The Operating Theatre Journal

For further information

01244 660 954wwwmelydmedicalcom

copy 2012 Allen Medical Systems Inc All Rights Reserved D-770675-A1

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June 2012 Issue No 261 ISSN 1747-728XThe Leading Independent Journal For ALL Operating Theatre Staff

nd out more 02921 680068 bull e-mail adminlawrandcom Issue 261 June 2012 3

The Next issue copy deadline Monday 25th June 2012All enquiries To the editorial team The OTJ Lawrand Ltd PO Box 51 Pontyclun CF72 9YY Tel 02921 680068 Email adminlawrandcom Website wwwlawrandcomThe Operating Theatre Journal is published twelve times per year Available in electronic format from the pages of wwwotjonlinecomand in hard copy to hospitals throughout the United Kingdom Personal copies are available by nominal subscriptionNeither 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 No part of this journal may be reproduced without prior permission from Lawrand Ltd copy 2012Journal Printers The Warwick Printing Co Ltd Caswell Road Leamington Spa Warwickshire CV31 1QD

Opioid Painkillers Try to Please their PatientsThe rapid growth of the elderly population worldwide is fuelling an escalation of age-related medical conditions such as cancer and arthritis boosting the need for opioids and pain management drugs However needs are still not being met by the healthcare industry according to a new report by medical intelligence experts GBI Research

The new report indicates that the pain therapy market is growing despite patent expiries generic substitutions and concerns over addiction Pain is a widespread problem considerably affecting day to day life with over 25 of the global population suffering from some form of clinically signi cant pain every year creating a signi cant patient pool that pharmaceutical players are keen to cater to

Despite this pain suffered by cancer patient still goes under-treated in more than 50 of treatment cases primarily due to the absence of an adequate pain management solution

A combination of unwanted side effects and the fear of addiction to certain classes of medications is preventing some individuals from relieving their discomfort

As a result pain management presents a considerable challenge for physicians who are struggling to meet the growing unmet clinical needs of their patients Rates of treatment-seeking patients and diagnosis are also low as the current offerings from the pain management market push fewer patients through surgery doors

The market for pain management therapeutics is comprised of therapies such as opioids non-steroidal anti-in ammatory drugs (NSAIDs) local anaesthetics tricyclic antidepressants and anticonvulsants Opioids which represent the largest pain therapy class can cause side effects such as nausea vomiting constipation and drowsiness and even severe respiratory depression Opioids are also often viewed in

a negative light for their addictive qualities NSAIDs in turn can cause gastrointestinal upsets increase cardiovascular risks and cause kidney and liver damage

However the future may hold some hope for chronic pain sufferers The unmet need for safer and more ef cient drugs has resulted in substantial RampD interest in treating pain conditions The current RampD pipeline for pain management has 282 trials in different stages of discovery and development Neuropathic pain currently accounting for almost half of the total pain management therapeutics market is the key therapy focus area in the current development pipeline More than 50 of the total trials for pain management therapeutics are in Phase III and Phase II research which indicates that some new drug candidates will emerge in the near futureCurrent competition between chronic pain therapeutics is strong as many treatment options for chronic

pain are available meaning that lower market potential is available for any new entrants without innovative rst-in-class drugs or disease-modifying mechanisms of action that can show improved overall survival safety and ef cacy Therefore new drug delivery systems look to favour novel techniques such as intravenous infusions time-release transdermal skin patches nasal sprays and inhaled aerosols

GBI Research estimates that the global pain management market was worth approximately $286 billion in 2010 Improved diagnosis of pain indications coupled with blockbuster sales of Lyrica (pregabalin) and Cymbalta (duloxetine HCl) are expected to drive the pain therapeutics market in the future While these two top-selling drugs are expected to face patent expiries in the forecast period the healthy development pipeline for pain management re ects positive prospects for the growth of the market in the future

New style of NHS leadership could deliver better patient care and nancial performance says The Kings Fund review

A year-long review carried out by The Kings Fund argues that a new style of leadership in the NHS could deliver lower mortality better patient experience and outcomes and nancial savings

The review builds on last years No more heroes report which criticised political attacks on the role of NHS managers It argues that the NHS should move away from the predominant pace-setting style of leadership based on meeting targets and makes a compelling business case for a new model of leadership based on stronger engagement between staff clinicians and patients

Drawing on seven commissioned papers and numerous submissions the review highlights the links between organisational performance and leaders who engage staff patients and others in improving care For example evidence suggests a strong correlation between levels of staff engagement and hospital mortality rates It shows that by increasing staff engagement to the level of the top 20 per cent of hospitals the average acute trust could reduce patient mortality by 24 per cent It also found that this could save an estimated pound150000 annually per trust by reducing staff absenteeism alone indicating the potential to make substantial savings across the NHS as a whole

The review found strong evidence linking effective engagement by doctors with improved organisational performance and better patient outcomes Organisations with medical engagement generally have higher quality patient care improved productivity (including signi cantly lower mortality rates) and better nancial performance The review also highlights the importance of NHS leaders engaging across organisational boundaries to deliver integrated care and calls for a stronger emphasis on increased patient engagement to improve patient outcomes

The review argues that leadership for engagement needs to be embraced at all levels of the NHS from the frontline to the NHS Commissioning Board This requires the new Leadership Academy to promote a diversity of leadership approaches and for NHS boards to set the tone for staff and for team leaders to create a climate that emphasises patient care and enables staff to perform to the best of their abilities

Chris Ham Chief Executive at The Kings Fund said

The NHS is facing unprecedented nancial and organisational challenges The need to improve service quality while nding pound20 billion in productivity improvements by 2015 and implement the NHS reforms means that effective NHS leadership has never been more important Our review reveals a compelling business case for leadership based on stronger engagement between staff clinicians and patients Instead of making swingeing cuts to the number of NHS managers our research suggests that a new style of leadership could signi cantly improve nancial and service performance

The reformed NHS must leave behind the command and control culture that has dominated health policy in the last decade and develop leaders who can engage others to deliver further improvements in performance and patient care

4 THE OPERATING THEATRE JOURNAL wwwotjonlinecom

From CR to DR - Dorset County Hospital upgrades X-ray rooms and adds

new DR mobilesDorset County Hospital founded in 1840 and established in its current site in Dorchester in 1991 serves a population of 210000 living within Weymouth and Portland West Dorset North Dorset and Purbeck

In its January 2012 Vision Statement Dorset County Hospital NHS Foundation Trust outlined its commitment to continuously improve the patient care it provides and to exceed its patientsrsquo expectations To help realise this vision the decision was taken in February 2012 to upgrade three of their existing X-ray rooms from Computed Radiography (CR) to wireless Digital Radiography (DR) These latest DR X-ray systems allow radiographers to enhance image quality with less than half the radiation dose to the patient After the X-ray is exposed the digital image is available for viewing in a matter of seconds which assists the department with swifter throughput giving less waiting time for the patients

UK privately owned Xograph Healthcare specialist integrators of Canon DR systems have been awarded the contract via the NHS Supply Chain to carry out this upgrade along with the supply of two digital MobileDaRt Evolution X-ray units that can be used in conjunction with the newly upgraded rooms

Linda Chappell Lead Superintendent Radiographer at Dorset County Hospital said ldquoThis new equipment is wonderful and will help staff as we all strive to continuously improve the care we provide to our patients We chose Xograph Healthcare because their after-sales service is superb and they have a selection of interchangeable wireless digital detector sizes that are suitable for both our xed X-ray rooms and mobile X-ray systems We look forward to working with Xograph Healthcare long into the futurerdquo

Paul Andrews Commercial Manager at Xograph Healthcare said ldquoI am delighted to be working with Dorset County Hospital this is a signi cant strategic investment by the Trust and I am sure they will quickly bene t from all the advantages that the latest DR Technology has to offerrdquo

wwwxographcom

Focus on change AfPP congress theme announced

The Association for Perioperative Practice (AfPP) has announced its 2012 congress theme for ICC Birmingham on 18 October - alongside a pair of prestigious key speakers

Managing Perioperative Care within Changing Environments has evolved from the turbulent journey of the NHS white paper and the overriding need for professional associations to respond with leadership and guidance for perioperative teams Taking an empowerment perspective as in previous successful years the event boasts a programme with something for everyone from leadership and safety issues to networking and peer discussions

The introductory Daisy Ayris lecture is to be given by Dr Jean White Chief Nursing Of cerNurse Director for Wales head of the Nursing and Midwifery professions in NHS Wales and responsible for the professional performance and development of Nurse Directors and the nursing profession Developing the events theme Dr White will expand on the challenges within the NHS of the future and the impact on perioperative teams how they can maintain patient safety and ultimately grow into national leadership roles and in uence healthcare delivery

A further keynote lecture Acute to Community Care Closer to Home - will be presented by Professor Hilary Humphreys part of the eminent team responsible for the paper Guidelines on the facilities required for minor surgical procedures and minimal access interventions a study of the circumstances in which surgical procedures can be undertaken outside of the traditional theatre environment Professor Humphreys a member of the Royal College of Surgeons in Ireland and specialist in clinical microbiology will discuss how the changes in the NHS will lead to a growing number of procedures being undertaken in primary care facilities and assess the training and environmental requirements necessary for patient safety to remain uncompromised

AfPPs agship event has undergone changes of its own Reacting to the heavy pressures on nance and resources facing practitioners in the current nancial climate the congress and exhibition are being staged over one very intensive day of education and training

AfPP CEO Dawn Stott explained AfPP2012 is about reacting to changes within the NHS and changes all around us As a charity we are totally dedicated to training and CPD for all practitioners and perioperative staff in particular and our previous 2- and 3-day events have proven extremely popular with delegates and exhibitors

However we also acknowledge the challenges faced by everyone in our profession in nding the time and nancial backing to attend longer events so we have crammed a fantastic range of lectures reports and interaction into one very intensive day and holding it at the ICC in Birmingham means its relatively easy to get there from almost anywhere in the country Were con dent that a smaller event will be an even bigger success

AfPP 2012 is being held on 18 October at ICC Birmingham For more information and to register visit wwwafpp2012orguk

a

o

tAow

soX

t be i en b Dr Jean White Chief

AFPP2012 - THE UKrsquoS LEADING EVENT FOR ALL PRACTITIONERS WORKING IN OPERATING THEATRES PROVIDING-

Over 400 delegates will attend to experience this unique day of intense education and networking with four continuing professional development hours for their portfolios Delegates will include all perioperative practitioners from an acute primary care setting or independent sector especially Directors of Nursing and Theatre Managers Operating Department Practitioners and Theatre Nurses plus any role working in Anaesthetics and Recovery Day Surgery Orthopaedics Endoscopy Radiology ITU and HDC and Sterile Services

AfPP member rate

One Great Day One Amazing City One Clear MessageThursday 18 October 2012The ICC Birmingham

Managing Perioperative Care within Changing Environments

pound199

Linda Chappell Lead Superintendent Radiographer Kate Lewins Radiographer Olivia Whitlock Radiographer and Georgina Morris Radiographer at Dorset County Hospital with Liam Neill Territory Manager at Xograph Healthcare Ltd

