It would be rather difficult to find an outpatient wound care clinic without some type of gas-detection system. Unfortunately, many administrators believe the investment in such a system ends there. Many don’t take that extra step of having the system maintained for proper functioning on a regular basis.
That’s an oversight that can have potentially deadly repercussions for patients and staff members (which can be quite ironic for clinics that utilize hyperbaric chambers to provide treatments). To a degree, the aforementioned mindset is understandable. A gas-detection system is not a small investment. With the installation for a single unit averaging $1,000, adding a maintenance contract for a new or newer gas system might seem like a luxury. But the very nature of a wound center makes assuring that these units are functioning a must in order to provide care safely and appropriately.
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Consequences of Faulty Systems
There are generally three outcomes to a gas-detection system that isn’t working properly. The first is an odd smell in the air. Secondly, there could be an odd smell followed by somebody becoming ill to the point of losing consciousness. In the third scenario, which is also the scariest, there is never any odor detectable by smell and nobody becomes aware of the gas leak until, undetected, the released toxin results in one or more fatalities.
It doesn’t take much of a leak to have an impact. For example, if employees work an eight-hour shift in an environment with an unknown carbon monoxide (CO) leak at a concentration of 200 parts per million (PPM), they would begin to experience headaches in as little as 2-3 hours. The Table provides more information.
Difficult Detection Details
Complicating matters more is that everyone reacts differently to CO. Some people fall ill in a fairly short amount of time; for others, it may take longer. For patients, who are already clinically compromised, it doesn’t take overnight exposure for CO to be lethal. In fact, with a high enough CO concentration, waiting in an examination room or lounge for 10-15 minutes can place patients at serious health risk, including death.
Regrettably, many facility directors go by the mantra “if the gas-detection system doesn’t detect anything, then nothing is wrong.”
This logic only holds true when there’s 100% certainty the system is working. There’s no way to know whether or not a gas-detection system is working unless it’s tested with the appropriate gases safely. Most facilities aren’t likely to be storing these gasses readily in order to conduct such tests. When it comes to gas exposure, it may only take one incident to put lives in jeopardy and leave an organization vulnerable to tremendous liability.
The flipside to gas-detection equipment not detecting potential dangerous gases is a system that’s oversensitive and produces false alarms, which occurs in many facilities. While most of these ambient gases are harmless, it is not unusual for a miscalibrated or infrequent detection system to be set off by them. This can trigger a very costly chain of events including chaos in the immediate vicinity, emergency personnel dispatched to the scene, evacuation of patients and staff, etc.
A false alarm alone can cost thousands of dollars in lost business, lost staff hours, and the price of emergency personnel dispersed to the site — not to mention bad publicity and lost confidence of those present or made aware. There also always exists the possibility that emergency personnel could be brought away from a true emergency.
CO detection systems are recommended for any wound care clinic that uses fossil fuel sources such as oil, propane, and natural gas. It is more important to have a detector if the heating systems employ elbow-shaped pipes, which can be particularly dangerous when there’s a leak because the shape of the pipe will actually slow the flow of CO and create greater exposure.
Detection System Options
Choosing the type of system for one’s facility can vary based on the size of the building, the number of people in that building at a given time, etc. A maintenance plan should always be purchased as part of the system.
When comparing the cost of an annual maintenance plan — roughly $1,000 — with the thousands of dollars associated with a wrongful death or liability lawsuit, the investment becomes necessary. Yet, it’s a conservative estimate that the majority of buildings that house wound centers do not have an active maintenance program with testing conducted on a quarterly basis (the recommended maintenance schedule for gas detection equipment, according to many manufacturers). Safety management within the wound center should consider patients, staff, and visitors.
John V. Carvalho III is president of Apollo Safety Inc., a company that specializes in detection products and services for portable and stationary systems. For information, visit www.gasmonitorinstallation.com or call 800-813-5408.