed to appoint

such an amazing team to help us shape the direction of IPS. Their

experience is going to be invaluable in helping us navigate both the

challenges and opportunities that the COVID-19 pandemic presents

and I can’t wait to get started’

For more information visit: www.ips.uk.net


Late stage cancers increase as Covid fall-out bites

The impact of delays in cancer diagnostic services caused by the

COVID-19 pandemic are emerging now with an increase in patients

seeking treatment for later stage conditions.

Breast cancer diagnostic services in the UK can detect over 20,000

cancers per year in the UK, saving thousands of lives.

The cancer backlog means that thousands of people may be living

with cancer without realising it, increasing the risk of an upward stage

migration in their cancers, according to a leading expert on cancer.

Referrals for cancer were down 15% in August compared with the

previous year, but it was 28% down for breast cancer, in part due to

the collapse in diagnostic services.

The impact on cancer diagnostics from Covid-19 could mean up to

9,000 women have breast cancer without being aware of it.

Professor Karol Sikora, chief medical officer at Rutherford Health and

the former director of the cancer programme at the WHO, said:

“This is a very serious crisis and with the return of Covid-19

restrictions in most parts of the country, the situation for breast

cancer care could become dire.

“We are witnessing the consequences of Covid-19 restrictions from

earlier in the year in the form of late stage cancers.

Our Rutherford Cancer Centre network has experienced a sharp

increase in the number of enquiries from breast cancer patients, and

a significant number of them appear to be late stage cancers.

“As we grapple with a second wave of Covid-19 transmission and

another lockdown in England, the NHS potentially faces the agonising

prospect of having to reduce cancer services once more, either to

make capacity for Covid-19 ill patients or to reduce the risk of cross

infection.

It is vital that we do not allow this to happen under any

circumstances.

“Cancer care services should not only be functioning as they were

pre-Covid, but should be expanded so that we can reduce the backlog

we have already accumulated.

Thousands of patients may be at risk due to the current backlog and a

repeat of this would be disastrous for cancer patients.

It appears that breast cancer patients are already being

disproportionately impacted by this.

As the second most common cancer in the UK, we cannot allow breast

cancer to become the forgotten casualty of this pandemic.”


Vygon signs exclusive agreement with Medovate to

distribute regional anaesthesia device

SAFIRA® device transforms Peripheral Nerve Blockade into one-person procedure, produced in conjunction with UK NHS clinicians

Vygon Group, a group specializing in single-use medical devices, and Medovate, a dynamic medical device company dedicated to the development

and commercialisation of innovative medical technologies, today announce that they have signed an exclusive deal to distribute SAFIRA® (SAFer

Injection for Regional Anaesthesia) across 60 countries. Vygon will start a phased launch of SAFIRA in Europe at the end of 2020, with other global

markets to follow.

Developed in collaboration with UK National Health Service (NHS) clinicians, SAFIRA transforms the technique of Peripheral Nerve Blockade into

a one-person procedure, giving the anaesthetist full control of the injection at all times. This pioneering technology also improves patient safety

by helping reduce the risk of nerve damage, as it prevents anaesthetic from being injected at high pressures. Furthermore, economic modelling

has shown SAFIRA has the potential to help generate significant time and cost savings in a medical setting.

Amid the current COVID-19 pandemic, the European Society for Regional Anaesthesia (ESRA) has recommended that regional anaesthesia be

considered whenever surgery is planned for a suspected or confirmed COVID-19 patient. Regional anaesthesia preserves respiratory function and

avoids aerosolization and the potential for transmission of COVID-19, compared to general anaesthesia. By making regional anaesthesia a oneperson

procedure SAFIRA helps hospitals meet these recent recommendations.

Vygon is one of the largest independent French medical device companies. It supplies more than 205 million products globally per year. A worldleader

in the regional anaesthesia arena, it is perfectly placed to ensure SAFIRA – which recently attained EU CE regulatory approval – achieves

its maximum reach and potential across Europe and beyond. Medovate is a medtech company that develops essential new technologies created

through its development pipeline of NHS innovations, with a focus on anaesthesia, airway, critical care and surgery.

“This agreement with Vygon marks a significant milestone in the launch of SAFIRA across Europe, the US and a number of other markets,” said

Stuart Thomson, Managing Director, Medovate. “This will help establish Medovate on the world stage as a recognized medical device developer

and manufacturer. In addition, it raises the international profile of the UK NHS and its clinicians, who are key stakeholders in Medovate and

inventors of the SAFIRA innovation.”

“This is a very exciting partnership for Vygon,” said John Kerridge, Vice President, Anaesthesia & Emergency Business Unit, Vygon. “The SAFIRA

technology, in terms of its impact on patient safety and clinical end-user efficiency, is in-line with our overall objective of patient/practitionerbased

healthcare solutions.

The fact that in the very near future the SAFIRA technology will be

available in NRFit format further supports this objective. It will enable

us to offer a complete NRFit solution for those markets that demand it.”

NRFit (trademark of GEDSA) devices provide dedicated connectors,

compliant with ISO 80369-6. NRFit connectors aim to reduce the risk

of wrong route administration of medications associated with regional

anaesthesia procedures.

It is estimated that ten million regional anaesthesia procedures are

performed across Europe every year. As the use of regional anaesthesia

continues to grow steadily across Europe, SAFIRA has the potential to

make a significant impact.

Further information:

www.medovate.co.uk

www.vygon.com


We are pleased to accept

clinical articles for publication

within the pages of

The Operating Theatre Journal

Please send for the attention of the

Editor at:

admin@lawrand.com


A new technique could make more livers

available for transplant

2020doi: 10.3310/alert_41703

Demand for liver transplants is so high that many people on the waiting

list die before they can receive a transplant. But surgeons are rejecting

increasing numbers of donated livers because they are not satisfied

with the quality. New research could address this problem and make

more livers available for transplant.

Current practice is for most organs to be stored in ice after being

removed from donor patients. But organs can deteriorate in ice or be

judged to be unsuitable for transplant.

Researchers studied a technique called Normothermic Machine

Perfusion (NMP). It keeps blood flowing through the liver while it is

outside the body. The liver is preserved in a near real-life condition

while it is assessed for transplant.

The new trial, called VITTAL, showed that many livers which had been

rejected by surgeons could be transplanted successfully into patients.

This is a step forward in making more livers available for transplantation.

What’s the issue?

In recent years, more livers are becoming available for transplantation,

but they are increasingly from older, more obese, donors. That means

the livers are of lower quality and many are rejected by surgeons.

In 2016-17, 240 patients (19%) waiting for liver transplants in the UK

either died or were removed from the waiting list.

Liver donations increased markedly between 2008 and 2018. At the

same time, the proportion of livers that were rejected almost doubled.

Surgeons are concerned about offering lower quality livers to sicker

patients. But these decisions are often based on opinion, not hard fact.

The quality of livers stored in ice can deteriorate between removal

from a donor and transplant into the recipient. The NMP technique

mimics real life. The donor liver receives oxygenated blood and other

nutrients while outside the body. Its condition is preserved and may

even improve.

