Health Care Systems Comparison Between Third World Countries and Rest of the World

This may be one of the hot topics during this pandemic covid19 now a days I have gone through many articles, blogs and videos, strong health care system has excellent clinical staff sharing their experiences to handle the patient. This disaster situation occurs first time in their life to handle so many patients at one time, on other end third world countries we can pick some of them from the huge numbers, like Pakistan, India, Afghanistan and so on, where health care systems are very limited against population of the nation, there hospitals are always over budded cannot accommodate everyone in daily routine.

US, UK, Spain, France, Germany, Italy and China have strong health systems their system shook due to Pandemic covid-19. Usually they handled limited patients, 90% of them are insurance coverage patient and rest are government responsibilities, which they treat accordingly, they don’t have to face financial issues, because they have strong backing of government to support.

Comparative to them, we have many issues to cater, first of all the 3rd world countries already far behind from developed and rich countries, they have social, economic, law and order issues, they cannot provide coverage to ¼ of their citizens a quality care, but they have well trained staff, they handle thousands of patients in their daily routines. In my experience I have faced received daily gunshots during city crises in Karachi, Gang wars, Snatching and blind bullets are taking life of many, I was working in Private Hospital where only affording patients were coming

for quality care as followed by JCIA protocols. During my training government hospitals visit was also part of our studies, where I have seen thousands of peoples, most of them can’t afford shoes and slippers, they were barefooted, follow long queue, the casualties only open wound and fresh trauma’s other than that treat as clinic patient and have to wait for the turn.

It’s not about our country that never deliver basic health system to the citizens, reason may be anything we have 40% of the population is illiterate or proper system. Our Nurses and Doctors are well trained because they handle large number of patients on daily basis which polish their skills.

The University Hospital where have I have been trained, also recognize my clinical expertise during city crises, assassination of former Prime Minister of Pakistan, Mohtarma Benzair Bhutto and other crises. I am glad that I got opportunity to perform CPR Codes with Colleague Doctors in Emergency Department as a Nurse to revert patient back to life.

Covid 19 Pandemic has started its root into Pakistan, India and other backward countries, they are trying to pause its spread by strict lockdown, educational institution, and worships, still on daily basis 2-digit peoples are dying that’s a controlled figure, but numbers of suspected and victims are increase on daily basis, Nurses, Doctors and other paramedics are highly motivated to cater the situation as we believe

Medical Air Systems for Healthcare Facilities

Medical air systems are a vital element of all hospitals and most other healthcare facilities. The engineer must consider expense, capacity, physical size and weight, space limitations, and mechanical and electrical utility availability in choosing a system for a particular project. It is important to coordinate the equipment selections with the owner as well as other engineering and architectural disciplines.

The first priority is life safety. Medical air is used for respiratory therapy and calibration of medical devices for respiratory application. Providing clean, oil-free air is mandatory. The medical air system should not be used to supply air for any other purpose (e.g., hospital laboratory use) because of the opportunities for contamination of the distribution system. If a patient inhales medical air contaminated by oil from a defunct compressor or nitrogen from a brazing purge, the consequences could be irreversible. In addition, a utility or pipeline shutdown must be coordinated with the hospital staff to prevent an accidental service termination while patients are connected to the system. Engineers should be aware of the requirements before designing any medical gas system.

Distribution Systems

Medical compressed air systems must be designed to prevent the introduction of contaminants or liquid into the pipeline. Medical air systems must:

• be supplied from cylinders, bulk containers, or medical air compressor sources; or reconstituted from oxygen USP and oil-free, dry nitrogen

• meet requirements of the medical air

• contain no detectable liquid hydrocarbons

• contain fewer than 25 ppm gaseous hydrocarbons

• contain 5 mg/m3 or less of permanent particulates sized 1 micron or larger at normal atmospheric pressure.

In a typical fully functioning healthcare facility, the medical air is supplied by a high-pressure cylinder manifold system or a medical air compressor system. Manifold distribution systems typically are used in facilities that have very little demand for medical air. Medical air compressor plants typically are for larger facilities.

Existing facilities may choose to upgrade their equipment and associated pipeline or add medical air plants as the facility expands. When selecting a piece of equipment for a new facility, the possibility of future expansion should be considered. To allow for future growth, it is good practice to be conservative in sizing a system.

Duplex Medical Air Compressor Source Systems

An engineer usually has more options available when designing for a new facility than for a renovation or replacement project. Electrical and mechanical utilities can be more easily calculated, and chilled water, ventilation, and electrical services can be sized and adequately located. The ideal schematic design contains a well-ventilated, easily accessible mechanical room dedicated to medical gas equipment.

In selecting a medical air compressor for an upgrade, the engineer may have some trouble due to mechanical utility inefficiencies (e.g., poor chilled water quality, a poorly ventilated mechanical space). The local electric utility may not support the pump arrangement, or poor equipment access may require breakdown of equipment parts at a significant cost increase. It is imperative to conduct thorough surveys of the surrounding mechanical space and utilities before determining the best type of compressor for the project.

It is a good idea to select more than one type of compressor at the schematic design phase. You should develop a master plan that shows existing demand and estimated spare capacity. The owner may want to obtain a cost estimate before making a final decision.

Types of Compressors

All medical air compressors must be able to deliver compressed air that does not contain oil. This article specifically deals with medical air systems for Level 1 hospitals.

There are three acceptable types:

• Oil-free compressors: These reciprocating compressors have no oil film on surfaces exposed to air being compressed. They do have oil in the machine and require separation of the oil-containing section from the compression chamber by at least two seals. The interconnecting shaft and seals must be visible without disassembling the compressor.