Please quote lsquoOTJrsquo

When responding to articles please quote lsquoOTJrsquo

ScalpelScalpelA new lsquocutting edgersquo discussion forum for all

those involved with patient careand the operating theatre environment

Start a discussion Join a discussion Offer your opinion Have your say

httpotjonlinecomscalpel

NHS cancelled elective operations quarter ending 31 March 2012

The following statistics were released today by the Department of Health

The key points from the latest release areDuring the quarter ending 31 March 2012 16719 operations were cancelled at the last minute for non-clinical reasons In the same period in 2011 there were 15287 cancelled operations

Cancelled operations during the quarter represented 09 of all elective activity compared to 10 in the corresponding period in 2010 Of these cancellations 1052 (63) of patients were not treated within 28 days of a cancellation In the same period in 2011 844 (55) of patients were not treated within 28 days

NB The 09 was calculated using an estimate of elective activity as the full data for the quarter is not yet availableFull tables are available herehttpwwwdhgovukenPublicationsandstatisticsStatisticsPerformancedataandstatisticsCancelledoperationsindexhtm


Operating Kinect ndash The Kinect in the operating room

THE surgeon enters the operating theatre covered in sterile blue scrubs Machines beep and hiss Nurses wait tools at the ready scalpel forceps bandage Xbox Xbox

On 15th May a surgeon at Guyrsquos and St Thomasrsquo hospital in London began trials of a new device that uses an Xbox Kinect camera to sense body position Just by waving his arms the surgeon can consult and sift through medical images such as CT scans or real-time X-rays while in the middle of an operation

Maintaining a sterile environment in the operating room is paramount but scrubbing in and out to scroll through scan images mid-operation can be time-consuming and break a surgeonrsquos concentration or sense of ow Depending on the type of surgery a surgeon will stop and consult medical images anywhere from once an hour to every few minutes To avoid leaving the table many surgeons rely on assistants to manipulate the computer for them a distracting and sometimes frustrating process

ldquoYou usually think of Kinect in a game-like scenario where you can jump around and move your hands as wide as possible but surgeons are not allowed to reach such a large areardquo says Gerardo Gonzalez of Microsoft Research in Cambridge UK who helped develop the system in conjunction with surgeons from Guyrsquos and St Thomasrsquo and Kingrsquos College London

So Gonzalez and colleagues developed a set of gestures that a surgeon can perform in a constrained space while standing at the operating table For the most common actions - rotating the 3D model or placing a marker on the image - the team designed one-handed gestures that combine with voice commands leaving the other hand free for operating To position a marker for example the surgeon simply points at the image to activate a cursor and says ldquoplace markerrdquo Other functions such as panning or zooming require two hands

You can view the full article here httpwwwnewscientistcomarticlemg21428655200-kinect-imaging-lets-surgeons-keep-their-focushtml

Fukuda Denshi publish handy pocket guide on their Critical

Care rangeFukuda Denshi is a leading supplier of advanced patient monitoring and user-con gurable clinical information management systems as well as cardiac monitoring and imaging technology The company recently published a full colour handy pocket guide on their range of patient monitoring solutions

The 12 page pocket guide is a perfect pocket companion to provide comprehensive product information on Fukuda Denshirsquos range which includes

bull The new DS-8500 system with the most intelligent interface yet The DS-8500 is available with 15 or 19rdquo display options and has a modular design for a better exible con guration

bull The DS-7700 system with multiple display con gurations Arrythmia analysis and convenient bed-transfer between centrals and team nursing option

bull The DS-7000 system ideal for OR applications with 12rdquo colour LCD touch-screen display

bull The DS-7100 system offering various displays and multiple variations in a portable multi-parameter monitor and an 84rdquo touch-screen display

bull The DS-7200 integrated monitor with 12rdquo display and exible modules

Product dimensions weight and key features are all provided within the pocket guide along with product images For a copy of Fukuda Denshirsquos Critical Care product guide telephone Fukuda Denshi on 01483 728065

When responding please quote lsquoOTJrsquo

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James Corden Business Development Manager at TRUSTECH has been working closely with Adam during the initial development phases He said We are very excited to have received this funding from SPARK Impact managers of The North West Fund for Biomedical The device has real potential to reduce the burden of stroke on the NHS and the devastating effects it has on patients The SPARK Impact investment will help TRUSTECH develop a commercially viable device to address this unmet clinical need

Rapid Rhythm Ltd is a tenant at The MedTECH Centre based on Manchester Science Park The centre will be able to accommodate the needs of the company as it grows as a business Dr Paul Hanmer MedTECH Centre Manager said Initially the MedTECH Centre will provide space for meetings as the team make arrangements for the next stages of development We can provide business advice to ensure Rapid Rhythm lay down sustainable business plans and also introduce them to partners who may be interested in getting involved in the project Further down the line we have workspace which will allow for re nement of the physical device before it goes to trial The MedTECH Centre offers the perfect facilities to edgling companies such as Rapid Rhythm

wwwmedtechcentrecoukwwwtrustechorgukwwwsmartsolutionsforhccouk

pound50000 boost for stroke prevention deviceRapid Rhythm Ltd a spin-out company jointly owned by TRUSTECH Smart Healthcare Ventures Ltd (SHV) and Central Manchester University Hospitals NHS Foundation Trust (CMFT) has successfully secured path nder investment from The North West Fund for Biomedical to develop a handheld device which aims to provide a quick automated diagnosis of Atrial Fibrillation (AF)

AF is an abnormal heart rhythm which affects around 1 million people in the UK and is a major cause of stroke It is diagnosed using an Electro Cardio Gram test (ECG) which is usually performed at a hospital once a GP suspects AF is present and makes a referral Once AF is diagnosed the risk of stroke can be reduced by about two thirds using drugs that prevent blood clots however the overall process of getting to the point of diagnosis is extremely time consuming and disruptive particularly for elderly patients

Adam Fitzpatrick Consultant Electrophysiologist at the Heart Centre in Manchester Royal In rmary has been working with TRUSTECH to develop the Rapid Rhythm device a portable ECG analyser for GPs that provides an automatic diagnosis of AF at the point of care It is intended to be used to check for the presence of AF each time an elderly patient visits their GP in the same way that they have their blood pressure checked on a regular basis This would identify more patients in AF and could reduce the number of AF related strokes If 30 of GPs were to use the device it could potentially save the NHS pound64m in stroke care costs

A prototype device has recently been tested within CMFT to assess the accuracy of the algorithm and the usability of the device by health professionals The pound50000 funding will now be used to fund a range of activities including re nement of the ECG electrode design market research and a health economics analysis of the potential impact of the device within the NHS

Dr Adam Fitzpatrick said AF carries with it a high risk factor for stroke which is the third largest cause of death in the UK and many western countries

For patients in AF their risk of stroke can be substantially reduced using anti-coagulant drugs but there is currently no device available which enables healthcare professionals to quickly test patients for the presence of AF prescribe anti-coagulants and reduce the incidence of stroke

Adam Fitzpatrick and James Corden at MedTECH Centre


B Braun to hold Hernia Fundamentals conference at The Royal College of

Surgeons of EnglandA leading medical company is holding its Hernia Fundamentals training course at the Royal College of Surgeons of England on 21st June 2012 The aim of the course is to give trainee and newly quali ed doctors an insight into this specialist area of hernia surgery

B Braun Medical Ltds educational arm - Aesculap Academia - has organised the event at The Royal College of Surgeons in London at which experts will deliver sessions on a range of hernia surgery topics including open surgery and laparoscopic techniques

The conference on June 21 will be introduced by Martin Kurzer President of the British Hernia Society

Delegates will have the opportunity to learn about laparoscopic repair of groin hernias femoral hernia emergency hernia and potential medico-legal issues relating to hernia surgery There will also be sessions around anatomy patho-physiology and diagnostic techniques

Mark Culf National Business Development Manager VasTech at B Braun Medical Ltd said Following two very successful conferences in Scotland we have decided to bring the concept to England

It is an opportunity for doctors who are interested in hernia surgery to nd out more about the treatment of this problem from some of the countries leading experts in this eld

Aesculap Academia has a world-wide reputation as a leading forum for surgical and medical training and runs accredited courses to help medical and surgical professionals to keep ahead of fast moving changes in health care

Mr Culf added In modern health care there are stringent requirements for hospitals and quality management and an increasing demand in many specialist areas for training and to share knowledge

Expert sessions will be led by doctors Martin Kerzer from the London Hernia Centre Paddy O`Dwyer from Glasgow Andrew de Beaux from Edinburgh Brian Stephenson from Newport and Ali Sheen from Manchester

For more information or to register for a conference place please contact 0114 225 9057 or 0114 225 903536 Fax 0114 225 9119 or email academiabbmukbbrauncom

Showing in your Theatre now

THE

OPERATING

THEATRE

JOURNAL



Timescorsquos new ION-AIR range of Resuscitation amp

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via NHS Supply Chain (Ref FAG324)

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NHS adopts intraoperative uid management

The NHS Technology Adoption Centre has published its Intraoperative Fluid Management Technologies Adoption Pack which aims to guide the successful implementation of intraoperative uid management technologies (IOFMT) across the NHS in England

The report informs all NHS organisations of the steps they need to take to start using or increasing their use of these technologies and reiterates that full adoption across the NHS is forecast by NICE to bene t 837000 patients and generate net nancial savings of pound400 million per annum

Of the 800000 patients a year in the UK who are applicable for this advanced monitoring less than 10 are currently monitored This illustrates the potential size of the UK market and the very substantial opportunity available to companies such as cardiovascular monitoring company LiDCO whose uid management technology is highlighted in the report among others

Dr Terry OrsquoBrien CEO LiDCO Group plc stated ldquoThis is another major milestone in realising the NHSrsquos vision of implementing uid optimisation for 800000 applicable patients and the substantial positive outcomes both clinically and economically that will ensue This is a terri c endorsement for the area and we greatly welcome the opportunity this presents for LiDCOrsquos uid monitoring technology which is already in wide use across the NHSrdquo

wwwlidcocom

People with severe allergies advised to see their GP after recall of Anapen adrenaline injector

The Medicines and Healthcare products Regulatory Agency (MHRA) today 23rd May issued an alert to healthcare professionals and is advising people who suffer from severe allergic reactions to see their GP or clinic as soon as possible to discuss alternative products after Anapen ndash an adrenaline injector used to treat anaphylactic shock ndash was precautionary recalled by the licence holder Lincoln Medical Limited

A potential problem with the speed and delivery of adrenaline by the Anapen injectors was found during development work by the manufacturer Owen Mumford Ltd No problems with these injectors have been reported by people or healthcare professionals but in the worst case scenario the injector could fail to deliver adrenalin in an emergency situation when a person has a severe allergic reaction caused by peanuts or other foods insect bites or stings

People with the injectors below at home are advised to continue using their Anapen injectors until they can discuss using alternative products with their GP or clinic

Anapen 500 micrograms in 03ml solution for injection in a pre- lled syringe PL 188130003Anapen 300 micrograms in 03ml solution for injection in a pre- lled syringe PL 188130001Anapen Junior 150 micrograms in 03ml solution for injection in a pre- lled syringe PL 188130002

