Archaic system, crumbling infrastructure behind Goa Medical College’s Oxygen woes

PANAJI: Virtually scoffing at the state government’s move to blame “logistical issues” for the erratic oxygen supply, doctors and industrial oxygen users said that the pattern suggested that infrastructural lacunae and lack of clear guidelines were responsible for the dip in supply to patients.
Engineers, doctors and industrialists said that the Goa Medical College’s reliance on a trolley-based oxygen supply system is an outdated model for hospitals. Present day hospitals use an independent liquid oxygen plant which generates medical oxygen on site similar to the ones already installed at the South Goa district hospital and the super speciality block.
“The oxygen manifold panel at the GMC is designed to pump 2,500 litres of oxygen per minute and is good enough for a 1,500 bedded hospital, but the medical gas pipeline system is not designed for a Covid hospital,” an official said.
A senior engineer, who is on site at the GMC, said that with the surge in Covid-19 cases, the oxygen supply system is overburdened.
“The GMC kept asking for the oxygen pipelines to be added to more and more wards which was done,” the engineer said.
Goa Association of Resident Doctors (GARD) president Dr Pratik Sawant said that the demand supply ratio of oxygen is skewed and that the oxygen supply is just not enough to cater to the increase in Covid patients.
“The government should have thought about this and improved the infrastructure at the GMC before the second wave,” an engineer who oversees the maintenance of the GMC’s infrastructure said.
The government appears to have finally swung into action and has installed a modern 23,000 litre liquid oxygen tank within the GMC’s campus. The tank has been taken on a long-term lease from Praxair India Pvt Ltd and has been shifted from Bicholim.
The tank has been erected and installed while the distribution pipes and welding of the oxygen gas pipelines will be completed by Saturday. An additional 6,000 litre oxygen tank will be purchased and installed by Goa State Infrastructure Development Corporation in the weeks to come.
“The 23,000 litre tank is expected to be operationalised by Monday and once the second 6,000 litre tank is installed next to the manifold, the dependence on oxygen trolleys will end,” a source said.
In a submission before the high court, the state government blamed “logistical issues” such as the lack of “expert drivers” as the reason for the erratic supply of oxygen. The passage where the tractor trolley has to manoeuvre and deploy the oxygen cylinders is narrow.
“A doctor in any of the critical Covid-19 wards has to manage 40-50 patients and if there are transitory oxygen pressure drops and if at the same time four or five patients desaturate, then the doctor is helpless. He can help just one or two patients. It cannot be called a logistical issue when there are lapses in the oxygen supply in the night or delay in transport,” Sawant said.
For over a fortnight, the GMC has reported fluctuations in the oxygen supply which has resulted in an additional burden for doctors.
A Goan industrialist, who uses industrial oxygen, said that medical oxygen is a cold gas and if the usage requirement of gaseous oxygen exceeds the original design requirements for an excessive amount of time, the system may be overdrawn and will cause a build-up of frost or ice near the internal valves, regulator or in the distribution system.
“The government should check if this is the case with a flow meter or if the regulator itself is faulty,” industrialist Chandrashekar Chari said.
The government constituted a three-member committee to inquire into the issue of interrupted oxygen supply in the GMC. The committee comprises IIT director B K Mishra as chairperson and former GMC dean Dr V N Jindal as member and secretary (urban development) Tariq Thomas as member and convenor of the committee.
Doctors also said that the technicians in-charge of the switch-over of the oxygen cylinders need to be given clear guidelines on the process to switch over the oxygen cylinders so that the least amount of time is taken and that doctors also need to be kept informed when the cylinders are being changed.