Prior Intellectual Property Search
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Delivery of OXYPLY prototype
- Delivered 2 prototype packagings at 2023 April 7th to Mulago Hospital Dr. Gingo Ped and Nurse Mr. Samson Udho
Prototype
Interview with Dr. Gingo Ped (Former Mulago Hospital, Present Makerere University Pediatrician
Do you use an oxygen regulator often?
‘Oxygen concentrators’ are mostly used in Mulago hospitals as ‘oxygen regulators’ are not widely available → cannot know how much oxygen yes how much oxygen the child is receiving at any particular time
If you don’t have enough oxygen regulators, what are the potential reasons?
- Various people have not yet thought about it and we're mostly in resource-limited settings. we don't have enough pots for each one of them.
- So that is why we eventually improvise with the octopus but otherwise, right now, the acute care unit in Mulago is under renovation and they're going to have various small ports
- If we have access to a regulator, then regulators will come in handy for us to measure how much oxygen each child gets off the octopus
- We have a high patient turnover very many patients and very low resources and yet we have to improvise (similar to continued COVID situations)
What safety measures do you take when testing a new oxygen regulator to avoid any hazards?
- We usually have technical people from the oxygen plant come and check out the oxygen and how it is going through the wall
- If they're to deliver any oxygen cylinders, then they deliver them, refill them and monitor them and ensure that for example, when we need to have any servicing of equipment or any of that, the people from the oxygen plant assist us with that
- We still follow up with the warrant.
- Mostly it is the people from the oxygen plant that assist us to check for any leakages or any technical issues or to see that it really works well otherwise we have some senior people like
How can the community at large, including local businesses and organizations, support the testing and maintenance of oxygen regulators?
- We could have some of those connected to portable, for example, oxygen cylinders or portable oxygen delivers, yea or concentrators then it will come in handy to solve that problem.
- Most of the people who regulate that, or who monitor that within the facility, are the people at the oxygen plant.
- But in the community, we don't have a lot of oxygen concentrators
Interview with Mr. Samson Udho (Nurse for Lira Regional Referrall Hospital)
Do you use an oxygen regulator often?
- Mothers who are already given birth and their newborns who are having difficulty in breathing are referred to NICU (NATO intensive care unit).
- There are three major things you find there. You'll find phototherapy which is trying to help baby fight illnesses then you'll find incubator. The best way we try to regulate it was to use like a sea pipe also to increase the rate of flow. So we don't have a very technical thing to use but some hospitals which are a bit well equipped they have oxygen concentrators.
- But what we notice in with oxygen concentrator is most of them tend to break down very easily. Secondly, most of them are power dependent. So if there's no power that means there's no oxygen. So they use a bit limited in our setting. So most of the hospitals I see are using a lot of the oxygen.
How has the situation changed before and after the COVID-19 pandemic?
- We generally see that the health seeking pattern of clients tend to change with the advent of COVID-19. For instance in the university hospital, we had very large numbers of patients until the COVID pandemic. When COVID-19 happened, the numbers reduced because of lockdown, which is for people who are in critical stage and needing recitation, needing breeding-related support. So we used that opportunity to set up HDU (high dependency unit.) It's not like a typical ICU; it's more leading to a complete ICU. Inside, there are people with COVID we are targeting people who are having difficulty in breathing. That was the major presenting complaint with COVID.
- We now have HDU four beds and we have the oxygen cylinders and oxygen concentrators. In the neighboring facility hospital, they also use the opportunity to really revamp their ICU for them. They have a proper ICU and and they have more equipment now as I speak. COVID-19 pandemic has significantly impacted the new borns.
What are some potential reasons for the lack of oxygen regulators or concentrators?
- One of the commonest thing we see for lacking proper regulation for oxygen is that in settings where we are using the concentrator, the oxygen concentrator depends on electricity and power. Blackout is very common in our area. So we have a distribution company called 'UMEME' and send a message in the morning to notify the power supply situation. The generators are quite expensive to operate and most of the facilities don't use the generators a lot as they depend on electricity and the issue of electricity becomes a big challenge in trying to use the oxygen concentrator per se.
- The other problem with the oxygen cylinder is that when we are using the oxygen cylinder, you have one channel coming and then you have to get this Nasal prongs. It's usually difficult to regulate the oxygen flow for their newborns or for the patients because we are all getting from the same source and you regulate from the cylinder. When you regulate from the cylinder, the nurse or the midwife has to find ways of trying to do it mechanically. Sometimes as a midwife I can use I have Nazo ProM with two openings.