Gerald Heddell the MHRArsquos Director of Inspection Enforcement and Standards said

ldquoThis is a precautionary recall and no problems with Anapen adrenaline injectors have been reported by people or healthcare professionals People should continue to use their existing Anapen injectors until they can obtain an alternative product and they should make an appointment with their GP or clinic as soon as possible to discuss thisrdquo wwwmhragovuk

Use the Power of

Available in Print Locally and Worldwide via the Internet

twittercomOTJOnline


NEW POSITIONING PAD RANGE

REVIEW INTO PIP IMPLANT SCANDAL PUBLISHEDLord Howe - serious lessons must be learnedA review into the PiP breast implant scandal has found that although the regulator acted appropriately and followed scienti c and clinical advice there is room for improvement and serious lessons must be learned

Health Minister Lord Howes report into PiP breast implants has looked at whether the UK regulator - the MHRA - and the Department of Health acted appropriately both before and after information about the problems with these implants came to light

The report states that the MHRA and the Department of Health must learn lessons so that they can continue to improve their approach to communicating with affected individuals and the general public particularly around issues that cause such understandable anxiety

They must ensure that full clear and accurate information is made available promptly in a way that is easily accessible and re ects the concerns that weigh so heavily on the lives of patients who are affected by doubts over the safety of speci c medical devices

The role of the MHRA is to monitor all incidents that are reported to it make sure that these incidents are investigated fully and that any necessary action is taken

The evidence shows that the regulator did this but that improvements are needed in its communication and data collection and the whole European system and processes for gathering and analysing data where concerns arise

Lessons need to be learnt by the MHRA the Department of Health and the wider system so it can uncover problems early be better placed to take robust action and provide clarity for the public should anything like this happen in the future The report has found that the MHRA

bull Should review and further develop its communications capability to ensure it can rapidly establish and provide centralised communications regarding device alerts and related issues on an ongoing basis This should be a proactive capability serving the needs of patients professionals and the press and public

bull Must be able to obtain evidence from a wider and more detailed set of sources including robust data from clinicians It needs to be at the forefront of using more sophisticated and rich sources of data to help determine if there are problems with a device and

bull Must be able to routinely review the sum total of the information about speci c higher-risk devices so any problems are identi ed early

Lord Howe said It must be emphasised that this case was one of deliberate fraud by the PiP manufacturer which purposefully misled European regulators Regulation alone cannot prevent fraudulent activity such as this

But serious lessons must be learned from this scandal The MHRA needs to look at how it gathers evidence so it is able to identify problems early

It needs to better analyse reports about higher risk medical devices And it needs to improve the way it communicates with the public

It is clear that problems occurred that werent reported to the regulator A vigilance system is only as good as the information that is reported to it More needs to be done to ensure that problems with medical devices are reported so problems can be identi ed and action taken to address them

This report wont repair the distress caused to women who have PiP implants but it should give them and the public reassurance that we have identi ed the lessons that we will take all steps to act on them and that should something like this happen again our systems for dealing with it will be stronger

The Government is supporting women affected by this scandal and providing information based on sound solid scienti c and medical advice The responsibility for the distress caused to UK women and indeed many thousands of women worldwide lies squarely with the fraudulent manufacturer which actively covered up its deceit and showed a complete disregard for the welfare of its customers But we openly acknowledge that we must learn lessons from this in the future so we put all possible protections in place for patients

The report also found that the regulators in all EU countries need to work better together to support early detection of problems share the information they gather and take appropriate action to protect patients

The Government will work to ensure that the ongoing revision of the European regulation of devices ensures the system works robustly and that information sharing across international boundaries is made much easier

Sir Bruce Keogh - the NHS Medical Director - is currently carrying out a separate review of the wider system of regulation for cosmetic interventions His review will also look at whether a breast implant registry could be put in place in this country to help monitor any problems that occur and perhaps make it easier to trace people affected if there is ever a problem in the future

Women who have PiP implants and who are concerned are advised to

bull Find out if they have a PIP implant

bull Speak to their specialist or GP if they had them done on the NHS or clinic if they had them done privately

bull Agree whatrsquos best Get advice on whether or not they need further assessment and discuss appropriate action with their doctor

The NHS will support removal of PIP implants if following a clinical assessment a woman with her doctor decides that it is right to do so The NHS will replace the implants if the original operation was done by the NHS If a clinic that implanted PiP implants no longer exists or refuses to care for their patient the NHS will remove the implants but not replace

Correct positioning is crucial for patient wellbeing Not only does it increase the comfort of the patient during a surgical procedure and post-operatively it also minimises the risk of nerve and tissue damage And this also makes sense nancially as prevention of such problems is much more economical than treating them

For this reason TRUMPF Medical Systems is now enhancing the exibility of its operating tables with a choice of high quality positioning pads All are available for every model of TRUMPF operating tables and other branded systems too

A patient unable to move due to paralysis or anaesthesia is vulnerable to tissue damage due to pressure friction or shear forces on the operating table or during transfer Correctly applied the TRUMPF positioning pads substantially reduce the risk of these complications

Optimally designed for ease of use the TRUMPF positioning pads can be employed preventatively and also as part of the treatment if tissue damage is already present They lighten the work of theatre staff and are easy to reposition during long operations to ensure optimal pressure relief

The choice of TRUMPF positioning pads is extensive They include products for general surgery gynaecology and urology traumatology and orthopaedic vascular and cardiology neurology ophthalmology and ENT paediatric and bariatric surgery

And naturally all are compatible with all types of TRUMPF extensions and table con gurations for a wide variety of interventions

The TRUMPF positioning pads are made from a two-layer visco-elastic foam construction More environmentally-friendly than other foams this material maintains body temperature during surgery

The padrsquos cover is made from waterproof and breathable Decu-Tex material which is polyurethane based For optimal hygiene the cover is fully-welded and tted with a plastic zip for easy removal for cleaning

It can be washed at 95oC tumbled dried at 130oC and is resistant to both bacteria and fungus To avoid any injury to the skin of the patient or theatre staff the cover is folded over the zip

The price of pressure problems is high from both a human and economical perspective

The new range of positioning pads from TRUMPF offers important advantages in this regard Although the products are primarily introduced for use in the operating theatre and intensive care they are also eminently suited for use in aftercare

Tel +44 01582 399201httpwwwuktrumpfcomsalesuktrumpfcom



Our combination of high quality innovative products and

exceptional levels of service provide supreme clinical value

Your sterile single-use solution without compromise

Specialities served General and Vascular ENTMaxFax Gynaecological Neurosurgical Orthopaedic

T +44 (0)1792 797910F +44 (0)1792 797955 E infodtrmedicalcomwwwdtrmedicalcom

DTR Medical ndash a leading manufacturer of sterile single-use surgical instruments ndash has upgraded its Negus Aspirating Dissector improving the devicersquos suction ow by 20

In line with DTR Medicalrsquos core values to innovate and improve this research project was a direct response to surgeonsrsquo requests for improved suction ow

Using Computational Fluid Dynamics and expertise within Cardiff University enhancements were made to the predicted ow of uids by increasing the hole size from 15mm to 225mm

The front edge of the hole is now 075mm closer to the blade tip allowing blood to pool in to the hole facilitating prompt removal The proximity of the hole to the blade tip also provides better visibility for the surgeon

The enlarged hole increases the rear aperture size offering less resistance and is less prone to blockage and subsequent theatre delays

The new Negus forms part of an extensive ENT range complementing other dissectors such as the Tonsil Aspirating Dissector and the Freer lsquoHockey Stickrsquo

DTR Medicalrsquos complete range of single-use instrumentation aims to deliver clinical value by improving procedures and helping save time lives and cost

For further information please contact Andrew Davidson DTR Medical Ltd +44 (0)1792 797 910 infodtrmedicalcom

Redesigned Negus set to improve

work ow


New balloon catheter system shows promise to advance endovascular technique

Journal of Endovascular Therapy - A new balloon catheter system could advance the endovascular approach to treating obstructed arteries in the leg offering an alternative to surgical revascularization Peripheral artery disease affects about 12 to 14 percent of the general population and revascularization can be achieved through bypass surgery or a number of minimally invasive endovascular techniques that seek to reduce or eliminate symptoms of reduced blood ow by improving tissue perfusion Chronic total occlusions of the super cial femoral artery and popliteal artery some of the most dif cult lesions to recanalize with conventional guidewire techniques were treated with this new system

This rst-in-man experience of the ENABLER-P Balloon Catheter System is reported in the current issue of the Journal of Endovascular Therapy The ENABLER-P Balloon Catheter System features a unique balloon-anchoring mechanism and an automated balloon in ation device that allows steady controlled guidewire advancement by the operator through an occlusion The new system incorporates increased top force and better pushability of a standard guidewire

Thirty-seven patients with a variety of occlusions including heavily calci ed long and brotic lesions participated in the study A successful procedure was achieved in 86 percent The average time to successfully navigate the occlusion was 53 minutes Physicians participating in the study reported success in maintaining positioning of the guidewire in the lumen of the blood vessel even in curvilinear and other challenging areas

The authors of a commentary about this article welcome this test of new endovascular techniques and tools Although an increasing number of facilities favor rst trying an endovascular approach to obstructed arteries in the leg there is a lack of adequately designed clinical studies helping to establish these techniques The authors note that this new system may offer new possibilities and change attitudes toward lower limb revascularization in the setting of critical limb ischemia

Full text of the article Recanalization of Femoropopliteal Chronic Total Occlusions Using the ENABLER-P Balloon Catheter System and commentary The ENABLER-P Balloon Catheter System A New and Exciting Tool for Recanalization of Femoropopliteal CTOs Journal of Endovascular Therapy Vol 19 No 2 2012 are available at

httpwwwjevtonlineorgtocenth192





Specialities served General and Vascular ENTMaxFax Gynaecological Neurosurgical

T +44 (0)1792 797910F +44 (0)1792 797955 E infodtrmedicwwwdtrmedicalcom

Orthopaed

calcom

dic

DTR Medical ndash a leading manufacturer of sterile single-use surgical instruments ndash has upgraded its Negus Aspirating Dissector improving thedevicersquos suction ow by 20

In line with DTR Medicalrsquos core values to innovate and improve this researcproject was a direct response to surgeonsrsquo requests for improved suctio ow

Using Computational Fluid Dynamics and expertise within Cardiff Universitenhancements were made to the predicted ow of uids by increasing thhole size from 15mm to 225mm

The front edge of the hole is now 075mm closer to the blade tip allowinblood to pool in to the hole facilitating prompt removal The proximity of thhole to the blade tip also provides better visibility for the surgeon

The enlarged hole increases the rear aperture size offering less resistancand is less prone to blockage and subsequent theatre delays

The new Negus forms part of an extensive ENT range complementing othedissectors such as the Tonsil Aspirating Dissector and the Freer lsquoHockeStickrsquo

DTR Medicalrsquos complete range of single-use instrumentation aims to deliveclinical value by improving procedures and helping save time lives and cost

For further information please contact Andrew Davidson DTR Medical Lt+44 (0)1792 797 910 infodtrmedicalcom

