How Much?

So, I was at the RRU meeting yesterday, where we talked about response times, the future of the ambulance service and the new piece of equipment us RRU people are getting.
I'm not working for the next couple of days, so I'll spread these subjects out over the next few posts.

(It'll give me something to do in between wallpapering my new place).

The RRU cars are all getting a new piece of equipment, a propaq monitoring device.

They measure blood pressure, oxygen saturation, pulse, respiration, ECG, and end-tidal CO2.

They weigh a lot. They also come in their own shoulder-strap bag.

At the moment we can measure blood pressure, oxygen saturation, pulse, respiration and ECG. We can't measure end-tidal CO2, but it is incredibly rare that we would need to. Ambulances, as opposed to RRUs can monitor end-tidal CO2.

The equipment we are using at the moment is lightweight, and fits in one hand (or our primary response pack).

Cost per unit for the Propaq? £9,000 each. (That is a discount because we are buying in bulk)

Cost for the kit we are using now? £320 (roughly).

Number of RRUs in service? 60.

Total cost for this new equipment that we really don't need? £540,000

Yes. Over half a million pounds for a bit of kit that is heavier, more fragile, more expensive to replace and does essentially what we can do right now.

I suspect that there is someone high up in management who. much like the Blair government, thinks that throwing I.T. at things will make life better.

I think I'll stick to manual blood pressure measurement, and an oxygen monitor that is the size of a box of matches.

Oh, and some bright spark has made them cut off the carrying handle, so that it wouldn't be so heavy…

23 thoughts on “How Much?”

  1. …”Oh, and some bright spark has made them cut off the carrying handle, so that it wouldn't be so heavy…”Did you check the calender…it isn't April 1st or anything is it?

  2. Gah.They chuck money at stuff people don't need and yet we have to buy our own thermometers for work.




  3. By removing the carry handles, they make it more likely you will leave the Propac in your car where it can't be damaged, thus saving tens of thousands in repair costs.

  4. we could do with some! ##but thats because I am a lazy basta.d and get bored of taking BP's after the first 100 in a day…

    and 1 pulse ox for an entire department! crazy!

  5. Thats a bit crappy.Why not use the big heavy expensive thing though? It'd be fun. Build up muscle mass and all that….

  6. Since when did common sense have any place in NHS decision making Tom?I'm surprised at you. You've worked in the NHS for pretty much your entire life and your still surprised by things like this? Stupidity and idiocy are part of management of any organisation, more so in the NHS. Wasting nearly half a million is nothing.

    What is more annoying is when the same manager's turn round and tell you that you can't have a new computer because there's no room in the budget – or they make stupid decisions like stopping purchasing lined paper and making you use recycled printer paper.

    but since management knows best ™ then you just have to take these decision and make sure you said I told you so when it goes A over T.

  7. Or if intubated with a regular ETT. Like Tom said, it's rare that it would be used, we know how much some EMT's hate intubation:)On a different note, the ECG readout on these things is pretty dire. We have one that gets used quite regularly in house. Working in non-cardic Paed's, we dont have to worry too much about the ECG, but the morphology is so hard to make out it's rediculous. It seems to flatten alot of the QRS out and the T is really hard to see…in my opinion.

    Has'nt anyone mentioned that a portable ABG analyser might be more useful (I have links if anyone wants them)? Getting you lad's doing this might help out department staff too. “Compensated respiratory acidosis” might sound better than “some old dear who's turned a bit blue, might have COPD”!


  8. I was in Theaters yesterday and got ridiculed for saying “I'm following the patient through the system” There is no system within the NHS

  9. What the hell is it with the NHS and purchasing?.. I had an interesting conversation with a theatre nurse about clips. The clips they use to hold down sterile sheeting are quite expensive (around a tenner each IIRC), but theyre made out of metal, last for ages, and stand up well to being sterilised etc. But theyre not allowed to buy any. Instead, they use some other types of plastic clip that are designed for a completely different purpose. They sort of work, but break after a couple of uses and get binned. Cost? Around 15 quid. But as theyre classed as a consumable, they can buy them… Insane.(sorry, Im not a healthcare pro, I do IT, so forgive the lack of proper teminology!)

  10. Jeez man, thats awful! I've been a student again for the past year (I'm converting from adult to paed's…apparently they are put together differently or something) and I've been astonished by the attitudes of some toward students. I dont think you notice it first time round, because that's all your used to. For example-Identifying a pneumo on a chest film and being told by a house officer to be quiet unless I have something helpful to say.

    I could go on but…meh. There is a system in the NHS but it mainly consist's of knowing where you are in the pecking order and not straying from it.

  11. Ridiculous…or maybe someone is on the board of Directors of the company that makes the new machines…….allegedly, and purely my own opinion of course!!

  12. P.S Just to say Hi to Reynolds…been reading your blog for a few weeks but only just 'joined' so I can leave my unprofessional uneducated comments and opinions all over your nice blog!!! Keep up the good work, you do a sterling job and if I had my way, all Emergency Service Personnel would be paid triple what they are paid now (not that its all about the money of course!!)

  13. The folks in charge who make these decisions are never the folks who actually know what the things they are purchasing are for and how they work. If they were the kind of people who would know to bother to ask the people who actually do the work, they would be the kind of people who are actually doing the work that the folks who make the high level procurement decisions wouldn't know to bother to ask.If you pretend you can follow that, you may be a manager.

  14. Depends on which budget. If one comes out of capital and one revenue then it'll be easy to spend the revenue budget. Or it might just be different pots in the various budgets. I remember years ago failing to sell some kit that someone really needed in an ECG department because they had no capital budget left – plenty of revenue money though which couldn't be used for it. And don't get me started on the old March (end of financial year) “spend all the money fast” rush

  15. Besides, Propaqs suck. They have a habit of dying on you right when you need them…. Out of interest, what's the unit that's being scrapped?

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