The VITTAL trial looked at livers classed as unsuitable for transplantation

by surgeons. It assessed whether the NMP technique could revive livers

so they could be offered to patients.

What’s new?

The VITTAL trial was the first to investigate and evaluate NMP for donor

livers that were initially discarded. It found that the technique could

salvage some of the livers that are currently discarded.

The study has already made a difference. The research team is now

using NMP as a clinical tool to assess livers. They are now transplanting

some livers that they would previously have thrown away. This means

more livers are available to patients. Other UK liver transplant centres

are considering a similar move.

What’s next?

During the VITTAL study, livers were only offered to the least sick

patients who were most likely to respond well. Another study is

underway to assess the use of these “rescued” livers on other patients.

The study will include patients on the waiting list who are more

unwell, or who are waiting for a second transplant and have limited

life expectancy.

Further work is needed to look for markers in blood and perfusion

samples which could help predict the outcome of liver transplants using

NMP.

All seven UK liver transplant centres have the technology to use

this technique. The researchers hope that the trial will help build

the experience and confidence to use livers previously regarded as

unsuitable for transplant.

You may be interested to read

The full paper: Mirza DF, and others. Transplantation of discarded

livers following viability testing with normothermic machine perfusion.

Nature Communications, 2020;11:2939

Nasralla D, and others. A randomized trial of normothermic preservation

in liver transplantation. Nature, 2018;557;50–56

Porte R, and others. Pretransplant sequential hypo‐ and normothermic

machine perfusion of suboptimal livers donated after circulatory death

using a hemoglobin‐based oxygen carrier perfusion solution. Am J

Transplant, 2019;19(4);1202–1211.

Clavien P-A, and others. Recommendations for liver transplantation

for hepatocellular carcinoma: an international consensus conference

report. Lancet Oncol, 2012; 13(1); e11–e22.

Funding

This study was funded by the Wellcome Trust and Cancer Research UK.

It was supported by the NIHR Birmingham Biomedical Research Centre

at the University Hospitals Birmingham NHS Foundation Trust and the

University of Birmingham.

Source: NIHR

Between November 2016 and February 2018, livers dismissed by surgeons

as unusable were assessed. They were transplanted into patients who

had been counselled about the high-risk nature of this trial.

During the trial, 185 livers were discarded by surgeons across the UK

and offered to the study. Of these, 31 were re-examined and 22 were

transplanted into patients.

The study found that:

• all patients were alive when followed up one year or more later,

though some had developed complications

• by day 542, four patients needed another liver transplant for problems

related to the bile duct.

Why is this important?

Keeping livers in a near real-life situation, rather than in ice, may give

a better indication of whether they will be successfully transplanted.

If they are working well on NMP, they may be more likely to work well

in a patient.

Using some of the livers which are currently discarded would add

significantly to the number of livers suitable for transplant in the UK.

This would help reduce the numbers of patients dying while on the

waiting list.

Interventional Approaches for Cancer Related

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Pain Two-day Virtual Conference

10th – 11th December 2020

Cost:

Day 1 & Day 2 Sessions £120 per delegate

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For further information and to book your place please visit:

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Get in touch:

Conferenceteam@rmh.nhs.uk or Telephone: 020 7808 2921

The Royal Marsden Education and Conference Centre

Stewart’s Grove, London, SW3 6JJ


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Olympus Launches ENDO-AID, an AI-

Powered Platform for Its Endoscopy System

Setting the foundation for a new era of endoscopy

Hamburg / Tokyo, October 9, 2020 Olympus Corporation (Director,

Representative Executive Officer, President and CEO: Yasuo Takeuchi)

today announced the launch of ENDO-AID *1 , a cutting-edge platform

powered by artificial intelligence (AI) that includes the endoscopy

application ENDO-AID CADe (computer-aided detection) for the colon.

This new AI platform enables real-time display of automatically detected

suspicious lesions and works in combination with Olympus’recently

introduced EVIS X1, its most advanced endoscopy system to date.

As a global leader in designing and delivering innovative solutions

for medical and surgical procedures, Olympus aims to improve the

health and quality of life of patients by providing advanced medical

technologies. Its latest endoscopy system, EVIS X1, was developed to

set new standards for image detection, characterization, staging, and

treatment. With the newly introduced endoscopy CAD (computer-aided

detection/diagnosis) platform ENDO-AID, Olympus is now enhancing the

capabilities of EVIS X1 through AI technology, aiming to elevate the

standard of endoscopy around the world – whether for applications to

disorders of the esophagus, stomach, colon or other gastrointestinal

organs.

ENDO-AID CADe: real-time computer-aided detection for endoscopy

“With the launch of ENDO-AID, we are not only providing endoscopists

across the world with an additional innovative tool,”says Takaharu

Yamada, Vice President, GI Endoscopy Business Leader, Endoscopic

Solutions Division. “We are also preparing for the future and following

our vision of putting CRC in the history books.”

Official launch at United European Gastroenterology Week (UEGW)

During the virtual UEGW from October

11 to 13, ENDO-AID will be presented to

the public for the first time. ENDO-AID is

initially and commercially being launched

in Europe beginning in November,

followed shortly afterwards by some

Middle Eastern, African and Asian-Pacific

countries. Japan, the Americas and China

markets will follow at a later time after

complying with laws and regulations

in each region. EVIS X1 and ENDO-AID

are manufactured by Olympus Medical

Systems Corporation. The company and

product names specified in this release are

the trademarks or registered trademarks

of Olympus.

*1 Product Name: Endoscopy CAD system

ENDO-AID CADe is an application for computer-aided detection powered

by AI which runs on ENDO-AID. It uses a complex algorithm via a neural

network developed and trained by Olympus. With this new application,

the system’s sophisticated machine learning can alert the endoscopist

in real time when a suspected colonic lesion (such as a polyp, malignant

neoplasm or adenoma) appears on the screen.

ENDO-AID CADe was developed toward the following improvements:

• Improved observational performance in adenoma detection: By

providing visual support, ENDO-AID CADe aims to improve the

observational performance of the endoscopist’s adenoma detection.

• Support of the colonoscopy screening process: The system provides

visual support during screening, allowing the endoscopist to focus

on any abnormalities indicated by the software regardless of the

experience level of the endoscopist.

• Efficient endoscopy operation: Due to the simple and intuitive display

of lesions, ENDO-AID CADe has the potential to make endoscopy

easier and more efficient for the endoscopist by reducing the need

for excessive eye movements.

A first step towards the future of endoscopic diagnosis and therapy

With ENDO-AID, the latest feature of the EVIS X1 endoscopy system,

Olympus has created the basis and infrastructure for the installation of

future applications supported by AI.“At Olympus we are committed to

innovation and driving our research and development with passion,”says

Frank Drewalowski, Head of Endoscopic Solutions Division, Olympus

Corporation. “Especially in AI, we recognize the power of elevating

endoscopic imaging to uncharted levels. Considering ENDO-AID as a

first step, we are planning additional AI-powered applications for image

detection and characterization – not only for colonoscopy.”