• Oilless compressors: These reciprocating or rotary-scroll compressors do not have oil in the machine. Lubrication is limited to seal bearings.

• Liquid ring pump: These rotary air compressor pumps have a water seal. It is recommended that a heat exchanger be utilized to conserve seal water.

Medical air compressor plants should be sized to serve peak calculated demand when the largest compressor is out of service. In an efficient design of a larger system (i.e., three pumps or more), each compressor is sized to handle an equal percentage of the peak demand and create redundancy. There never should be fewer than two compressors.

Accessory Equipment

Several pieces of mechanical equipment accompany the medical air compressor system:

• Intake: The compressor’s air intake must be located outdoors, above roof level, and at least 10 ft from any door, window, other intake, or other opening. Intakes must be turned down, screened, and equipped with intake filter mufflers. These filters remove large amounts of particulates (microscopic particles of solid or liquid matter suspended in the air) and contaminants at the compressor inlet.

• Air receiver: The role of the air receiver is to store air and balance pressure variations. It must have a full-size bypass as well as a manual and automatic drain to remove any collected condensate. It must meet American Society of Mechanical Engineers ( https://asme.org ) Section 8 boiler and pressure vessel construction standards. The receiver is sized based on system demand, compressor size, and compressor running times.

• Compressed air dryer: The dryer is used to remove water vapor from the air stream. At a minimum, it must be a duplex system valved to allow one unit to be serviced. Dryers should be of the desiccant twin-tower type, sized for 100% of calculated load at design conditions. They should be rated for 32°F (0°C).

• Duplex final filters: These should be rated for 100% system capacity, with a minimum of 98% efficiency at 1 micron or greater. The filter must be equipped with a visual indicator showing the remaining filter element life.

• Medical air regulators: Regulators control the pressure of the air system. They should be sized for 100% of the system’s peak calculated demand at design conditions. Pressure regulators should be set to provide the most distant outlet with 50-psig medical air.

• Alarm sensors: A medical air compressor must have alarm sensors located nearby where they can be continuously monitored by hospital personnel. Typical alarms are for high pressure, low pressure, and other trouble (e.g., lead/lag pump operation, high temperature, high dew point, carbon monoxide). Additional alarm signals can be added depending on the type of compressor and the owner’s preference.

• Anti-vibration mountings: These should be provided for the compressors, receiver, and dryers, as required by the manufacturer.

Piping

Medical air piping is sized according to the calculated flow rate in cubic feet per minute (cfm). Compressed air piping is constructed of brazed type-L copper prepared for oxygen service. The piping must be pitched toward the central plant, have drains at low points and it must be valved and identified.

Remote Patient Monitoring – The Future of Healthcare

How do healthcare professionals ensure that they can provide constant and quality care to remote patients? How do patients ensure that they have professional support without having to spend time and effort at hospital visits? Well, the answer lies in remote patient monitoring, which is an act of monitoring the health of a patient without being physically present. The integration of communication technologies in patient care has provided professionals with a revolutionary solution to deliver superior medical care remotely.

Consumer health devices such as portable blood pressure trackers, blood sugar tester, and ECG monitors have facilitated remote sharing of patient information. Doctors today can monitor patient health by using a secure web page where information is shared by a mobile transmitter that acts as a support between the device and the physician. More recently, manufacturers of implantable medical devices such as pacemakers have integrated connectivity into their products. These can be questioned manually by a third party to perform tests that would otherwise require a doctor to administer.

These tests are doing remote device maintenance checks, effective and convenient. In addition, these devices have been enabled to transmit statistics such as arrhythmias, which could help prevent emergency situations. Technology like this provides valuable support to healthcare providers, particularly in providing assistance to patients who need regular monitoring. An entire segment of patients suffering from long-term conditions such as congestive heart failure, hypertension, and diabetes will benefit from Remote Patient Monitoring with the convenience of care without spending time in clinics.

Another trend that is getting more and more adoption in the healthcare sector is the use of e-ICU models. These models allow physicians specializing in remote locations to monitor patients using two-way cameras, high-speed internet, and related devices. REMOTE PATIENT MONITORING helps move healthcare to an ever-changing environment where personal data is facilitated by data from connected devices.

The proliferation of devices enabled for Remote Patient Monitoring is further accelerated by the integration capabilities of the database. Remote Patient Monitoring Emerging Devices such as bands and bracelets that transmit patient position along with health readers transfer this information to a central database. Database-enabled tools can then alert doctors and their patients to improve disease treatment. Soon patients may have USB sticks connecting to a history database that can be instantly shared with institutions. REMOTE PATIENT MONITORING-based solutions are also entering the workforce with modules that provide monitoring solutions to employees with chronic conditions. Workplace productivity may increase timely alerts on devices and custom Web pages that monitor employee’s welfare levels.

Remote patient monitoring systems, therefore, can change how patient care is done by greatly reducing efforts and errors. Consequently, frequent visits to the hospital are reducing costs and encouraging adoption. The IHS research firm suggests that wireless remote monitoring devices will be used by more than 1.8 million people around the world in four years. Soon these systems could become a standard across the industry, driven by the high reception capacity and advances in database maintenance.

Mediklik is a new generation Patient Engagement & Doctor Discovery Platform where thousands of patients are browsing through millions of pages of contents related to health Each of these information pages show related doctors present in the nearby area, so patients are able to search and navigate doctors through map, book appointments or consult and follow up online. It also provides Remote Patient Monitoring services through which patients can consult a doctor at their home thus reducing time wasted in long waiting queues and traveling cost at the same time.