R d i d NRedesigned Neggned Neguuuuuuuuuss set to improvvvvvvvveeeeeeet t i

work owwwwwwwwwwwwww

When responding please quote lsquoOT

New balloon catheter system shows promiseto advance endovascular technique

Journal of Endovascular Therapy - A new balloon catheter system couldadvance the endovascular approach to treating obstructed arteries in theleg offering an alternative to surgical revascularization Peripheral arterydisease affects about 12 to 14 percent of the general population andrevascularization can be achieved through bypass surgery or a number of minimally invasive endovascular techniques that seek to reduce or eliminatesymptoms of reduced blood ow by improving tissue perfusion Chronic totalocclusions of the super cial femoral artery and popliteal artery some of themost dif cult lesions to recanalize with conventional guidewire techniqueswere treated with this new system

This rst-in-man experience of the ENABLER-P Balloon Catheter System isreported in the current issue of the Journal of Endovascular Therapy TheENABLER-P Balloon Catheter System features a unique balloon-anchoringmechanism and an automated balloon in ation device that allows steady controlled guidewire advancement by the operator through an occlusionThe new system incorporates increased top force and better pushability of a standard guidewire

Thirty-seven patients with a variety of occlusions including heavily calci edlong and brotic lesions participated in the study A successful procedurewas achieved in 86 percent The average time to successfully navigate theocclusion was 53 minutes Physicians participating in the study reportedsuccess in maintaining positioning of the guidewire in the lumen of the bloodvessel even in curvilinear and other challenging areas

The authors of a commentary about this article welcome this test of newendovascular techniques and tools Although an increasing number of facilities favor rst trying an endovascular approach to obstructed arteriesin the leg there is a lack of adequately designed clinical studies helping toestablish these techniques The authors note that this new system may offer new possibilities and change attitudes toward lower limb revascularization inthe setting of critical limb ischemia

Full text of the article Recanalization of Femoropopliteal Chronic TotalOcclusions Using the ENABLER-P Balloon Catheter System and commentary The ENABLER-P Balloon Catheter System A New and Exciting Tool for Recanalization of Femoropopliteal CTOs Journal of Endovascular TherapyVol 19 No 2 2012 are available at


Innovation amp Issues in Perioperative and Operating Theatre Management

eventsmkupdatecoukT 01768 773030

wwwmkupdatecouk

Manchester Conference Centre Manchester 13 September 2012pound199 per place









































NEW POSITIONING PAD RANGEN

REVIEW INTO PIP IMPLANT SCANDAL PUBLISHEDord Howe - serious lessons must be learnedreview into the PiP breast implantandal has found that although thegulator acted appropriately andllowed scienti c and clinical adviceere is room for improvement andrious lessons must be learned

ealth Minister Lord Howes reportto PiP breast implants has lookedwhether the UK regulator - the

HRA - and the Department of ealth acted appropriately bothefore and after information aboute problems with these implantsme to light

he report states that the MHRAd the Department of Healthust learn lessons so that they can

ontinue to improve their approachcommunicating with affected

dividuals and the general publicarticularly around issues that causech understandable anxiety

hey must ensure that full clear d accurate information is madeailable promptly in a way that is

asily accessible and re ects theoncerns that weigh so heavily one lives of patients who are affected

y doubts over the safety of speci cedical devices

he role of the MHRA is to monitor incidents that are reported tomake sure that these incidents

e investigated fully and that anyecessary action is taken

he evidence shows that the regulator d this but that improvementse needed in its communicationd data collection and the whole

uropean system and processes for thering and analysing data where

oncerns arise

Lessons need to be learnt by theMHRA the Department of Healthand the wider system so it canuncover problems early be better placed to take robust action andprovide clarity for the public shouldanything like this happen in thefuture The report has found that theMHRA

bull Should review and further develop its communicationscapability to ensure it can rapidlyestablish and provide centralisedcommunications regarding devicealerts and related issues on anongoing basis This should be aproactive capability serving theneeds of patients professionalsand the press and public

bull Must be able to obtain evidencefrom a wider and more detailedset of sources including robustdata from clinicians It needs tobe at the forefront of using moresophisticated and rich sources of data to help determine if there areproblems with a device and

bull Must be able to routinely reviewthe sum total of the informationabout speci c higher-risk devicesso any problems are identi edearly

Lord Howe said It must beemphasised that this case wasone of deliberate fraud by the PiPmanufacturer which purposefullymisled European regulatorsRegulation alone cannot preventfraudulent activity such as this

But serious lessons must be learned from this scandal The MHRA needsto look at how it gathers evidence soit is able to identify problems early

It needs to better analyse reportsabout higher risk medical devices And it needs to improve the way itcommunicates with the public

It is clear that problems occurred that werent reported to the regulator A vigilance system is only as goodas the information that is reportedto it More needs to be done toensure that problems with medical devices are reported so problems can be identi ed and action taken toaddress them

This report wont repair the distress caused to women who have PiPimplants but it should give them and the public reassurance that wehave identi ed the lessons that we will take all steps to act on them and that should something likethis happen again our systems for dealing with it will be stronger

The Government is supportingwomen affected by this scandal and providing information based onsound solid scienti c and medical advice The responsibility for thedistress caused to UK women andindeed many thousands of women worldwide lies squarely with the fraudulent manufacturer which actively covered up its deceit andshowed a complete disregard for the welfare of its customers But we openly acknowledge that we mustlearn lessons from this in the futureso we put all possible protections inplace for patients

The report also found that the regulators in all EU countries needto work better together to supportearly detection of problems sharethe information they gather andtake appropriate action to protectpatients








orrect positioning is crucial for atient wellbeing Not only does itcrease the comfort of the patienturing a surgical procedure andost-operatively it also minimisese risk of nerve and tissue damagend this also makes sense nancially

prevention of such problems isuch more economical than treatingem

or this reason TRUMPF Medicalstems is now enhancing the

exibility of its operating tables withchoice of high quality positioning

ads All are available for everyodel of TRUMPF operating tablesd other branded systems too

A patient unable to move due toparalysis or anaesthesia is vulnerableto tissue damage due to pressurefriction or shear forces on theoperating table or during transferCorrectly applied the TRUMPFpositioning pads substantially reducethe risk of these complications

Optimally designed for ease of usethe TRUMPF positioning pads can beemployed preventatively and also aspart of the treatment if tissue damageis already present They lighten thework of theatre staff and are easy toreposition during long operations toensure optimal pressure relief

The choice of TRUMPF positioningpads is extensive They includeproducts for general surgerygynaecology and urologytraumatology and orthopaedicvascular and cardiology neurologyophthalmology and ENT paediatricand bariatric surgery

And naturally all are compatible withall types of TRUMPF extensions and table con gurations for a wide variety of interventions

The TRUMPF positioning pads are made from a two-layervisco-elastic foam constructionMore environmentally-friendly thanother foams this material maintains body temperature during surgery

The padrsquos cover is made from waterproof and breathable Decu-Tex material which is polyurethanebased For optimal hygiene thecover is fully-welded and tted witha plastic zip for easy removal for cleaning

It can be washed at 95oC tumbleddried at 130oC and is resistant to both bacteria and fungus To avoid any injury to the skin of the patientor theatre staff the cover is foldedover the zip





0915 - 0950 Registration

0950 - 1000 Chair open Kathryn Bridgeman Nurse Manager General Anaesthetic Department

University Dental Hospital Cardiff

1000 Transformation of pre-operative assessment Pre-operative health evaluation and optimisation beyond surgery

many medical conditions

Ahmed Chekairi Consultant Anaesthetist and Pre assessment Service Clinical Lead The Whittington Hospital NHS Trust London

1030 How to increase productivity in the operating theatre using dashboards and briefi ng staff

sessions and workforce planning

Mark Rigby Theatre Manager Warrington amp Halton NHS Trust

1100 TeaCoffee

1130 Anaesthesia workforce planning

with expanding service requirement

planning model for recruitment

alternative personnel

Dr Claudia Paoloni Lead Doctor Anaesthesia Bristol Royal Infi rmary


prevailing economic climate Managers and clinicians are under constant pressure to fi nd and

opportunity to network and learn of some of those initiatives

Book by email bookingsmkupdatecouk or phone 01768 773030 amp online wwwmkupdatecouk
















work ow















Orthopaed

calcom

dic



















1200 Developing a risk profi le for your department

to reduce risk in a particular environment

organisational risk register

Kathryn Bridgeman Nurse Manager General Anaesthetic Department University Dental Hospital Cardiff

1230 Lunch

1330 Working together works

Alison Wells Independent Consultant Smart Work Consulting

1400 Human factors and communication skills within the theatre team

Keith Underwood Medical Devices Trainer RODP Scarborough and North East Yorkshire Healthcare NHS Trust

1430 TeaCoffee

1500 Reducing post operative complications an implication for commissioning

Jon Gardner Senior Night Nurse Practitioner Queen Elizabeth Hospital Kings Lynn

1530 Competency ndash When to Say No

Rachel Morris Anaesthetics ODP University Hospital of Wales Cardiff

1600 Chair amp Evaluation

1630 Close


wwwmkupdatecouk























































oncerns arise



































Innovation amp Issues in Perioperative and Operating Theatre Management Manchester Conference Centre Manchester 13 September 2012 pound19900 per place

Includes vat conference fee handout lunch refreshments and certifi cate For terms amp conditions visit our website BOOK BY PHONE WITH DEBITCREDIT CARD 01768 773030

Email bookings accepted We will need invoice details your full name and contact details eventsmkupdatecouk

CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

CHEQUES To be made payable to MampK Update LtdINVOICES Please obtain permission from your paying authority before reserving a place

Purchase Order (PO) reference

Full name of person to invoice

Job title Dept

TrustOrganisation

Address

Postcode

Email Tel

Please send completed forms amp payment to MampK Update Ltd The Old Bakery St Johnrsquos Street Keswick Cumbria CA12 5AS







Orthopaed

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dic










work ow










The award judges said ERAS ldquohad the edge in this strong category because the team was truly multi-disciplinary and passionate about their work with a clear vision for Wales about how to give patients a better dealrdquo The judges commented positively that it was ldquodriven by bottom-up clinical leadership and that it was highly transferable elsewhere in the UKrdquo

Dr Alan Willson 1000 Lives Plus Director welcomed the award saying ldquoWe know that we have innovation and excellent practice happening throughout Wales and it is encouraging when this is recognised in a wider context ERAS has made a tremendous impact in the lives of patients in Wales and it deserves to be held up as an example of how better practice leads to better outcomes for both patients and staffrdquo

bull For further information about Enhanced Recovery After Surgery visit www1000livespluswalesnhsukeras

bull A video explaining how Enhanced Recovery After Surgery is being used in Hywel Dda Health Board is also available online httpwww1000livespluswalesnhsukopendoc179811

National recognition for the all-WalesEnhanced Recovery after Surgery programme

NHS Wales staff involved in work to improve the quality of patient care following major surgery are celebrating after winning a UK-wide award

Dr Rachael Barlow and Marilize du Preez were presented with the 2012 Advancing Healthcare Award for the lsquoResearch into Actionrsquo category for the successful implementation of research ndings in the Enhanced Recovery after Surgery (ERAS) programme

The awards recognised the work of allied health professionals and healthcare scientists in leading changes and making improvements within healthcare