Prevention of colorectal cancer remains our focus

There is a positive impact of an increase in adenoma detection rate

(ADR) on the prevention of colorectal cancer (CRC) *2 . Supporting

the identification of lesions, ENDO-AID CADe is designed to increase

ADR *3 . We are aiming to increase the quality of CRC screening and

its preventive efficacy against CRC. The prevention of CRC is a core

element of Olympus’ endeavors in medical endoscopy and beyond.

*2 Corley, D.A.; Jensen, C.D.; Marks, A.R.; et

al. Adenoma Detection Rate and Risk of

Colorectal Cancer and Death. N Engl J Med.

2014; 370: 1298-1306. Available at:

https://www.ncbi.nlm.nih.gov/pmc/articles/

PMC4036494/. Accessed in October 2020

*3 Compared to WLI (white light imaging) without CADe

ENDO-AID with EVIS X1

The 13th Royal Marsden Opioid, Cannabinoid

& Gabapentionoid Virtual Conference

Cost:

19th – 20th November 2020

Day 1 & Day 2 Sessions £120 per delegate

1 Session only: £60 per delegate

For further information and to book your place please visit:

www.royalmarsden.nhs.uk/studydays

Get in touch:

Conferenceteam@rmh.nhs.uk or Telephone: 020 7808 2921

The Royal Marsden Education and Conference Centre

Stewart’s Grove, London, SW3 6JJ

In case you missed it………..


Investigation into COVID-19 transmission in hospitals (HSIB)

http://bit.ly/OTJ3oFTf6U


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Innocoll Announces Commercial Launch of

XARACOLL® (bupivacaine HCI) implant,

A Non-opioid, Drug-device Treatment Option for Acute Postsurgical

Pain Relief for up to 24 Hours Following Open Inguinal Hernia Repair

in Adults

First-in-class, fully bioresorbable, collagen implant delivers postsurgical

pain relief directly to the surgical site

Innocoll Holdings Limited, a specialty pharmaceutical company and

portfolio business of Gurnet Point Capital, announced on the 29th

of October the commercial launch of XARACOLL® (bupivacaine HCI)

implant for acute postsurgical pain relief up to 24 hours in adults

following open inguinal hernia repair, a painful and commonly

performed surgery.1

Approved by the US Food and Drug Administration (FDA) in August 2020,

XARACOLL is a unique, non-injectable, drug-device combination in the

form of a fully bioresorbable collagen implant containing bupivacaine

hydrochloride. XARACOLL is placed directly into the surgical site during

surgery and, after placement, releases bupivacaine immediately and

over time.1,2

“XARACOLL has the potential to be a new standard of care as the first

and only drug-device combination product to provide local, non-opioid

pain relief to adults following open inguinal hernia repair,” said Innocoll

CEO Rich Fante. “XARACOLL provides long-lasting pain relief at the

surgical site where pain originates. We are excited to begin sharing

more information about this effective, well-tolerated treatment option

with surgeons immediately.”

XARACOLL will be launched through a partnership between Mallinckrodt

Pharmaceutical’s Acute Care Sales Team and Innocoll’s Hospital Sales

Team.

In two Phase III studies, XARACOLL met the primary endpoint

demonstrating statistically significant pain relief through 24 hours in

patients undergoing open inguinal hernia repair while also decreasing

the amount of opioids needed following surgery. Additionally, the

proportion of patients who did not receive opioid rescue analgesia

through 72 hours in the XARACOLL and placebo treatment groups was

Professor Helen Stokes-Lampard, Chair of the Royal College GPs, said:

36% and 22%, respectively, in Study 1, and 28% and 12%, respectively, in

“Sepsis is a huge worry for GPs as initial symptoms can be similar

Study 2. The most common adverse reactions in clinical trials (incidence

to other common illnesses, and the College is putting a lot of effort

≥2% and higher than placebo) included incision site swelling, dysgeusia,

into helping family doctors recognise potential sepsis and ensure that

headache, tremor, blurred vision, seroma, scrotal swelling, pyrexia,

patients rapidly receive appropriate assessment and treatment.

oral hypoesthesia, and post procedural discharge.1,3

“We Over have the next produced few weeks, a toolkit, XARACOLL in partnership will become with available NHS England, to order which for

brings next-day together delivery. existing The wholesale guidance, acquisition training cost materials of XARACOLL and patient is $234

information per surgery. to encourage us all to ‘think sepsis, talk sepsis and treat

sepsis’.

References

“We are pleased to be working with NHS England to raise awareness

1. Data on file. Innocoll Pharmaceuticals Limited.

and improve outcomes for patients. It really could save lives.”

2. Leiman D, Niebler G, Minkowitz H. Pharmacokinetics and safety

Anna of the Crossley, bupivacaine Professional collagen-matrix Lead for implant Acute, Emergency (INL-001) compared & Critical to

Care liquid at the bupivacaine RCN, said: “Sepsis infiltration is a after life-threatening open inguinal condition hernia and repair. early

identication Poster presented is the key at: World to survival, Congress but on it can Regional be difcult Anesthesia to diagnose & Pain

and Medicine; often symptoms April 19-21, can be 2018; mistaken New York, for a NY. u-like Accessed illness. July This 30, is 2020. why

raising https://epostersonline.com/ASRAWORLD18/node/1154

awareness among carers, health care professionals and the

public is so vital. Even though there has been good progress to improve

diagnosis, 3. Velanovich a cohesive V, Rider national P, Deck plan is K, needed et al. to Safety ensure and that efficacy healthcare of

professionals bupivacaine are HCl supported collagen-matrix and equipped implant to (INL-001) identify in and open treat inguinal sepsis

early. hernia repair: results from two randomized controlled trials. Adv

Ther. 2019;36:200-216.

“If sepsis is not recognised quickly, it can lead to shock, multiple organ

About XARACOLL

failure and death, which is why early detection is critical to start

treatment XARACOLL within is a bioresorbable the hour. Nurses collagen and implant health care providing support postsurgical workers,

who pain relief see their through patients the delivery on a of regular bupivacaine, basis, and a local are anesthetic, often at rst the

healthcare surgical site. worker XARACOLL to see implant them, are releases well placed bupivacaine to recognise after placement the signs

of at the sepsis surgical early site and through raise the diffusion alarm. If from a person the porous has signs collagen or symptoms implant,

that which indicate dissolves possible over time. infection, XARACOLL think was ‘could approved this be in sepsis?’ August and 2020 act by

fast the US to raise Food the and alarm, Drug Administration wherever you are. (FDA). XARACOLL is a registered

trademark of Innocoll Pharmaceuticals Limited.

https://www.england.nhs.uk/wp-content/uploads/2015/08/Sepsis-

Action-Plan-23.12.15-v1.pdf

Further reading: https://www.innocoll.com

twitter.com/OTJOnline

Royal Free surgeon says ‘hospital came

together’ to keep vital operations going,

ahead of BBC documentary return

“We wanted to make sure services were robust enough to withstand

a second spike.”

