1995 OPEN FORUM Abstracts
O_2 OPERATING COSTS OF RESUSCITATION BAGS IN THE NICU AND PICU.
Jim Keenan BS RRT, Julie Ballard BS RRT, and John Salyer BS RRT. Primary Children's Medical Center, Salt Lake City, UT.
Introduction: Standby resuscitation bags are supplied for all 26 beds in the PICU and 35 beds in the NICU in the event of any emergency that may require supplemental bagged oxygen. It has been a standard practice at our facility that flow meters supplying O_2 to these bags are running at all times. In our NICU, a blender is always used to power the bag, to approximate the ventilator's FIO_2. We sought to determine the amount of O_2 wastage and its cost, per intensive care unit.
Methods: Fourteen random weekdays of data were gathered from each unit. We recorded: 1) flow rates of all flow meters and 2) blender usage (we use the Sechrist Air-Oxygen Mixer, Model 3500HL, which has a measured O_2 bleed of approximately 6.5 lpm). We also took into account the number of blenders plugged in, with flow meter off, at empty bed spaces. We assumed that the flow rates varied very little throughout a 24 hr period and that the amount of time actually bagging was minimal because of the widespread use of closed catheter suction systems. All daily flow rates and blender bleeds were totaled, then average O_2 daily costs were computed using our cost of: $.533/100 ft³ and 28.3 L/100 ft³. The mean cost of the fourteen days was then used to extrapolate yearly totals for each unit.
Results: Daily and yearly cost estimates are described in figures 1 and 2.
SEE ORIGINAL GRAPH
FACILITY $98 $35,651
Figure two: Daily and yearly O_2 wastage costs
Discussion: We feel that wastage costs of supplying standby O_2 in both intensive care areas are financially significant. This study reveals that the use of blenders with bleeds, as in our NICU, greatly increases these costs. Habits of practice will often dictate whether these resuscitation bags can and should be turned off when not in use. Even if the practice of tuming off the flow meters is adopted, the bleed factor on the blenders is still a problem. Many clinicians will argue that clinical safety outweighs the cost. There are automatic shut off devices and blenders with little or no bleed available. The capital cost of these products have limited their widespread use. Further studies need to be performed on these cost saving devices, to determine if the cost to savings ratio will minimize the cost of operating resuscitation bags.