Dr Barlow who developed ERAS in Wales and now provides clinical leadership for the programme said ldquoThis award recognises the dedicated work of many teams across Wales who are committed to improving patientsrsquo recovery after surgery

ldquoThe programme puts patients at the centre of their care and empowers them to take steps to speed up their recovery The results have included reduced hospital stays potentially improving bed capacity and patient ow Staff have bene ted from improved team morale and working relationships

ldquoERAS includes optimal nutrition the use of minimally invasive surgical techniques where possible optimal pain control and early planned mobilisation Clinical and therapy staff including physiotherapists occupational therapists and dietitians are all involved if required to ensure patients are in the best possible state of tness for surgeryrdquo

The work is part of 1000 Lives Plus the national improvement programme supporting organisations and individuals to deliver the highest quality and safest healthcare for the people of Wales

The awards which took place in London in March were presented by BBC medical correspondent Fergus Walsh When responding to articles please quote lsquoOTJrsquo

Heart failure research will save NHS millions

A senior lecturer from the University of Brighton is conducting research that could save the NHS millions of pounds by treating heart patients in their own homes

One of 12 pilot schemes around the country the project is nanced by the British Heart Foundation (BHF) which is evaluating the ef cacy and safety of administering medication intravenously to patients with heart failure in their homes rather than in hospital

Ms Watson a nurse and senior lecturer with the universitys School of Nursing amp Midwifery is the project manager and is employed by both East Sussex Healthcare NHS Trust and the University of Brighton Dr Hugh McIntyre consultant physician at the Conquest Hospital in Hastings devised the national protocol and is the clinical lead

Ms Watson said patients with heart failure often ll up with uid and can spend 10 to 14 days in hospital while they are given diuretic medication intravenously to encourage the body to drain the uid naturally

There are 700000 people in the UK with heart failure and patients account for ve per cent of all emergency medical admissions and two per cent of the NHS budget is spent on them

Earlier BHF trials involving heart failure nurses treating patients in their homes reduced hospital admissions by 43 per cent and saved the NHS more than pound800000 over the12-month sample period

Ms Watson said the bene ts were not just nancial Providing diuretic medication intravenously in patients own homes is so much nicer and less stressful than doing so in hospital It improves patients quality of life by reducing some of the distressing symptoms of heart failure

She said the project in Hastings and Rother will run for two years This is a cutting-edge scheme which follows the national agenda for hospital avoidance and the transfer of care into the community

Be sure to view the latest vacancies from the following organisations

Theatre Practitioners Recovery Nurses Anaesthetic Nurses ODPs Scrub Practitioners

Nurse Practitioners Medical Representatives and Clinical Advisers

wwwOOpera ngpera ngTTheatreheatreJJobscomobscomA one-stop resource for ALL your theatre related Career opportuni es


UKrsquoS FIRST O-ARM SPINAL IMAGING UNIT GIVES GREATER

INSIGHT AND ACCURACY TO BMI THE CLEMENTINE CHURCHILLS

SPINAL SURGEONSBMI The Clementine Churchill Hospital which is part of BMI Healthcare has become the rst hospital in the UK to acquire and implement the pioneering new spinal O-Arm Imaging System The new device represents an investment of pound600000 made into the hospitals spinal care service and will both improve patient outcomes and the level of complex procedures offered at the hospital

The O-arm Imaging System provides revolutionary complete multi-dimensional intra-operative surgical imaging allowing a spinal surgeon to carry out complex spinal procedures with ease The O-Arm device provides surgeons with real-time 3D images as well as multi-plane 2D and uoroscopic imaging of a patient during their operation Most spinal patients undergo imaging procedures such as CT scans MRI and X-rays before surgery With this new imaging device spinal surgeons can view the patient anatomy in the operative position monitor the status of the surgery and verify surgical changes made during surgery The ability to obtain live accurate images during surgery provides a great bene t to the surgeon and the patient and dramatically reduces the risk of complication

Mr Sean Molloy a Consultant Orthopaedic amp Spinal Surgeon at BMI The Clementine Churchill Hospital trained to use the O-Arm Imaging System in Europe and was the rst physician to utilise the new imaging system here in the UK Mr Molloy explained that placing screws in the spine usually requires estimating the location of the bone with simple X-rays With the O-Arm system this accuracy is dramatically improved because of the real-time 3D images provided by the device The O-Arm images can also be linked to an intra-operative navigation system called the Stealth Station

Using the O-Arm and the Stealth Station together creates a Global Positioning System for the spine During the surgery I am able to view a monitor and ensure the placements of screws in the spine are perfect every time Mr Molloy commented The greater accuracy afforded by the O-Arms imaging capability in theatre means the procedure is less invasive faster with quicker recovery times and improved patient outcomes

Before the procedure is completed the O-Arm can also generate a nal 3D CT scan of the spine to check the position of the hardware In less than 30 seconds it takes almost 400 images which are reconstructed on a at panel monitor for the patients surgeon to review These images provide immediate con rmation that the hardware has been positioned in its optimal location before the patient leaves the operating room Mr Molloy concluded

Jan Hale Executive Director at BMI The Clementine Churchill Hospital commented The addition of the O-Arm Imaging System at BMI The Clementine Churchill Hospital demonstrates our commitment to cutting-edge surgical technology that bene ts all our spinal patients We already have some of the nest consultants in this eld practising at BMI The Clementine Churchill and we are con dent this new investment will allow us to continue expanding the level of complex procedures at our hospital whilst also improving the outcomes and level of care available to our patients

PENTAX UK To Launch New Endoscopy Products At DDF 2012Stand A12 17th-20th June ACC LiverpoolPENTAX UK experts in high de nition endoscopy will be exhibiting and hosting a scienti c symposium at the Digestive Disorders Federation (DDF) Conference 2012 17th-20th June at the Arena Convention Centre (ACC) Liverpool Located at stand A12 PENTAX UK will be showcasing a selection of its current endoscopy product range as well as introducing a number of new products for superior detection demarcation and characterisation With three demonstration areas on the stand manned by PENTAX UK experts delegates can explore the worlds rst HD+ megapixel technology and the ease of use of PENTAXs broad range Additionally there will be opportunities to discuss best value nancial solutions from affordable HD to premium HD+ endoscopy and the expert after-sales care available from PENTAX

Amongst the new products being presented will be the latest in high de nition endoscopic imaging the EPK-i5000 video processor the PENTAX EC-3490Ti colonoscope with 210deg tip de ection for detection and treatment of polyps or lesions in hard-to-reach areas the PENTAX VSB-2990i entroscope with unique HD+ resolution for detailed visualisation of the small bowel and the PENTAX EC-2990Fi This is the worlds slimmest HD+ colonoscope offering manoeuvrability comfort and control in areas that conventional colonoscopes could only reach with dif culty

At the forefront of state-of-the art endoscopy and designing innovative technology for meeting clinicians needs PENTAX UK is also offering delegates an on-stand sneak preview of the EPK-i7000 the next step in high de nition endoscopic imaging Alongside its new products PENTAX UK will also be demonstrating its Zero-Wire technology with wireless HD medical grade screens Removing the need for complex and expensive wiring systems Zero-Wire delivers clear high resolution images wherever you are in the theatre

PENTAX UK is also hosting an evening symposium on Tuesday 19th June 500-700pm Room 1B titled Endoscopy and Early Neoplasia Embracing The Future Chaired by Professor Pradeep Bhandari from Queen Alexander Hospital Portsmouth and Dr Matthew Banks from University College Hospital London attendees have the opportunity to hear talks from both chairs and Professor Ralf Kiesslich (University of Mainz Germany) Dr Banks will be discussing the ABC of HD endoscopy Prof Bhandari will be focusing on endoscopic resection and Prof Kiesslich will be discussing the journey to confocal imaging Attendance is free and on a rst-come- rst-serve basis

DDF 2012 is an important event in our calendar said David Moore Managing Director PENTAX UK Ltd It provides an ideal opportunity for both our current and prospective customers to come and meet and ask questions of our team of endoscopy experts as well as see our technology in action In so doing we aim to demonstrate how we can fully support them in making the right decision for themselves and the hospitals they work with

For more information please visit wwwpentaxmedicalcom or call PENTAX UK on (0)1759 792733

wwwfacebookcomTheOTJ

O-Arm Imaging Device in Theatre




Barnsley Breast Screening Goes DigitalFuji lm is a pioneer in diagnostic imaging and information systems for healthcare with a range of constantly evolving clinically proven products and technologies designed to assist medical professionals perform ef ciently and effectively Recently the company provided a turnkey solution to Barnsley Hospitalrsquos Breast Screening Unit involving refurbishment of all clinical areas including new and legacy systems and an ultrasound room in a project causing minimal disruption to the service

Barnsley MP Dan Jarvis of cially re-opened Barnsley Hospitalrsquos Breast Screening Unit on Monday 13th February after its refurbishment and conversion to a digital imaging unit where two new Fuji lm Amulet 24x30 digital machines have been installed

The conversion has seen the analogue breast screening mammography equipment replaced with digital imaging systems in an investment to meet the requirements of the Cancer Reform Strategy and the NHS Breast Screening Programme

Dave Houghton Radiology Services Manager at the hospital said ldquoThe digital imaging equipment will bring many bene ts the main one being the ability for the hospital to increase the number of women coming through breast screening therefore ensuring we can see women in the extended age range of the screening programmerdquo

ldquoThe image quality will also be improved and aid in earlier detection of breast cancerrdquo he concluded

The new equipment will also provide a more pleasant working environment for staff as it doesnrsquot involve processing or chemicals

Health Enterprise East Wins pound50K Award For Clinical Database

At the 2012 Fast Forward Awards left to right Stuart Thomson Head of Innovation Robert Donald Intellectual

Property Manager both HEE with Baroness Wilcox Minister for Intellectual Property

Pictured with Fuj lmrsquos Amulet are from left to right Judy Clark Superintendent Radiographer Dave Houghton Trust Radiology Services Manager Lisa Brammah Assistant Practitioner Mary Sawyer Trainee Assistant Practitioner Aline Picken Administration Manager and Lynda Kent Mammographer

UKrsquos Largest Childrenrsquos Heart Charity Launches New lsquoThink HEARTrsquo Acronym To Help Detect Heart Problems Early

The Childrenrsquos Heart Federation the UKrsquos largest childrenrsquos heart charity is launching a new information campaign directed towards parents and medical professionals Think HEART provides parents with ve easy to spot signs to help identify if their child may have a heart problem

The Think HEART campaign aims to empower and inform parents giving them the con dence to raise their concerns about their child with their doctor or a health professional

The Think HEART acronym has ve easy to remember steps to identify a possible heart problem

H - Heart Rate (Is their heart rate too fast or too slow Normal rate is between 100 to 160 beats per minute)

E - Energy (Are they sleepy quiet and too tired to feed)

A - Appearance (Is your baby a pale waxy dusky blue or grey colour)

R - Respiration (Are they breathing too fast or too slow Normal rate is between 40 to 60 breaths per minute)

T - Temperature (Are they cold to touch - particularly their hands and feet)