Royal Free Hospital surgeon Daren Francis told Ham & High how the

“whole hospital” has come together to ensure rising Covid-19 cases

wouldn’t derail important treatment for other patients.

Dr Daren Francis prepares for surgery at the Royal Free in the first new

episode of the BBC’s Hospital. Picture: Ryan McNamara / BBC / Label 1

The 50-year-old features in the new series of the BBC’s Hospital

documentary programme – filmed at the Royal Free and its sister

hospital in Barnet.

He is a senior colorectal surgeon and in the first episode he is seen

performing a complicated double procedure on patient with cancer.

The surgery took place just as hospital staff were working out how

best to bring procedures back to the hospital. During the height of

the pandemic, private hospitals like the Princess Grace in Marylebone

offered theatre space to the NHS to help keep Covid patients separate

from other urgent cases who needed surgery.

Even with this help, Daren said doctors and nurses found they had to

carefully consider how to prioritise surgery.

He said: “When Covid-19 came along we had a few issues to deal with.

The whole team came together, all across the hospital - everyone

across management, nursing staff, ITU staff - came together to think

how we were going to cover coronavirus, and how we were going to

keep covering emergency work, too.

“Emergency work doesn’t stop coming in because of Covid. People still

suffer things like acute appendicitis,”

The consultant surgeon added: “We looked at all of our patients waiting

for surgery and risk assessed them into those who we felt a delay would

cause a negative outcome with their treatment.”

As the summer ended, the NHS deal with private hospitals ended and

surgery was “repatriated” to the Royal Free – where services were

redesigned to be as robust as possible.

“We have always got to think of the patient first and foremost,” Daren

said. “It’s not just about the surgery in the operating theatre. It’s about

the consultation and all the time they spend in hospital.

“We wanted to make sure it was a service robust enough to cope with a

second spike. We were suspicious there might be a second spike, and as

this starts to come about, we are seeing the fruits of our hard labour.”

The first new episode of Hospital aired at 9pm on November 9 on BBC1.

Source: Ham & High Sam Volpe

wrand.com Issue 316 January 2017 7


Nexxis digital OR

enriched with flexible

support of 3D imaging

Hospitals with Nexxis OR-over-IP now have access

to high-quality 3D imaging for their interventional

surgeries. Barco, global leader in visualization

technology, has enhanced Nexxis to show and

share 3D images in the operation room. A new 3D

surgical display can be integrated into new and

existing Nexxis configurations.

Why 3D in the OR?

Complex, minimally invasive surgical

interventions will typically benefit from 3D

imaging and visualization. Minimally invasive

surgeries today are mainly performed with a 2D

endoscopic camera, leaving the surgeon with

limited immediate depth perception. 3D imaging

solves this issue.

Given that surgical teams rely on the camera,

the display(s) and the real-time quality of the

video stream, it is critical that the same video

performance capabilities guaranteed in a Nexxis

installation, are maintained when integrating a

3D display in the system.

Maximum usability and flexibility

With the Nexxis 1.17 update, all new and existing

Nexxis configurations are upgraded to support

3D imaging. Up to today, 3D sources could not

be integrated into digital ORs. Nexxis 1.17 solves

this in a flexible way: 3D sources come with all

possibilities traditionally available for 2D sources,

so the OR staff can use them the same way as

they are used to. For example, they share their

images between ORs, and they can also be

streamed or recorded.

Nexxis also automatically switches between 2D

and 3D modes, adapting images to the capabilities

of each display in the operating room. As such,

the OR staff has the best suitable formats at their

disposal.

Easy connectivity with new surgical 3D display

Alongside the update, Barco also releases a new

3D and 4K surgical display, which hospitals can

effortlessly connect with their Nexxis integration

thanks to a built-in decoder.

The MDSC-8232 M3D display is not restricted to

3D endoscopic interventions alone, as it can also

show 2D images in excellent quality. When used in

3D mode, the surgical team can work with a large

viewing area and comfortable depth perception.

The display offers high color accuracy, detailed

images thanks to its 4K resolution, and near-zero

latency for optimal hand-eye coordination.

Davide Nocentini, VP Surgical Imaging at Barco,

comments: “3D technology has been around for

a while now, but never really entered the OR at

full speed, due to limitations mainly related to

the image quality and comfort for the surgeons.

With our latest release, we aim to overcome

those challenges and ensure a more immersive

experience for the surgeons and the clinical staff,

during surgery and interventional cardiology

procedures. Releasing this 3D package is another

step we are taking to improve patient outcomes

and efficiency in the operating room.”

Upgrading to Nexxis 1.17 to support 3D happens

as any other software update.

For more information, visit us on www.barco.com

Follow us on Twitter (@Barco), LinkedIn (Barco),

YouTube (BarcoTV), or like us on Facebook

(Barco).

Healthtech startup aims to revolutionise patient

NHS waiting lists and operating theatre use

The software product is the work of a consultant anaesthetist and already

has a six figure investment

A Scottish healthtech startup is aiming to revolutionise the way patient waiting lists are

managed and improve the utilisation of operating theatre capacity in the NHS.

Founded by consultant anaesthetist Dr Matthew Freer last September, Infix is starting a trial a

with one of Scotland’s largest health boards NHS Lanarkshire.

His aim was to, in his words, “develop an intuitive software product that enables NHS staff to

improve efficiencies in patient pathways”.

Data from Audit Scotland for 2018/2019 revealed that only 72% of patient operations were

completed within 12 weeks compared with the national target of 100%.

With the onset of Covid-19 and the increased demand on NHS resources, the 2020/2021 figures

are expected to drop significantly.

Dr Freer said: “Inconsistent manual processes being used in scheduling are a key factor in our

under-utilised operating theatres.

“Not only will Infix be able to improve theatre capacity but the patient database tool will

allow us to prioritise cancer and other urgent patients.

“It is vitally important to improve patient outcomes in our current climate.”

Infix has developed a cloud-based patient database tool optimised to tackle waiting list

backlogs that have been exacerbated by Covid-19, and the company recently secured more

than £300,000 from private investors and Innovate UK grant funding to develop its product in a

clinical environment.

Freer, who is Infix’s CEO, said: “The trial with NHS Lanarkshire enables us to demonstrate the

efficacy of Infix, before rolling the product out across other health boards in Scotland.

“The progress we’re making on the product roadmap front has also led to engagement with

NHS health authorities in England and other health organisations outside the UK.

“Our primary focus at the moment is NHS Lanarkshire and the other Scottish health boards but

we’ve also got an eye on UK and international expansion.”

Donald Wilson, director of information and digital at NHS Lanarkshire, said: “We are excited

to be working with Infix, who have developed an innovative digital service to improve the

management of waiting lists, theatre scheduling and utilisation.

“There is huge potential behind this to improve patient care.

Dr Matthew Freer and

Sorcha Lorimer, of Infix

Photo by Stewart Attwood

“With a secure cloud-based product, we have been able to move quickly and feel fortunate

to be working with Matthew and his team as they have a strong desire to improve patient

outcomes through digital innovation.”

