• NHS estates teams alerted to fire risks posed by using more ventilators
  • Increased oxygen levels in air means fire spreads faster
  • Hospitals also warned of cross-contamination risks in airflow systems 

Health chiefs have warned hospitals of increased risks of “combustion” on wards caused by more ventilators being used to treat covid-19 patients.

According to guidance sent to hospital estates teams by NHS England and Improvement earlier this week, the density of ventilators could “enrich” the air with oxygen, which increases the “combustion risk”.

Due to the likelihood of “enriched oxygen” in treatment areas, the guidance advised hospitals to maximise their levels of air changes through “natural and mechanical ventilation”.

This will lower the air’s oxygen level and therefore reduce the “risk of combustion”.

Trusts have also been ordered to carry out regular monitoring of “potentially exposed rooms” to “ensure oxygen enrichment is controlled”.

Oxygen is not flammable, but large amounts of it in the air enables fire to spread faster.

Jonathan Stewart, chair of the Health Estates and Facilities Management Association, told HSJ fires would be “massively exaggerated” by higher oxygen levels in the air.

“Oxygen is not in itself a risk as long as it’s managed correctly, but if you do get a fire and there are much higher amounts of oxygen in use then it becomes a much greater risk,” he said.

“I’m not aware there should be a particular risk from just the use of ventilators, it’s just that the risk increases when you bring more oxygen into high density areas.”

There were 1,541 fires recorded in the NHS in 2018-19 – the highest amount since 2015-16. 

Meanwhile, trusts have also been warned of the risk of cross-contamination in their airflow systems when establishing new treatment areas for covid-19 patients connected to ventilators.

According to the same NHSE/I guidance, the temporary use of rooms for covid-19 patients could create a risk of contamination “via an existing piped medical vacuum system”.

Estates teams should isolate and/or seal these systems to “prevent ingress of harmful bacteria”, the guidance stated.

The government is attempting to buy thousands of new ventilators to help covid-19 patients on intensive care units.

Currently the NHS is thought to have access to around 8,000 ventilators, but health and social care secretary Matt Hancock last week said the service did not have enough to meet anticipated demand from covid-19 patients.

The government has launched an appeal to engineering companies asking for help in building more ventilators for hospitals. However, a body representing clinical engineers has warned it could take months before ventilator manufacturing can be significantly boosted.