Heart problems go undiagnosed in far too many children and Think HEART will increase early diagnosis and help to save childrenrsquos lives These conditions affect 5000 children a year almost 1 per cent of all children and currently only around a third of them are picked up before birth

Alex Smith mum of Georgina a child with CHD who was diagnosed after over 2 years said ldquoThis campaign is such a great idea We really understand the importance of early diagnosis and how our lives would have been so different in the early days of Georginarsquos life if we had known what was really wrong with her

ldquoIt was so stressful having a sick child knowing there was something wrong with her but not knowing for almost two years that it was her heart Even though as a mother I had bought up my concerns with a number of medical professionals they didnrsquot spot the problem as they werenrsquot fully aware of these conditionsrdquo

Anne Keatley-Clarke Director of CHF commented about the upcoming campaign ldquoThis Childrenrsquos Heart Week we are aiming to spread the word about the Think HEART campaign as far and as wide as possible Information is power and this easy to follow guidance will enable more children with congenital heart problems to be diagnosed much sooner This will ultimately help save lives and reduce the impacts on children and their familiesrdquo

Think HEART yers available to view here httpsdocsgooglecomopenid=0BxDDaen5r3MeMjRHel92TWp4SGc

f l N l

The development of a web-based tool to accelerate and increase knowledge transfer interactions between the NHS and industry has resulted in an award for Health Enterprise East (HEE) worth pound50000

The 2012 Fast Forward Competition was launched to nd examples of knowledge sharing with industry to help boost UK economic growth

HEE the NHS partner organisation for innovation entered its Clinical Expertise Database for increased knowledge transfer in the NHS offering a system to identify and contact NHS experts by their clinical and research interests

Robert Donald HEErsquos Intellectual Property Manager said ldquoExpert clinical opinion is vital for companies when developing new medical technology to ensure unmet clinical needs are lled as effectively as possible and new products are lsquo t for purposersquo within the NHS

ldquoFor many SMEs within the medtech sector it can be dif cult to identify clinical and research staff who have both the time and wish to engage with them at an early stage of new product development Our Clinical Expertise Database will facilitate this important exchangerdquo




Fuji lm ndash pioneers in diagnostic imaging and information systems


Trust Starkstrom to provide pendants lights amp tables

Contact us now for quotations free trials and site visits

t +44 (0)20 8868 3732e infostarkstromcom

w starkstromcom

Whether itrsquos our own superior world class medical pendants the award winning range of KLS Martin marLED operating lights or the superb Merivaara operating tables Starkstrom is the company to contact for the very best in cutting edge fully integrated operating room and critical care infrastructure

and clinical equipment

STARKSTROM S-EQUIP A COMPREHENSIVE SOLUTION WITH FAULTLESS COMMUNICATION BETWEEN PRODUCTS

S-equiP is the new name for Starkstromrsquos market-leading fully integrated operating theatre equipment solution As sole supplier Starkstrom is able to guarantee full and faultless communication between all the products which form the S-equiP solution In addition any potential issues during installation and commissioning are identi ed and dealt with immediately reducing risk for the buyer and ensuring the least possible disruption to the hospital

S-equiP provides all the equipment needed for the 21st century operating room or critical care area clinical lighting pendants surgeonsrsquo control panels isolated power supplies (IPS) uninterruptible power supplies (UPS) PACS viewing stations battery backup systems operating tables transfer trolleys MRI RF CT and X-Ray shielding UCV canopies SCP clocks and a range of consumables S-equiP also offers Starkstromrsquos exciting new audio visual system VisionOR in partnership with Richard Wolfrsquos Core System a multilevel audio visual communication platform that is bespoke vendor neutral and future proof

Products from the S-equiP solution can be purchased and installed separately but it is Starkstromrsquos ability to provide and t a comprehensive package of integrated operating room and critical care equipment as well as offering the fullest post-installation service provision and warranty which makes it stand out from the competition ndash by using S-equiP operating rooms and critical care areas can be tted out to world class standards

When choosing S-equiP clients bene t from Starkstromrsquos unparalleled project management skills - working with one specialist experienced supplier with UK-based design engineers and production facilities saves time and money and ensures that projects run smoothly and ef ciently

To support S-equiP Starkstrom has once again increased its sales force and has announced the formation of a Clinical Sales Team Headed up by Keith Bolton and covering the whole of the UK the team deals with all clinical aspects within operating room and critical care areas

The team has over 40 yearsrsquo collective experience in the industry and as Sales Director Will Evans says ldquopresents the perfect scenario for our clients with a dedicated team supporting our clinical products alongside our engineering productsrdquo

With Starkstromrsquos S-equiP solution clients are assured of the best equipment supplied tted and project-managed by the best in the business meaning fewer headaches and a world class operating room or critical care area


Further information Starkstrom Tel 0208 868 3732 Web wwwstarkstromcom E-mail infostarkstromcom Amanda Parkin 07810 636467 amandaparkinstarkstromcom


as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199












































Property Manager both HEE with Baroness WilcoxMinister for Intellectual Property

Pictured with Fuj lmrsquos Amulet are from left to right Judy Clark Superintendent Radiographer Dave Houghton Trust Radiology Services Manager Lisa BrammahAssistant Practitioner Mary Sawyer Trainee Assistant Practitioner Aline PickenAdministration Manager and Lynda Kent Mammographer

UKrsquos Largest Childrenrsquos Heart Charity Launches New lsquoThink HEARTrsquo AcronymTo Help Detect Heart Problems Early

The Childrenrsquos Heart Federation theUKrsquos largest childrenrsquos heart charityis launching a new informationcampaign directed towards parentsand medical professionals Think HEART provides parents with veeasy to spot signs to help identifyif their child may have a heartproblem

The Think HEART campaign aims toempower and inform parents givingthem the con dence to raise their concerns about their child with their doctor or a health professional

The Think HEART acronym has veeasy to remember steps to identify apossible heart problem

H - Heart Rate (Is their heart rate too fast or too slow Normal rate isbetween 100 to 160 beats per minute)



R - Respiration (Are they breathing too fast or too slow Normal rate isbetween 40 to 60 breaths per minute)


Heart problems go undiagnosed in far too many children and Think HEARTwill increase early diagnosis and help to save childrenrsquos lives These conditionsaffect 5000 children a year almost 1 per cent of all children and currently onlyaround a third of them are picked up before birth

Alex Smith mum of Georgina a child with CHD who was diagnosed after over 2 years said ldquoThis campaign is such a great idea We really understandthe importance of early diagnosis and how our lives would have been sodifferent in the early days of Georginarsquos life if we had known what was reallywrong with her

ldquoIt was so stressful having a sick child knowing there was something wrongwith her but not knowing for almost two years that it was her heart Eventhough as a mother I had bought up my concerns with a number of medicalprofessionals they didnrsquot spot the problem as they werenrsquot fully aware of these conditionsrdquo

Anne Keatley-Clarke Director of CHF commented about the upcoming campaign ldquoThis Childrenrsquos Heart Week we are aiming to spread the wordabout the Think HEART campaign as far and as wide as possible Informationis power and this easy to follow guidance will enable more children withcongenital heart problems to be diagnosed much sooner This will ultimatelyhelp save lives and reduce the impacts on children and their familiesrdquo


f l N l

The development of a web-based tool to accelerate and increase knowledge transfer interactionsbetween the NHS and industry has resulted in an award for Health Enterprise East (HEE) worthpound50000

The 2012 Fast Forward Competition was launched to nd examples of knowledge sharing withindustry to help boost UK economic growth

HEE the NHS partner organisation for innovation entered its Clinical Expertise Database for increased knowledge transfer in the NHS offering a system to identify and contact NHS experts bytheir clinical and research interests

Robert Donald HEErsquos Intellectual Property Manager said ldquoExpert clinical opinion is vital for companies when developing new medical technology to ensure unmet clinical needs are lled aseffectively as possible and new products are lsquo t for purposersquo within the NHS

ldquoFor many SMEs within the medtech sector it can be dif cult to identify clinical and research staff whohave both the time and wish to engage with them at an early stage of new product developmentOur Clinical Expertise Database will facilitate this important exchangerdquo





1

This yearrsquos congress theme ldquoManaging Perioperative Care within Changing Environmentsrdquo has emerged after the challenging ride for the NHS white paper at Parliament and its final acceptance through the constitutional process Our keynote speaker Dr Jean White Chief Nursing Officer for Wales will set the scene for the day covering the impact of government reform within the NHS and the effect it will have on your role This yearrsquos programme has been shaped to provide leadership and guidance on how you can continue to deliver the best quality care for your patients as situations alter

An outcome of the current financial challenges and resources to organisations and industry has led to the congress and exhibition being delivered over one intense day of education and networking for delegates This day forms part of a year-round programme of AfPP education to support perioperative practitioners as well as providing opportunities for employers to comply with the NHS constitution in enabling practitioners to access CPD for the benefit of patient safety and professional responsibilities

We have derived a congress programme that offers something for all practitioners from leadership through to safety issues within the perioperative environment together with the impact evidence based patient pathways can have In an environment where healthcare structures the economy staffing high risk operating processes and operating platforms are continually changing it is important to get an understanding of the pressures we are facing and how to deal with them

2 LEARN Six forums to provoke conversation will be run in addition to our main congress programme- the latest on the Francis

Report a theatre managers forum decontamination guidance defining advanced surgical roles and AGMengagement PLUS our call for papers session

Two of the four key main congress sessions will cover the following-

This session will go through the main findings of the recent NCEPOD report released last year

It will alert you to the four main areas that you need to address to assist you in helping to reduce complications for your high risk patients coming to theatre As care for patients moves closer to home you will see increasing numbers of high risk patients coming through acute hospital Trusts You therefore need to be more aware of these findings to enable you to prepare for future care for your patients ensuring you have the right knowledge skills and resources to put this in place

This session will cover the positive impact that good team working within the perioperative environment can have on improving patient care It will give you good insight on the national picture for the introduction of the Enhanced Recovery Programme as well as the practicalities of how to put it in place in your own hospital and the benefits it can bring to your patientsrsquo experience It will give you ideas and advice on how to motivate your theatre staff and the wider professional team in implementing this very successful approach to patient care

3 NETWORK Refreshments and lunch are included in your delegate ticket price and located in the exhibition hall These are ideal times to

meet and network with both old and new colleagues suppliers and friends

There is a unique opportunity for all theatre managers and senior practitioners to network at our theatre managerrsquos forum where discussions about why your influence over staff development is key in an ever changing healthcare landscape

4 SOURCE With over three and a half hours of dedicated exhibition viewing and an enviable range of medical

companies on the show floor You cannot fail to find what you need and see a whole host of new innovative products

If you have a scanner on your smart device scan the QR code opposite to go straight to the event home page

SaferSurgeryUK





w starkstromcom
















w starkstromcom

Whether itrsquos our own superiorworld class medical pendants the award winning range of KLS Martin marLED operating lights or thesuperb Merivaara operating tablesStarkstrom is the company to contact for the very best in cutting edge fully integrated operating room and critical care infrastructure