Since its recent investment round, Infix has appointed Forrit founder and CEO Peter Proud and

Tracedata founder and CEO Sorcha Lorimer to its board.

Dr Freer said: “Getting Peter and Sorcha’s industry expertise on board is a big coup for us and

we look forward to them helping to guide us through our next phase of growth.”

Sorcha Lorimer said: “Matthew combines a strong passion for the NHS with an unwavering

dedication to the kind of digital transformation that will enable clinicians to work much more

efficiently and patients who will benefit the most from vastly improved productivity levels.

“Data and patient ethics are front and centre of Infix’s innovative approach and, with a

clinician-led team, the company is set to go from strength to strength.”

Source:Insider.co.uk


Discovering the many more pages available online @

Official opening of our new centre in Stourside Hospital

Ramsay Health Care UK’s new Stourside Hospital in Stourbridge was officially opened the end of October by Lord David

Prior, Chairman of NHS England.

The new £7.5 million state-ofthe-art,

day surgery hospital

building funded by assura

includes an operating theatre,

seven consulting rooms, six-day

case bays and a physiotherapy

suite. As part of building the

new hospital, antimicrobial

copper ironmongery has been

installed to aid prevention of

healthcare associated infections.

The hospital provides a range

of services including pain

management, urology, general

surgery and eye care for private,

insured and NHS patients within

the local community and further

afield. In addition, the hospital

has created 40 new jobs in the

local area in nursing, clinical and

administrative role.

Stourside Hospital will provide a

hub and spoke model to Ramsay’s

existing West Midlands Hospital

in Halesowen. The new facility

provides additional capacity

within the local healthcare

system, supporting the strong

partnership between West

Midlands Hospital and The Dudley

Group NHS Foundation Trust to

deliver joined up healthcare

services, and offering the primary

care network in Stourbridge

greater access to timely clinical

care for their patients. Our

investment forms part of this

work to help build additional

space and capacity in local health

systems.

The event was attended by a small

number of guests, and staff from

West Midlands Hospital were able

to attend virtually on a big screen

to see Lord Prior and Dr Andy

Jones, CEO, Ramsay Health Care

UK ‘cut the ribbon’ to officially

open the hospital.

Lisa Powell, Hospital Director

at West Midlands and Stourside

Hospitals said: “This modern-day

case facility enables us to build

and enhance on the fantastic

healthcare services already

being offered at West Midlands

Hospital. Stourside Hospital

is a great example of joint

partnership working with the

local NHS Trusts to improve the

healthcare services for the local

community.”

Dr Andy Jones, CEO, Ramsay

Health Care UK said: “I am

delighted to be opening this

superb state-of-the-art hospital

which will provide the local

community with access to first

class healthcare provided by top

consultants. This is the second

brand new day case facility that

Ramsay has built and opened this

year and is part of our ongoing

day case strategy. We hope the

local community are as proud

as we are of this superb facility

and the high-quality care it will

provide”

Paul Warwick, our Senior Project

Manager, said: “It’s been fantastic

to work with Ramsay to provide a

state-of-the-art day clinic which

will be vital in supporting West

Midlands Hospital and The Dudley

Group NHS Foundation Trust. The

facilities are second to none and

we’re excited to continue our

partnership with both Ramsay and

the trust.”

Source: assura


Digital health is on the rise due to COVID-19 and is in the spotlight at virtual.MEDICA

From apps to wearables, from robotics and AI to big data, start-ups are getting in on the action in the Internet of Medical Things

MEDICA in Düsseldorf is a world-leading platform for the medical technology business and the healthcare industry and has always been one of the

places to be for the entire sector as it covers current digital health trends, innovative products and services for linking all of the major stakeholders

in medical care. Consequently, digital health is a mainstay of virtual.MEDICA (https://virtual.MEDICA.de), which, due to the pandemic, will be

broadcasted online by MEDICA from 16 – 19 November. It will be in fully digital format with many exhibitors and themed highlights and will be

globally accessible.

It’s evident that the corona pandemic has given the digitalisation of the healthcare sector a huge boost. It’s now easier for doctors to offer

patients video appointments, and restriction regulations relating to case numbers and service provision have been lifted here. Providers of digital

healthcare solutions reacted quickly by putting out a multitude of test offers for relevant software tools, many of which were free. Start-ups

position themselves as a creative partner in developing digital solutions for the medical technology industry. Using remote health applications,

big data analyses or artificial intelligence (AI) in the medical sector is considered to have high potential and all of these specialisms are under the

spotlight in the virtual.MEDICA programme, for example in the English sessions in the Conference Area at the MEDICA CONNECTED HEALTHCARE

FORUM and the MEDICA HEALTH IT FORUM.

The MEDICA CONNECTED HEALTHCARE FORUM kicks off with a bang on its launch day (16.11.) with the finale of the 12th Healthcare Innovation

World Cup. The top 12 start-ups for the Internet of Medical Things will be presented here from 2 pm. PKvitality from France will be one of the

participants. They have developed a watch that enables users to discreetly monitor their blood sugar levels. A trend indicator and graph displays

help the wearer to improve their control of their blood sugar.

This forum offers another exciting pitch format with the 9th MEDICA Start-up COMPETITION (17.11. from 2 pm) and healthcare innovations in

health apps, diagnostics, robotics and even AI from the start-up scene. Among the numerous remarkable COMPETITION applications, Mediquo from

Spain deserves a special mention. They are presenting a professional tool for enhancing communication between doctors and patients. Another

competitor, GenuSport, have gameified knee rehabilitation. These companies will be competing in the health app segment. In the diagnostics

sector, Higo from Poland offers tools that can be used to examine children at home and then send the data to the doctor for a diagnosis. Artificial

intelligence is being used by Evercot AI from Germany, among others, in order to capture brain changes, strokes, Alzheimer’s disease, glioma and

Parkinson’s disease remotely. H Robotics from Korea has developed a device in the robotics segment that can be used for wrist, elbow, ankle and

knee exercises to assure rehabilitation at home.

COVID-19 – Redefining Connected Health

Prof. Dirk Brockmann of the Humboldt-Universität in Berlin will appear in the “COVID19 – Redefining Connected Health” section, held from 2 pm on

Wednesday 18. November within the Conference Area at virtual.MEDICA. He initiated the Corona data sharing app from the Robert Koch Institute,

which is also being discussed in the virtual sessions of the MEDICA MEDICINE + SPORTS CONFERENCE 2020. Once it has been voluntarily enabled,

the data sharing app collects data from wearables such as fitness bracelets and is intended to help the Robert Koch Institute estimate the spread

of infection. This has enabled scientists to better assess the current epidemiological situation and use it as an early warning system. In the same

session on Wednesday, solutions for measuring temperature will be presented by Dr. Holger Hendrichs from greenTEG. Core body temperature

is an important vital parameter in determining a person’s state of health. greenTEG offers a unique core body temperature measuring sensor for

continuous non-invasive measurement. It can, for example, be used for monitoring purposes when integrated into a wearable for people who need

additional care or even, with regard to COVID-19, implemented as a type of early warning system for company employees.

