Hospital kit that puts you at risk

There are, apparently, 100,000 brands of medical equipment, reflecting just how much modern medicine has come to rely on sophisticated technical gizmos for everything from monitoring the blood pressure to maintaining the body's vital functions.

This is all to the good, but it does have its downside: the more sophisticated the equipment, the greater the number of ways in which it can go wrong, with potentially (very) serious consequences.Indeed, the recent report into the lamentable standard of care at Stafford General Hospital noted that poorly maintained equipment posed a major hazard to patients' welfare, with only two fully functioning infusion pumps in the whole hospital, where both, bizarrely, were stored unused in a linen cupboard.

This situation may not be unusual, as a Surrey reader with a professional interest in maintaining (non-medical) equipment discovered following his admission to hospital with a life-threatening pneumonia. "The whole experience was perfect in every respect, including the food," he writes. Until, that is, his last day, when, though he was apparently fully recovered, the electronic device for measuring his blood pressure showed it to be dangerously low.

When he inquired when the machine had last been calibrated, the nursing staff seemed to have no idea what he was talking about. It was only when he insisted his blood pressure be checked again, with an "old-fashioned" mercury machine – which showed it to be entirely normal – that he was allowed to
go home.

Subsequently, he felt compelled to write to the hospital about his experience, only to receive the standard brush-off that "patient safety is our first concern; we carry out all necessary tests on our equipment…"; which, clearly, they did not.

Being a persistent sort of fellow, he wrote again to the hospital's chief executive, warning that if he heard of any misfortune concerning malfunctioning equipment at the hospital in future, he would have to notify "a higher authority" of his prior warnings. This, it seems, had the desired effect.

Chewing gum is not, perhaps, the most attractive of habits. Still, over the years it has found many practical applications, especially in its ABC (already been chewed) form – sealing car radiators and gas pipes and even, reputedly, the hydraulic piping of a bomber's landing gear.

It also has useful therapeutic value for those troubled by the discomfort of a dry mouth, by means of stimulating the salivary glands. Recently, in an ingenious piece of lateral thinking, Canadian neurologist Dr Mandar Jog, has shown that it also has the reverse effect in reducing the excess saliva (which often results in drooling) that is a common feature of Parkinson's disease.The rationale is as follows: the many disturbances of function associated with this (and similar) neurological disorders include reduced frequency and poor 

co-ordination of the swallowing reflex, with the result that saliva "overflows".

Dr Jog speculated that chewing gum might mitigate this by stimulating the reflex to work more effectively. So, although it would generate more saliva, this would be more readily cleared. And so it turned out, as he recently reports in the journal Neurology, concluding that chewing gum "is a cost-effective, self-managed approach" to reduce excess saliva.

This week's conundrum comes courtesy of Mr S J from Wimbourne, Dorset, now in his early eighties but in reasonably good health and taking no medication. He reports that every second or third night, he wakes feeling hot and has to lie on top of the bed.

He then starts to cough, bringing up a clear fluid full of bubbles, while his breathing sounds like "a concert at the Proms". This lasts for about an hour; his body cools down, the coughing stops and he can then
go back to sleep. His GP is baffled. Perhaps another point of view might clarify what is amiss.

Source:Telegraph.co.uk