The tail-end of the webinar featured a Q&A session, where guests answered questions on a range of topics from hospital’s medical oxygen flows and telemedicine to PSA plants and lessons learned from the Covid-19 pandemic.
Referring to Leonardo Ferrari’s earlier mention of the risk of oxygen enriched atmospheres in rooms where Covid-19 patients were all treated with high medical oxygen flows, Cockerill asked what Ferrari would recommend to the hospital’s management in such cases.
Leonardo Ferrari revealed that the intensive care units (ICUs) where Covid-19 patients were being treated were not necessarily designed to renew ambient air so fast as to maintain the risk of high oxygen concentration under control.
“For this reason, the use of a continuous oxygen monitoring system is strongly recommended,” he said. “It would be even better if it could be directly connected with HVAC which, in turn could switch to a higher airflow with the activation of alarms, for example.”
With digitisation of industry proliferating, homecare could also be revolutionised. In terms of innovative services in the homecare industry, Leonardo Ferrari was asked to provide more details of the SOL Group’s involvement in the sector.
“It was very important to monitor the patients affected by Covid-19 at home and we also provided a telemedicine service to more than 400 patients in Lombardy,” he said.
“These patients were constantly monitored by a remote clinical centre where physicians took care of these patients, monitoring during their critical condition, retrieving data form medical devices and collecting information through digital questionnaires.”
Patients were then contacted remotely, according to the ‘strict follow-up’ protocols and – in the worst of cases – activated procedures for hospital admission.
Commenting on the role that pressure-swing adsorption (PSA) plants have played and how they’ve developed over the years, Leonardo Ferrari and Pinzi both emphasised the importance of the technology.
Referring to the structured nature of Europe’s supply chain, Leonardo Ferrari said, “If we speak about Covid itself, the PSA has very evident limitations.”
“What about those countries where there is nothing else available? The gas industry has been using PSA for different applications, but so far we never considered using PSA in the medical sectors for a variety of reasons.”
He added that – although SOL Group owns and operates PSA plants, it sticks to the industrial sectors as it is where the plant’s work best.
Discussing the use of PSA, Pinzi called its role ‘extremely important’ in specific conditions.
“I am not talking about the solution for domestic oxygen generation because, in that case, the situation is completely different,” he said. “The main infrastructures like hospitals natural depends on the country.”
“As Ferrari has said, in Europe, where the distribution organisation is extremely different, the capability of a PSA system is more important when taking into account the usage of cryogenic gases.”
He added that this is completely different in some situations present in foreign countries.
Giving an example, PSA systems may not be the ideal solution if the distance between the gas producer and the hospital is very far, although it could be regarded as the most efficient solution as transportation is relatively simple.
Praising the potential for PSA, he said, “PSA can be fabulous addition to the medical gases and gases supply chain system and particularly those in remote locations as a foreign technology. I think we’ve got some space for development.”
Leading on to lessons learned from the pandemic, Pemberton was asked how hospitals could reconsider the sizing of their medical gases’ equipment.
Referring to it as an ‘enormous task’, Pemberton stated that the requirements with Covid for oxygen therapy was significantly different. Instead of taking the average levels of two to 10 litres a minute, patients were using up to 60 litres a minute.
“That wasn’t all actually being consumed by the patient,” he added. “Some of that was due to inefficiencies in the way that ventilators work. This is another place that needs to be looked at as well.”
“If you go to resize these hospital areas to have every terminal unit requiring 60 litres a minute, the impact would be that an enormous cryogenic tank will be required, and that’s not the day-to-day requirements.”
Various factors have to be taken into consideration, such as the understanding of actually how to resize the hospitals themselves and how would that work in an emergency situation. Another factor is the efficiency of ventilators, can they be made more efficient in their gas usage?
“What about the general gas consumption? All of these questions, they need to be reconsidered in this post-pandemic era,” said Pemberton.
The final question was posed to the entire panel: what is the one ultimate lesson that has been learnt by you throughout this pandemic?
Pemberton revealed that his key takeaway was teamwork, saying, “Global teamwork. That’s the best thing that we all have learnt through the pandemic and the thing that we’ve taken most going forward as well.”
Along similar lines, Pinzi emphasised the benefits of working together, stating that teamwork between plant engineers have helped create the final devices in the supply chain to help realise customised solutions.
Acknowledging the importance of teamwork, Leonardo Ferrari revealed that his lesson learned surrounds the importance of the home care experience.
“Those home care providers used to deliver liquid and compressed oxygen at home were capable of reacting more effectively than others, improving and providing services to the patients,” he said.
“My lesson learnt is that providing a full range of technological solutions remains key.”
The full webinar, Medical Gases: A Picture of Health?, is available to watch on-demand here.