Clinically validated wearables can be used to capture a wide variety of cardiorespiratory signals, such as respiratory volume and frequency, blood

oxygen saturation, heart rate, lung sounds and core body temperature. These wearables can thus help doctors to care for patients remotely and

form diagnoses, whether it be for sleep apnoea, pulmonary hypertension or severe acute respiratory syndrome. Dave Hughes of Novosound will

give a lecture on a relevant solution which involves wearable ultrasound sensors that is used in pulmonary diagnoses and recovery management.

Digital applications for all

The excitement continues right through to the closing day (19.11) with start-ups and their innovations at the MEDICA CONNECTED HEALTHCARE

FORUM. On this date, numerous developer teams will present their innovations under the MEDICA DISRUPT label. In one session (held from 3:40

pm), Laszlo Bax from Braingaze will explain how digital biomarkers enable early detection of cognitive impairments. The extent to which AI is

capable of detecting brain disease early will be described by Roland Amba Assam of Evercot AI.

It’s becoming clearer and clearer that digital health applications open up a wide variety of options in terms of prevention, diagnosis and therapy,

and are not only advantageous for the treating doctor but also benefit to patients as hand-held digital helpers. The German Federal Institute for

Drugs and Medical Devices (BfArM) is also backing digital healthcare applications. With the Digital Healthcare Act (DVG) and the Digital Health

Applications Ordinance (DiGAV), the legislating body has laid the foundations for making apps available to the 73 million members of the statutory

health insurance bodies available quickly - and this project has also raised the hopes of many start-ups. The President of BfArM, Prof. Karl Broich,

gives an overview of the current status and acceptance of medical applications and even dares to state his predictions for them from 4 pm on

Wednesday 18 November. The DiGA App Store, which is already available, acts as a digital healthcare application directory. Dr. Benedikt Zacher

of Munich, who co-founded this directory, will explain the significance of this special app store.

Start-ups and the backers behind them

As one of the first digital healthcare investors, Flying Health states that it invested in digital healthcare in 2012 and brought the first app on

prescription onto the market in 2014. Currently, Flying Health participates in the heal capital venture capital fund. The German Association

of Private Health Insurers (PKV - Verband der Privaten Krankenversicherungen) thus promotes start-ups and their innovative digital healthcare

products. Lina Behrens, the Managing Director of Flying Health, will chair the “From treatment to prevention” session on Monday 16 November

from 10 am at the MEDICA HEALTH IT FORUM. One of the start-ups supported here is HelloBetter. They develop and market online training courses

that promote mental wellbeing.


Their portfolio comprises a range of online offers to help deal with stress, depression and anxiety disorders and additional special programmes

for patients who experience these symptoms in conjunction with a chronic disease such as diabetes and preventive training sessions, which are

also appropriate for the corona pandemic. One specific HelloBetter course is intended to support users in reinforcing their own mental health. Dr.

Hanne Horvath, a Co-Founder of HelloBetter, Dennis Hermann from Kaia Health and Benjamin Westerhoff of the Barmer health insurance group

will all appear in this session held within the scope of the MEDICA HEALTH IT FORUM.

Combating the virus with data donations

Being fasterthancorona.org is the objective of the website that Dr. med. Tobias Gantner founded and operates with a pan-European team. The

founder and CEO of HealthCare Futurists GmbH, which holds its head offices in Cologne, will chair the “Sharing is caring - Data Sharing & Data

Donations” session on Tuesday 17 November from 10 am. As with the data sharing app from RKI, this project also wants to collect altruistic data

donations but without a direct link to wearables. Instead, they use clear medical hypotheses. “Ultimate success, for us, would be gaining more

knowledge on COVID-19 due to our initiative”. The potential hypotheses could be: “Are there medications that protect specific groups of people”,

or “ Who is really at high-risk, and in what situation?”. The web app creates course records for the data donators via an anonymised survey. The

evidence of the data does not reach the standards set for randomised, placebo-controlled clinical studies, but the total quantity of data generated

(big data) does support the notion that the data is useful for finding rudimentary patterns that indicate correlations and, in ideal scenarios, even

causation. The AI implemented here is thus not used for therapeutic decisions. Instead, it is used for pattern recognition. The aim is to define

computer-generated biomarkers using the evaluation of the data collected. Arthritic patients that are treated with chloroquine could be an

interesting group in which to research the course of COVID-19. The data are not just analysed by the group themselves here. The information is

completely anonymised and sent to other researchers, institutes and individuals upon request, after an external check of the scientific hypothesis

has been carried out. “We wanted to expand the toolbox for epidemiology a bit,” states Dr. Gantner.

The entire programme for virtual.MEDICA 2020 (16 - 19 November), which hosts one German and one English stream every day in the Conference

area, can be called up online from the middle of October. Online visitors can register to participate for free now at: https://virtual.MEDICA.de.

The ventilation technology from Getinge that is

groundbreaking both for premature babies and adults

Born 12 weeks too early with a 50/50 chance at survival, Sabina Checketts has grown up to become a neonatal doctor herself, using new therapies

and sophisticated technology to improve outcomes for premature babies. One such technique called NAVA, invented by Getinge, utilizes sensors

to help babies on ventilators breathe more easily and naturally—and it’s increasingly being used on adults. And a new randomised study shows that

NAVA can significantly shorten the time on the ventilator.

Thirty-three years after her early birth, Sabina now works as a neonatal doctor in London. The ventilator that helped Sabina survive was a far cry

from what she sees today when she treats premature babies. “We’ve gone from a mode of ventilation where you were breathing for the baby to

one now where we can breathe with the baby as well,” she says.

Watch the mini-documentary about the NAVA technology, also featuring Sabina Checketts - http://bit.ly/OTJ3kLjMNO

As vulnerable premature babies fight to stay alive one of the most critical issues is something most people never think twice about - breathing. A

pivotal advance in neonatal medicine - and one that has a major impact in adult critical care - has been the development of better ventilators.

One ventilation technique that breathes with the patient is called Neurally Adjusted Ventilatory Assist (http://bit.ly/OTJ2HSzHLC), or NAVA,

developed by Getinge, a global leader in intensive care technology for both infants and adults.

In most intensive care units 20% of patients consume 80% of ventilation resources, which may lead to increased complications and unwanted

outcomes.1 NAVA, is also approved for adults, and the features that make the technique successful for neonates, translates well to adult patients.

“NAVA is a way to do a little better job,” says Sherry Courtney, a director of clinical research in neonatology, who has worked with premature

babies since the 1980s. “The diaphragm is a muscle. When it contracts, we’re going to breathe. When it relaxes, we’re going to exhale. So, NAVA

senses the breathing using a catheter that goes down into the stomach and rests close to the diaphragm.”

Electrodes on the catheter sense contractions in the diaphragm, resulting in an almost instantaneous signal that the patient wants to breathe.

Synchronously, the ventilator supplies air. And when the electrodes sense the end of diaphragmatic contractions, the ventilator allows exhalation.