STARKSTROM S-EQUIP A COMPREHENSIVE SOLUTION WITH FAULTLESSCOMMUNICATION BETWEEN PRODUCTS

S-equiP is the new name for Starkstromrsquos market-leading fully integratedoperating theatre equipment solution As sole supplier Starkstrom is able toguarantee full and faultless communication between all the products whichform the S-equiP solution In addition any potential issues during installationand commissioning are identi ed and dealt with immediately reducing risk for the buyer and ensuring the least possible disruption to the hospital

S-equiP provides all the equipment needed for the 21st century operatingroom or critical care area clinical lighting pendants surgeonsrsquo controlpanels isolated power supplies (IPS) uninterruptible power supplies (UPS)PACS viewing stations battery backup systems operating tables transfer trolleys MRI RF CT and X-Ray shielding UCV canopies SCP clocks and arange of consumables S-equiP also offers Starkstromrsquos exciting new audiovisual system VisionOR in partnership with Richard Wolfrsquos Core Systema multilevel audio visual communication platform that is bespoke vendor neutral and future proof

Products from the S-equiP solution can be purchased and installed separatelybut it is Starkstromrsquos ability to provide and t a comprehensive package of integrated operating room and critical care equipment as well as offering thefullest post-installation service provision and warranty which makes it standout from the competition ndash by using S-equiP operating rooms and criticalcare areas can be tted out to world class standards

When choosing S-equiP clients bene t from Starkstromrsquos unparalleled projectmanagement skills - working with one specialist experienced supplier withUK-based design engineers and production facilities saves time and money and ensures that projects run smoothly and ef ciently

To support S-equiP Starkstrom has once again increased its sales force andhas announced the formation of a Clinical Sales Team Headed up by KeithBolton and covering the whole of the UK the team deals with all clinicalaspects within operating room and critical care areas

The team has over 40 yearsrsquo collective experience in the industry and as SDirector Will Evans says ldquopresents the perfect scenario for our clients wa dedicated team supporting our clinical products alongside our engineeproductsrdquo

With Starkstromrsquos S-equiP solution clients are assured of the best equipmsupplied tted and project-managed by the best in the business meafewer headaches and a world class operating room or critical care area

When responding to articles please quote

Further information StarkstromTel 0208 868 3732 Web wwwstarkstromcom E-mail infostarkstromAmanda Parkin 07810 636467 amandaparkinstarkstromcom

Registration FormPlease complete all sections of the registration form in BLOCK CAPITALS and return toEvents Department AfPP Daisy Ayris House 42 Freemans Way Harrogate HG3 1DHIf you have any queries about the event please contact the AfPP events team on 01423 882948 or email joannaripleyafpporguk

Sections marked are compulsory

Your details

Title First name Surname

Home address

TownCity Postcode

Primary email

Daytime telephone number Mobile phone number

Job title

Department

EmployerUniversity

EmployerUniversity address

TownCity Postcode

Work email Work telephone number

NMCHPC PIN

Questions about you

Are you a

Day Surgery Manager Director of Nursing First Assistant HCA HCW ODP SCPASP

SeniorTheatre Sister SEPPA-A SSDDecontamination staff Student Theatre Nurse

Other please specify

Which of the following best describes the practice area you work in (select as many as relevant)

Anaesthetics Education (Clinical) Education (HEI) Pre-assessment Military Recovery

Scrub Theatre management

Which of the following best describes your area of specialism (select as many as relevant)

Bariatric Breast CardiacThoracic Day Surgery Endoscopy ENT General Surgery

Neurosurgery ObstetricsGynaecology Oncology Ophthalmic OrthopaedicsTrauma

Paediatrics PlasticsCosmetics Primary care UrologyRenal Vascular


How many times have you been to the AfPP Congress amp Exhibition before

Never Once Twice Three to five times More than five times




























































f l N l










1
















SaferSurgeryUK

How did you hear about AfPP2012

AfPP publication AfPP poster AfPP website Colleague Direct mail Exhibitor

Email from AfPP Contact with AfPP representative


What influence do you have on purchasing decisions within your department

Budget holder Decision maker Make recommendations (influencer) No influence

Membership and ticket details

Congress booking ndash please complete the section below

RegisteredNon-registered member membership number

AfPP membership rate (includes refreshments) ndash pound199

Non-member delegate rate (includes one year AfPP membership and refreshments) - pound299

I understand that to qualify for congress membership rates I must have been a member of AfPP for the previous 12 consecutive months prior to congress or I am a new member and have paid for a full 12 months subscription to AfPP (proof of membership must be shown at the event)

Please state any special needs that AfPP staff may be able to help you with (eg mobility or diet)

Cancellation Notice of cancellation should be made in writing to AfPP Only written cancellations will be accepted Cancellations received more than 20 days before the event (ie before 28 September) will receive a full refund less a 25 handling fee Cancellations from 28 September and thereafter will receive no refund AfPP reserves the right to add or remove elements from the Congress programme depending on availability of speakers and in the light of new events that may be of interest to delegates etc Data Protection AfPP does not sell or rent your personal information to others Your details will be added to the AfPP database in order to process your request and so that you can be kept up to date with relevant details of our future events and membership services Once a place has being booked at AfPP2012 this place cannot be swapped to another individual From time to time we may provide members with information from AfPPrsquos partner companies that may be appropriate If you do not wish to receive further information from partner companies whether by post telephone or e-mail tick this box

Payment I would like to pay by

Cheque I enclose a cheque payable to The Association for Perioperative Practice for pound

Invoice (pre-registration only) Please send an invoice for pound to

Purchase order number (compulsory)

BACS

Please make BACS payments to

AfPP Sort Code 5 3 5 0 2 1 Account Number 5 1 1 3 0 4 9 1

Please quote delegate name and organisation name with all BACS payments

Credit CardDebit Card - Please debit my Visa Mastercard Switch Maestro

Cardholderrsquos Name

Card no

3 digit security no Issue no (Switch) Valid from To

Signature

Card billing address (if different from reverse)

Postcode





w starkstromcom














----

Itrsquos easy to subscribe just visit our website at wwwotjonlinecom and pay via Card or Paypal

--- -- ---

Itrsquos easy to subscribe just visit our website at wwwotjonlinecom and pay via Card or PaypalSubscribeto the OTJ

Delivered to your door every month

Name ___________________________________________Address ___________________________________________ ___________________________________________Town ___________________________________________County ___________________________________________Postcode ________________Tel_________________________ Please enclose cheque made payable to ldquoLawrand Ltdrdquo and return to Lawrand Ltd PO Box 51 Pontyclun CF72 9YY

---

----

----

----

----

----

----

----

-

Subscribing to the OTJ costs pound1400 per year for delivery in the UK or pound2100 overseas Alternatively just ll in your address details below and return with a cheque

Inhaled pain relieving drugs have power to protect babies

from brain damage during birthA unique study funded by childrens charity Action Medical Research has discovered that a combination of anaesthetics not only prevent labour pains but might also protect babies from brain damage caused by a lack of oxygen during birth

The remarkable results discovered by a research team at Imperial College London have been published today in the online journal PLoS ONE

Lead researcher Dr Daqing Ma said Nobody has reported so far on anaesthetics reducing labour pain and protecting the babys brain This is a remarkable nding for us and we hope to take it further from bench to bedside

The researchers at Imperial had already discovered preliminary evidence to suggest that xenon and sevo urane might be able to protect babies brains from the damage caused by birth asphyxia Both of these anaesthetics are already being used safely to provide pain relief in other circumstances

When a baby is deprived of oxygen around the time of birth birth asphyxia it can lead to brain damage and devastating lifelong conditions including cerebral palsy learning disabilities and epilepsy1 Other organs can also be damaged and some babies are stillborn

Many different factors can lead to birth asphyxia including high or low blood pressure in the mother problems with the placenta compression of the umbilical cord and breathing dif culties in a newborn baby Sometimes the cause remains unknown

There is currently no preventative treatment for the condition and attempts to treat the consequences of it have been largely ineffective although cooling the baby after birth can sometimes bring bene ts Action Medical Research contributed to the development of the groundbreaking cooling therapy (therapeutic hypothermia) now being adopted in UK hospitals following NICE guidance in 20102

A grant from childrens charity Action Medical Research was used by the researchers to carry out a further two year study to test their theory which has now been shown to work in a laboratory model the next step is to take forward the ndings to a clinical trial If the inhaled anaesthetics xenon and sevo urane prove effective in these trials it is babies who are deprived of oxygen at birth who could be set to bene t

Dr Caroline Johnston Research Evaluation Manager from the charity said This is very exciting news Finding a way to prevent the brain damage caused by birth asphyxia could save babies lives and give children who would otherwise have faced a lifetime of complications a healthier life The researchers now believe that giving a pregnant woman the inhaled anaesthetics xenon and sevo urane during childbirth might help to protect her baby from the consequences of birth asphyxia while also relieving her labour pains

Xenon and Sevo urane provide Analgesia during Labor and Fetal Brain Protection in a Perinatal Rat Model of Hypoxia-Ischemia Ma D Yang T Rei Fidalgo AM et al PLoS ONE 17 May 2012

httpdxplosorg101371journalpone0037020

References1 CMACE Perinatal mortality 2008 London 20102 httpwwwniceorguknicemedialive113154880948809pdf actionorguk

Health Professions Council - Student registration statement

At its meeting on 10 May 2012 the Council reviewed the responses to its recent consultation on the most effective way of assuring the tness to practise of students across all its professions including the registration of social work students in England

Following analysis of the consultation responses and the independent research commissioned Council agreed that there would not be a student register for the professions it currently regulates

The Council also agreed that in the long term the tness to practise of social work students is best managed by the education providers in accordance with the HPCs standards for education and training However the Council acknowledged this would place new requirements on social work education providers in England and agreed to consider transitional arrangements to effect this change These will be discussed by Council in June 2012

Badging Staff Meets Care Quality Commission Outcome

Since 2010 healthcare practices regulated by the Care Quality Commission (CQC) must meet service delivery criteria including the clear identi cation of individual staff members

The guidance publication entitled Essential standards of quality and safety speci es that for providers to achieve the required standard of care and welfare of people who use their healthcare services their users ldquocan be con dent that wherever possible they will know the names and job titles of the people who provide their care treatment and supportrdquo (part of Outcome 4C)

Compliance with this standard is simple according to Badgemaster the UKrsquos leading supplier of name badges ldquoProviding name badges to customer-facing staff is a proven and very cost-effective solution to the Care Quality Commission regulationsrdquo con rms John Bancroft Managing Director of Badgemaster Dr Neil Shaw of Eyre Street Dental Practice in Clay Cross Derbyshire agrees commenting ldquobadging our team with Badgemasterrsquos help very quickly and painlessly satis ed this outcome for our auditrdquo

Nottinghamshire-based for 20 years Badgemaster designs and manufactures ready-to-wear employee name badges for thousands of hospitals surgeries and care homes and well understands the needs of healthcare professionals Badgemasterrsquos experience suggests that its own high product and service quality is greatly valued where time and budget come under pressure

ldquoBadgemaster has built excellent customer loyalty by providing a wide choice of name badge styles with clothes-friendly and patient-safe fasteners and high quality logo reproduction together with a very fast and easy ordering and delivery process all at the most competitive prices with no minimum orderrdquo states John Bancroft ldquoItrsquos also notable that many of the customers who compliment our staff for being so friendly and helpful are in the healthcare sectorrdquo he adds