- What I see is that the oxygen cylinder works best if it's you're dealing with adults who don't need a lot of regulation for oxygen flow because I mean the standard rate is ideal for all adults so there's no problem. But when you have a younger population, children units that need lower doses of oxygen then the oxygen sling that becomes a problem to regulate oxygen. Yeah and of course you know oxygen also becomes toxic when it's too much.
How have you resolved those problems you have faced when you use oxygen regulators?
- One of the ways I think we have tried to walk around the problem is to buy more oxygen concentrators. That's what I've seen my hospital do. But the oxygen concentrators have their own challenges. They tend to break down quite fast. Maybe the electricity shock on and off and they break down quite easily compared to the usual things. But generally speaking, in the events that you're using the cylinder, you don't have means to regulate the oxygen flow for every patient the midwife tries to improvise so you get another prongs of different sizes. So we have like from the sealing there then you have a sea pap somewhere then from the CPAP you have now connected different nasal prongs.
- You can also try to tighten the tube. You will use the concentrator to sort of narrow the the passage a bit. And that that can help you to regulate the oxygen flow. Secondly, the midwives also has to stay alert. Sometimes we say "I'm going to give this person oxygen therapy for 10 minutes and then remove then 10 minutes and then remove." So that means that steady supply of high dose oxygen we need may not be be very good. That makes working in Nku Ne Nitro intensive care unit very very intensive for a midwife. Like I've told you when you're in Niku you're working with those three major equipment incubator phototherapy and then the oxygen plant. But then also in Nikkei you have the medication to give usually nomocelline dextros. the extra 10 percent and then the antibiotics that you give a standard therapy for the newborns and can make it very difficult.
- So it's not uncommon that midwives will make mistakes with the three devices they're using. Sometimes the baby overstays in the incubator because they are busy giving treatment. Sometimes the baby overstays on oxygen because you are maybe focusing on giving phototherapy. And so those are some of the challenges we face. The beauty with the incubator is that you can regulate the temperature and it's stable. And also for the phototherapy you can regulate and it's stable. So those are some of the ways we've tried to improvise but it's not easy. It's a hectic thing.
How can the community at large like local businesses or organizations support your testing and maintenance?
- That's a case of the health system strengthening. And we have different structures to support the health system. So the first way as a hospital like hospital management that has a hospital director and board of governors and you introduce the problem to them and see whether they whether they can solve the problem. Most of the times they don't have the solution internally because of limited funding. And so it's not uncommon that they they extend the invitation to potential partners to partner with the hospital to help them gap fill or equipped in areas where they have shortages.
- Most of these equipments are expensive for the government to buy. So if they buy it's opportunity costs. If they buy for this particular region then the other region doesn't have and things like that. So I see opportunity for partnership with other organizations who have capacity to sort of gap fill in these areas. But I also see opportunities of partnership with also but also industries. For instance we have seen in Ladel that they do many kins. For instance, Ladel has been very supportive for instance in training of health professionals. They're like manufacturers but they identify institutions that need these manikins and they give them like subsidized rate. And they continue to offer capacity building on how to use the different many kinds appropriately and things like that.
- So I see opportunities for partnership to improve. And also the nurses and the midwives on the wards need like capacity building training refresher training on how to on how to administer oxygen for adults middle aged and the young people.
Interview with Myanmar Pediatrician
How has the situation changed/worsened before and after the COVID-19 pandemic?
- Situation changed significantly as reported in world news. While there was lack of oxygen concentrators/regulators even before the COVID-19 pandemic, situation was much worse/serious by the COVID-19 pandemic. The situation has reached full capacity and led to the shortage of both basic medicines and oxygen supplies.
What are the common problems that you have encountered during the testing of oxygen regulators, and how have you resolved them?
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How can the community at large, including local businesses and organizations, support the testing and maintenance of oxygen regulators?
- 2021 Myanmar coup d'état- military government control --> less opened/welcoming to foreigners
- especially in medical aspect, limited situation. For instance, the hospital very little or no advertisements regarding available surgeries or treatments due to the government's watch
- So, started to send patients to South Korea for better needed treatments and vice versa.
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