“NAVA just provides a little support, depending on the breath. The patient can be breathing as the patient wishes,” says Sherry Courtney.

Adults on ventilators generally start with a functioning diaphragm, but it will quickly become weaker if a machine breathes for them for too long.

Getinge Medical Director Miray Kärnekull says that advanced ventilator technologies like NAVA are used regularly in adult patients in Europe to

keep patients’ diaphragm muscles active.

And in a very recent multicenter randomised controlled trial, results showed that patients with acute respiratory failure on NAVA spent significantly

less time on the ventilator and experienced less extubation failure compared to conventional lung-protective mechanical ventilation.

Read more about the new independent study on the effects of NAVA - http://bit.ly/OTJ34Jc3ul

“In addition to helping maintain the diaphragm’s tone, the synchrony of a NAVA ventilator means patients don’t fight against the ventilator,” Miray

Kärnekull continues. “To prevent that, adults usually need to be sedated. With NAVA, doctors can reduce sedatives, allowing for earlier weaning

with fewer complications.”

“It’s really a groundbreaking technology”, says Miray. “NAVA gives the clinician a way to personalise not only the ventilation, but also the weaning

process for adult patients. “

These exciting advances have allowed physicians like Sabina Checketts to celebrate even more success stories. Sabina decided to become a doctor

at an early age, when her mother routinely pointed out a man walking down the street on his way to the hospital and said, “That’s the doctor who

saved your life”. That experience motivates her to be a positive force in the families of the babies she treats.

“When I talk to parents about the fact that I was premature, there’s always a sense of surprise, I think a little bit even shock, you know. Oh, oh,

and you’re a doctor,” Sabina says. “I think it’s a nice way to say to them that prematurity shouldn’t be a limit on what a child can do.”

“I mean, the advances we’ve made in even just the last 10, 15, 20 years mean the outcomes are much better than they used to be. And seeing

me, who developed before that, as a newborn doctor, I give them a sense of hope and possibility, I think.”

Read more about the NAVA technology http://bit.ly/OTJ3kLjMNO

1. Icuregswe.org. (2016). Start - SIR-Svenska Intensivvardsregistret. Available at: http://www.icuregswe.org/en/ [Accessed Dec 2. 2015].


Bassetlaw hospital worker recognised

for Covid-19 documentary photos

A Worksop hospital worker has won an international photography competition for her work documenting Bassetlaw Hospital’s

intensive therapy unit during the pandemic.

Operating Department Practitioner Jules Hunter spent ten weeks

photographing colleagues on the ward as it was flooded with Cov-19

admissions earlier this year.

Jules, 65, told how she was compelled to chronicle the extraordinary

time with her camera as she noted ‘each detail of how the team came

together in order to save lives’ - paying homage to colleagues at the

hospital.

Mum-of-two Jules, who has worked at Bassetlaw Hospital for eight

years, described how she had to isolate from her family ‘only to go to

work’ for the three months - coming home from each shift ‘exhausted

and lonely’.

She said: “I had to speak with my family as I knew I couldn’t be with

them or my partner due to the unknown risks of taking the virus home.

“I put my estate in order, paid off my mortgage with the savings I had

and informed my family of my wishes if anything should happen to me.”

Jules’ collection of pictures show what it was like on the ITU during

the pandemic - as health workers spent entire shifts behind personal

protective equipment.

One poignant shot shows a worker being fitted with a large hood with

her hands folded anxiously between her legs.

Another captures a nurse with her hand on a door window inside the

ITU - where no-one could enter without being fully encased in the

protective gear.

Jules told how while working on the unit workers often communicated

with walkie talkies so they could be heard through face masks - with

one shown in a photo next to some pens.

She said: “Each member of staff involved had to be fit-tested for masks

and outfits following Government and Nursing Council guidelines.

“My colleagues and I attended meetings, briefs, updates and intense

rapid training ensuring we were equipped with as much knowledge as

possible and we were scared.”

Grandmother-of-two Jules, who runs her own studio and has a First

degree in fine art photography has been awarded Bronze in the

Documentary category of the Rise International Photography Awards.

She said: “It’s great to be appreciated but I wanted to do this for the

patients and my colleagues.”

Source: worksopguardian - By Ben McVay

Photo by Jules Hunter



In case you missed it………..

Living with Covid19 - Redefining the research questions -

http://bit.ly/OTJ2HHXr5p


MMI SpA Launches Breakthrough Technology,

Advancing Robotic Microsurgery with the

World’s Smallest Wristed Surgical Instruments

First Procedures Performed with the Symani Surgical System

MMI SpA, an Italian company dedicated to improving clinical outcomes

for patients undergoing microsurgery, announced today the CE Mark,

launch and first human use of its Symani® Surgical System in Europe

for open microsurgical procedures. The first four robotic surgeries were

successfully performed in Florence, Italy, including three complex,

post-traumatic lower limb reconstructions as well as a post-oncological

reconstruction of the pharynx.

Addenbrooke’s first

in UK to deploy single

use scope

Cambridge University Hospitals NHS Foundation Trust (CUH) has

started using the world’s first disposable version of a medical

instrument that plays a vital role in diagnosing and treating diseases

of the small intestine.

“There is a clear demand for robotics in microsurgery as the limits

of the human hand have already been reached. We founded MMI to

develop a robotic system designed for and with microsurgeons that

will improve outcomes and address unmet patient needs, particularly

through supermicrosurgery techniques which are required for lymphatic

and other extremely delicate procedures. We are pleased to be at the

forefront of a new era in robotic surgery as we launch our Symani

System in Europe,” said Giuseppe Maria Prisco, co-founder and CEO of

MMI.

Dr Gareth Corbett (centre) with Laura Knowles and Ben Godfrey

from Boston Scientific

A duodenoscope is a hollow, flexible, lighted tube which passes

down the throat to allow doctors to see the top of the duodenum

and diagnose and treat diseases such as cancer or gallstones in the

pancreas and bile ducts. Until now, each instrument has had to be

sterilised or high level disinfected after use.

The EXALT Model D Single Use Duodenoscope benefited three

Addenbrooke’s patients for the first time last week and improved

at a stroke the already super-high infection control standards in the

endoscopy department.

The new scopes reduce the risk of bile duct infections, particularly for

patients with reduced immune systems. It helps in the ongoing fight

against hard-to-treat infections and has extra significance with the

arrival of COVID-19.

It is helpful to staff because they will be able to continue service

in the event of breakdowns of current endoscopes, or sterilising

equipment, ending delays in the therapeutic procedures for patients.

The Symani Surgical System combines the benefits of tremor

reduction and motion scaling (7-20x) with the world’s smallest

wristed instrumentation, offering seven degrees of freedom and

dexterity beyond the reach of human hands. The system’s NanoWrist®

instruments are designed to overcome the challenges of free-flap

reconstructions, replantations, congenital malformations, peripheral

nerve repairs and lymphatic surgery, which together represent over

one million procedures annually in the U.S. and Europe alone.