For more information call Badgemasterrsquos Customer Services team on 01623 723112 or visit either the Badgemaster website at wwwbadgemastercouk or the Care Quality Commission website at wwwcqcorguk Please quote lsquoOTJrsquo

ldquoit is recommended that all hospitals have second generation SADs available for both routine use and rescue airway managementrdquo 1

Reference (1) 4th National Audit Project of The Royal College of Anaesthetists and the Difficult Airway Society Major complications of airway management in the UK Report and findings March 2011 Section 3 Appendix page 210

Quality innovation and choicewwwi-gelcom


The Next issue copy deadline Monday 25th June 2012All enquiries To the editorial team The OTJ Lawrand Ltd PO Box 51 Pontyclun CF72 9YY Tel 02921 680068 Email adminlawrandcom Website wwwlawrandcomThe Operating Theatre Journal is published twelve times per year Available in electronic format from the pages of wwwotjonlinecomand in hard copy to hospitals throughout the United Kingdom Personal copies are available by nominal subscriptionNeither 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 No part of this journal may be reproduced without prior permission from Lawrand Ltd copy 2012Journal Printers The Warwick Printing Co Ltd Caswell Road Leamington Spa Warwickshire CV31 1QD

Opioid Painkillers Try to Please their PatientsThe rapid growth of the elderly population worldwide is fuelling an escalation of age-related medical conditions such as cancer and arthritis boosting the need for opioids and pain management drugs However needs are still not being met by the healthcare industry according to a new report by medical intelligence experts GBI Research

The new report indicates that the pain therapy market is growing despite patent expiries generic substitutions and concerns over addiction Pain is a widespread problem considerably affecting day to day life with over 25 of the global population suffering from some form of clinically signi cant pain every year creating a signi cant patient pool that pharmaceutical players are keen to cater to

Despite this pain suffered by cancer patient still goes under-treated in more than 50 of treatment cases primarily due to the absence of an adequate pain management solution

A combination of unwanted side effects and the fear of addiction to certain classes of medications is preventing some individuals from relieving their discomfort

As a result pain management presents a considerable challenge for physicians who are struggling to meet the growing unmet clinical needs of their patients Rates of treatment-seeking patients and diagnosis are also low as the current offerings from the pain management market push fewer patients through surgery doors

The market for pain management therapeutics is comprised of therapies such as opioids non-steroidal anti-in ammatory drugs (NSAIDs) local anaesthetics tricyclic antidepressants and anticonvulsants Opioids which represent the largest pain therapy class can cause side effects such as nausea vomiting constipation and drowsiness and even severe respiratory depression Opioids are also often viewed in

a negative light for their addictive qualities NSAIDs in turn can cause gastrointestinal upsets increase cardiovascular risks and cause kidney and liver damage

However the future may hold some hope for chronic pain sufferers The unmet need for safer and more ef cient drugs has resulted in substantial RampD interest in treating pain conditions The current RampD pipeline for pain management has 282 trials in different stages of discovery and development Neuropathic pain currently accounting for almost half of the total pain management therapeutics market is the key therapy focus area in the current development pipeline More than 50 of the total trials for pain management therapeutics are in Phase III and Phase II research which indicates that some new drug candidates will emerge in the near futureCurrent competition between chronic pain therapeutics is strong as many treatment options for chronic

pain are available meaning that lower market potential is available for any new entrants without innovative rst-in-class drugs or disease-modifying mechanisms of action that can show improved overall survival safety and ef cacy Therefore new drug delivery systems look to favour novel techniques such as intravenous infusions time-release transdermal skin patches nasal sprays and inhaled aerosols

GBI Research estimates that the global pain management market was worth approximately $286 billion in 2010 Improved diagnosis of pain indications coupled with blockbuster sales of Lyrica (pregabalin) and Cymbalta (duloxetine HCl) are expected to drive the pain therapeutics market in the future While these two top-selling drugs are expected to face patent expiries in the forecast period the healthy development pipeline for pain management re ects positive prospects for the growth of the market in the future

New style of NHS leadership could deliver better patient care and nancial performance says The Kings Fund review

A year-long review carried out by The Kings Fund argues that a new style of leadership in the NHS could deliver lower mortality better patient experience and outcomes and nancial savings

The review builds on last years No more heroes report which criticised political attacks on the role of NHS managers It argues that the NHS should move away from the predominant pace-setting style of leadership based on meeting targets and makes a compelling business case for a new model of leadership based on stronger engagement between staff clinicians and patients

Drawing on seven commissioned papers and numerous submissions the review highlights the links between organisational performance and leaders who engage staff patients and others in improving care For example evidence suggests a strong correlation between levels of staff engagement and hospital mortality rates It shows that by increasing staff engagement to the level of the top 20 per cent of hospitals the average acute trust could reduce patient mortality by 24 per cent It also found that this could save an estimated pound150000 annually per trust by reducing staff absenteeism alone indicating the potential to make substantial savings across the NHS as a whole

The review found strong evidence linking effective engagement by doctors with improved organisational performance and better patient outcomes Organisations with medical engagement generally have higher quality patient care improved productivity (including signi cantly lower mortality rates) and better nancial performance The review also highlights the importance of NHS leaders engaging across organisational boundaries to deliver integrated care and calls for a stronger emphasis on increased patient engagement to improve patient outcomes

The review argues that leadership for engagement needs to be embraced at all levels of the NHS from the frontline to the NHS Commissioning Board This requires the new Leadership Academy to promote a diversity of leadership approaches and for NHS boards to set the tone for staff and for team leaders to create a climate that emphasises patient care and enables staff to perform to the best of their abilities

Chris Ham Chief Executive at The Kings Fund said

The NHS is facing unprecedented nancial and organisational challenges The need to improve service quality while nding pound20 billion in productivity improvements by 2015 and implement the NHS reforms means that effective NHS leadership has never been more important Our review reveals a compelling business case for leadership based on stronger engagement between staff clinicians and patients Instead of making swingeing cuts to the number of NHS managers our research suggests that a new style of leadership could signi cantly improve nancial and service performance

The reformed NHS must leave behind the command and control culture that has dominated health policy in the last decade and develop leaders who can engage others to deliver further improvements in performance and patient care








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AfPP member rate



pound199





































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THE

OPERATING

THEATRE

JOURNAL



















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Use the Power of


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wwwmkupdatecouk























































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CANDIDATE 1

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Address

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TrustOrganisation

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as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

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Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

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f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-




































wwwxographcom










a

o

tAow

soX




AfPP member rate



pound199





































5 YEAR WARRANTY


























THE

OPERATING

THEATRE

JOURNAL



















wwwlidcocom








Use the Power of


twittercomOTJOnline























































work ow















Orthopaed

calcom

dic





















wwwmkupdatecouk
























































oncerns arise












































1100 TeaCoffee

























work ow















Orthopaed

calcom

dic























1230 Lunch





1430 TeaCoffee






1630 Close


wwwmkupdatecouk























































oncerns arise






































CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation




Job title Dept

TrustOrganisation

Address

Postcode

Email Tel








Orthopaed

calcom

dic










work ow
















































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-





















































5 YEAR WARRANTY


























THE

OPERATING

THEATRE

JOURNAL



















wwwlidcocom








Use the Power of


twittercomOTJOnline























































work ow















Orthopaed

calcom

dic





















wwwmkupdatecouk
























































oncerns arise












































1100 TeaCoffee

























work ow















Orthopaed

calcom

dic























1230 Lunch





1430 TeaCoffee






1630 Close


wwwmkupdatecouk























































oncerns arise






































CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation




Job title Dept

TrustOrganisation

Address

Postcode

Email Tel








Orthopaed

calcom

dic










work ow
















































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-





















































THE

OPERATING

THEATRE

JOURNAL



















wwwlidcocom








Use the Power of


twittercomOTJOnline























































work ow















Orthopaed

calcom

dic





















wwwmkupdatecouk
























































oncerns arise












































1100 TeaCoffee

























work ow















Orthopaed

calcom

dic























1230 Lunch





1430 TeaCoffee






1630 Close


wwwmkupdatecouk























































oncerns arise






































CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation




Job title Dept

TrustOrganisation

Address

Postcode

Email Tel








Orthopaed

calcom

dic










work ow
















































































f l N l














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as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


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Postcode





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----


--- -- ---




---

----

----

----

----

----

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-














































wwwlidcocom








Use the Power of


twittercomOTJOnline























































work ow















Orthopaed

calcom

dic





















wwwmkupdatecouk
























































oncerns arise












































1100 TeaCoffee

























work ow















Orthopaed

calcom

dic























1230 Lunch





1430 TeaCoffee






1630 Close


wwwmkupdatecouk























































oncerns arise






































CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation




Job title Dept

TrustOrganisation

Address

Postcode

Email Tel








Orthopaed

calcom

dic










work ow
















































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-



















































































work ow















Orthopaed

calcom

dic





















wwwmkupdatecouk
























































oncerns arise












































1100 TeaCoffee

























work ow















Orthopaed

calcom

dic























1230 Lunch





1430 TeaCoffee






1630 Close


wwwmkupdatecouk























































oncerns arise






































CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation




Job title Dept

TrustOrganisation

Address

Postcode

Email Tel








Orthopaed

calcom

dic










work ow
















































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-



















































































oncerns arise












































1100 TeaCoffee

























work ow















Orthopaed

calcom

dic























1230 Lunch





1430 TeaCoffee






1630 Close


wwwmkupdatecouk























































oncerns arise






































CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation




Job title Dept

TrustOrganisation

Address

Postcode

Email Tel








Orthopaed

calcom

dic










work ow
















































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-












































work ow















Orthopaed

calcom

dic























1230 Lunch





1430 TeaCoffee






1630 Close


wwwmkupdatecouk























































oncerns arise






































CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation




Job title Dept

TrustOrganisation

Address

Postcode

Email Tel








Orthopaed

calcom

dic










work ow
















































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-



















































































oncerns arise






































CANDIDATE 1

Full Name

Job title WardUnit

Email Tel

TrustOrganisation

Address

Postcode

CANDIDATE 2

Full Name

Job title WardUnit

Email Tel

TrustOrganisation




Job title Dept

TrustOrganisation

Address

Postcode

Email Tel








Orthopaed

calcom

dic










work ow
















































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-



































Orthopaed

calcom

dic










work ow
















































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-




































































































f l N l














w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-

































w starkstromcom














as Snts ginee

uipmmearea

quote

trom



AfPP member rate



pound199




























































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-
























































































f l N l










1
















SaferSurgeryUK





w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-

































w starkstromcom
















w starkstromcom















Your details


Home address

TownCity Postcode

Primary email


Job title

Department

EmployerUniversity


TownCity Postcode


NMCHPC PIN

Questions about you

Are you a









































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-
























































































f l N l










1
















SaferSurgeryUK



















BACS






Card no


Signature


Postcode





w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-

































w starkstromcom














----


--- -- ---




---

----

----

----

----

----

----

----

-






























----


--- -- ---




---

----

----

----

----

----

----

----

-





























The Operating Theatre Journal

Documents

Transcript of The Operating Theatre Journal