“Microsurgery and supermicrosurgery – as a tool, technique and

discipline – continue to evolve. The use of robotics holds great promise

to advance the specialty of microsurgery and improve care for patients

affected by trauma, cancer, congenital malformations and even chronic

conditions such as lymphedema,” commented L. Scott Levin, MD, FACS,

FAOA, Chair of the Department of Orthopaedic Surgery, Professor of

the Plastic Surgery Division at the University of Pennsylvania School of

Medicine.

“We are proud to bring this innovation to European patients and

look forward to enabling surgeons worldwide to address challenging

procedures on extremely small anatomy with increased precision,

reproducibility and efficiency,” said Hannah Teichmann, co-founder and

Vice President of Clinical Development of MMI.

The MMI system for robotic microsurgery is currently only commercially

available in the European Economic Area. www.mmimicro.com

CUH clinical director for digestive diseases and consultant

gastroenterologist, Dr Gareth Corbett, said: “This technology is

the first in a field change in endoscopy moving towards single use

instruments which are sterile packaged.

“As a centre that is a national and international leader in healthcare

treatments and technology, we are in a strong position to provide

evaluation and technical expertise to support the development of this

type of technology.

“We are delighted to be chosen to become the first Trust in the UK to

use and evaluate this particular instrument, which we think has great

benefits for our patients and our staff.”

The EXALT Model D, made by Boston Scientific, is the only CE Marked

single-use disposable duodenoscope. It was also granted Breakthrough

Device Designation from the American Food and Drug Administration.

Darragh Tolan, vice-president, Endoscopy at Boston Scientific said CUH

was first choice for the UK roll-out because of its standing as a worldleader

in the detection and treatment of biliary disease.

He added: “This is a great milestone for the UK and we are delighted

to work with the fantastic team at Addenbrooke’s to hold the

country’s very first case using EXALT Model D.

“At Boston Scientific, patients are at the heart of what we do and now

more than ever, we need to support healthcare providers such as the

NHS to provide the highest quality care.”

Source: BusinessWeekly


Neuromod Publishes Results of Large-Scale Tinnitus Clinical

Trial in Peer-Reviewed Top-Tier Scientific Journal

• Clinical trial concludes that bimodal

neuromodulation combining sound and electrical

stimulation of the tongue can significantly reduce

tinnitus symptoms, and therapeutic effects can be

sustained for up to 12 months post-treatment.

• 77.8% of participants said they would recommend

the Company’s Lenire® device to others with

tinnitus.

• 80.1% of treatment compliant participants

experienced continued improvement in tinnitus

symptom severity when evaluated 12-months posttreatment.

Neuromod Devices Limited (“Neuromod”), the Irish

medical device company specialising in the treatment

of chronic tinnitus, commonly described as ‘ringing in

the ears’, has published the results of the Company’s

TENT A1 (Treatment Evaluation of Neuromodulation

for Tinnitus) clinical trial in this week’s edition of

Science Translational Medicine in a paper titled:

‘Bimodal neuromodulation combining sound and

tongue stimulation reduces tinnitus symptoms in a

large randomized clinical study’.

The clinical trial was conducted between 2016 and

2019 and was designed to track changes in tinnitus

symptom severity. The trial investigated the bimodal

neuromodulation approach, using Neuromod’s noninvasive

stimulation device that delivers sound to the

ears and electrical stimulation to the tongue.

The study represents the largest and longest followedup

clinical trial ever conducted in the tinnitus field

with 326 enrolled participants, providing evidence

regarding the safety, efficacy and patient tolerability

of bimodal neuromodulation for the treatment of

tinnitus. 86.2% of treatment compliant participants

reported an improvement in tinnitus symptom

severity when evaluated after 12 weeks of treatment,

with many experiencing sustained benefit 12 months

post-treatment.

The study was conducted at the Wellcome Trust-HRB

Clinical Research Facility, St. James’s Hospital, Dublin,

Ireland and the Tinnituszentrum of the University

Regensburg, Germany. There were consistent

therapeutic outcomes across both clinical sites,

with no SAEs Serious Adverse Events (SAEs related

to the treatment and a high satisfaction rate across

a large cohort of participants. A Medical Research

Organization (NAMSA, Minneapolis, Minnesota,

USA) guided and assisted the close-out process of

Neuromod’s clinical trial.

The tinnitus treatment device, now branded as

Lenire®, which was used in the study was developed

by Neuromod and consists of wireless (Bluetooth®)

headphones that deliver sequences of audio tones

layered with wideband noise to both ears, combined

with electrical stimulation pulses delivered to 32

electrodes on the tip of the tongue by a proprietary

device trademarked as Tonguetip®. The timing,

intensity and delivery of the stimuli are controlled

by an easy to use handheld controller that each

participant is trained to use. Before using the

treatment for the first time, the device is configured

to the patient’s hearing profile and optimised to the

patient’s sensitivity level for tongue stimulation.

For the trial, participants were instructed to use the

Lenire® device for 60 minutes daily for 12 weeks. Out

of 326 enrolled participants, 83.7% used the device at

or above the minimum compliance level of 36 hours

over the 12-week treatment period. For the primary

endpoints, participants achieved a statistically and

clinically significant reduction in tinnitus symptom

severity.

When treatment was completed, participants returned their device and were assessed

at three follow-up visits up to 12 months. 66.5% of participants who filled out the exit

survey (n=272) affirmed they had benefited from using the device and 77.8% (n=270) said

they would recommend the treatment for other people with tinnitus.

Participants in the study were screened and selected based on a pre-defined list of

inclusion and exclusion criteria to ensure the trial had a wide distribution sample of

the tinnitus population. More information on the criteria can be found on https://www.

clinicaltrials.gov/ using the identifier NCT02669069 and the full paper can be accessed

here: https://www.neuromoddevices.com/tenta1results

Dr Ross O’Neill, Founding CEO of Neuromod commented: “We are delighted to announce

the publication of positive results from our TENT-A1 clinical trial, which has shown

significant improvements in tinnitus symptoms in patients using our unique Lenire®

device. There is a globally recognised clinical need for evidence-based treatments

for tinnitus, such as Lenire®, due to the lack of effective options for this debilitating

condition. Neuromod is proud to be at the cutting edge of efforts to research and develop

new solutions that can contribute to solving this chronic condition that affects 10-15% of

the population worldwide. We are committed to continuing our research in the field and

to advance our unique chronic tinnitus treatment technology”.

Hubert Lim, Chief Scientific Officer of Neuromod commented: “I am truly proud of our

Company’s ability to perform such a large-scale randomised clinical trial in two countries,

enrolling 326 participants to demonstrate the safety and efficacy of a new solution for

tinnitus. This study tracked the post-treatment therapeutic effects for 12 months, which

is a first for the tinnitus field in evaluating the long-term outcomes of a medical device

approach. The outcomes are very exciting and I look forward to continuing our work

to develop a bimodal neuromodulation treatment to help as many tinnitus sufferers as

possible.”

www.NeuromodDevices.com


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The Operating Theatre Journal November 2020

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