Why it’s important to monitor hospital staff exposure to Penthrox®

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Penthrox ® (methoxyflurane) is an anaesthetic agent that is being used more often in emergency departments, gynaecology departments, burns units and ambulances.

This is in part because it provides emergency pain relief for adult patients with trauma and associated pain, is easy to administer and leaves the body more quickly than Entonox.

In addition, methoxyflurane is much more environmentally friendly than Entonox. In fact, it has a climate change impact of 117.7 times less CO2e compared with Entonox(1), meaning it is a much better option for NHS Trusts working towards Net Zero.

How is Penthrox ® (methoxyflurane) administered?

The manufacturer recommends a maximum of 15 mL per week in 3–6 mL doses as required and that staff avoid administration on consecutive days.

The clear, volatile liquid has a characteristic fruity odour and is administered using a custom-built Penthrox® inhaler.

The patient inhales and exhales Penthrox ® through the mouthpiece to obtain analgesia. The exhaled vapour passes through the activated-carbon (AC) Chamber to adsorb any exhaled methoxyflurane.

Why do healthcare staff need to be monitored for exposure?

Even though the AC Chamber is designed to absorb exhaled methoxyflurane, there will still be some of it released to atmosphere.

Patients will find that pain relief occurs after 6–10 inhalations and that continuous inhalation of a bottle containing 3 ml provides analgesic relief for up to 25-30 minutes.

Not only does that mean that healthcare staff can be exposed to some exhaled methoxyflurane during one administration, but throughout a shift of administering the anaesthetic to multiple patients.

As there can be risks of serious side effects due to over-exposure, the manufacturer advises that exposure of healthcare professionals to methoxyflurane should be minimised.(2)

What side effects can healthcare staff experience?

Common side effects include dizziness, drowsiness, dry mouth, headache, and nausea. Other concerning symptoms include memory loss, hepatic disorders and renal failure. (3)

Elevation of liver enzymes, blood urea nitrogen and serum uric acid have been reported in exposed maternity ward staff in delivery wards when methoxyflurane was used in the past in obstetric patients at the time of labour and delivery.(3)

There have also been reports of non-serious and transient reactions such as dizziness, headache, nausea or malaise, and reports of hypersensitivity reactions to methoxyflurane or other ingredients in healthcare professionals exposed to Penthrox ®.(3)

Whilst an occupational exposure limit has not been established for methoxyflurane by NIOSH. Human clinical and toxicity data have been independently reviewed and used to derive a Maximum Exposure Limit (MEL) of 15 ppm.(4)

How we can help you monitor for exposure to Penthrox ®

We provide monitoring of Penthrox® (methoxyflurane) in a range of hospital departments in NHS Trusts and private hospitals.

Not only does this provide important data to indicate that any control measures already in place are working effectively, it also confirms that staff are not at risk from the negative effects of over-exposure.

We do this by providing personal sampling tubes that are worn by staff throughout their shift. On completion of the monitoring program, sample tubes are returned to our laboratory for analysis. A report on our findings is then supplied to the customer.

If we can help you with monitoring, please contact us on 0333 015 4345 or email info@cairntechnology.com.

 

References

  • Martindale AE et al. Environmental impact of low-dose methoxyflurane versus nitrous oxide for analgesia: how green is the ‘green whistle’? EMJ Published Online First: 28 September 2023. doi: 10.1136/ emermed-2022-213042
  • https://bnf.nice.org.uk/drugs/methoxyflurane/#prescribing-and-dispensing-information
  • https://www.medicines.org.uk/emc/product/1939/smpc#gref
  • https://medicaldev.com/wp-content/uploads/2023/08/SDS_0001_R9_SDS_Penthrox.pdf

Cairn’s Carbon Reduction Plan 2024 reduces Scope 1 emissions to zero

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Cairn Technology has released its Carbon Reduction Plan for 2024, showing a negligible 2.6% increase in its overall carbon equivalent emissions, despite a significant increase in business activities.

What’s more, it has also reduced its Scope 1 carbon emissions to zero.

All of the above has been achieved through a combination of insetting and offsetting approaches.

Scope 1 Insetting & Offsetting Measures

In terms of insetting, our move to having more hybrid and electric vehicles for our field-based team of consultants has continued to have a positive impact on minimising Scope 1 carbon emissions from our company vehicles.

This is reflected in the fact that we have only seen a 17.5% increase in our Scope 1 emissions in 2024, despite our field-based consultants travelling 22.7% more miles than in 2023.

That said, the short-term goal for our carbon reduction journey outlined in our 2023 Carbon Reduction Plan was to bring our Scope 1 net carbon emissions down to zero for 2024.

To achieve this, we have used carbon offsetting, by investing in the Carbon FootprintTM UK Tree Planting Scheme.

This scheme saw 85,000 native broadleaf trees planted in the UK over 2024, across 27 different species.

Our funding will help support the planting of trees in the Yorkshire and Humber region in school locations, helping to educate children and support wildlife habitats, whilst sequestering carbon emissions.

Scope 3 Insetting Measures

Carbon emission insetting also had a positive impact on our Scope 3 emissions total, through the continued use of our hybrid working model and consolidation of product deliveries, wherever possible.

These measures ensured that we only saw an increase of 4.19% in Scope 3 emissions from 2023 to 2024, despite the turnover of the business increasing by 6.3% in the same period.

Sharon Evans, Sales & Marketing Manager of Cairn Technology says: “We recognise how important it is to support our NHS and private hospital clients in their journey towards Net Zero.

“For this reason, our Carbon Reduction Leadership Team is drawn from across sales, marketing, logistics and finance to ensure a truly business-wide focus on minimising our carbon footprint within the company.

“For 2025, our eye is already on further opportunities for carbon insetting and offsetting to ensure that our carbon equivalent emissions are kept to a minimum as our business activities continue to grow.”

See our Carbon Reduction Plan 2024

To see our full Carbon Reduction Plan for 2024 just click here.

 

Ruth Palfreyman and Olivia Athersych boost mat sales

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Ruth Palfreyman, Area Sales Manager for London and the South East.

Ruth Palfreyman, Area Sales Manager, Cairn Technology Ltd

Ruth Palfreyman and Olivia Athersych have worked hard to enhance sales of Cairn Technology’s absorbent mat range this year, with sales in January alone being 50% higher than in the year before.

Both Area Sales Managers for Sheffield-based medical product sales company, Cairn Technology, Ruth’s sales territory covers London and the much of the South of England, whilst Olivia’s covers the North of England and Scotland.

Whilst Ruth has spent 7 years at Yorkshire-based Cairn Technology, Olivia has now been with the company for 12 years.

As well as selling absorbent mats for theatres, scrub rooms and other medical settings, they also sell Stille surgical instruments to theatre managers, consultant surgeons and instrument managers.

Absorbent Theatre Mats

Cairn’s absorbent mat range includes superabsorbent mats for theatre floors, anti-skid absorbent mats for scrub areas, hybrid mats for very wet procedures, and sterile mats for use next to the patient’s skin. To view our mat range just click here: https://cairntechnology.com/fluid-management/

Stille Surgical Instruments

Cairn Technology’s range Stille surgical instrument range includes instruments for a variety of disciplines including, general, plastic, ENT, cardiothoracic, orthopaedic and microsurgery, plus much more.

Warrantied for 30 years of use, they are handmade for exceptional handling, precision and durability. For more information click here: https://cairntechnology.com/surgical-instruments/

Can Ruth and Olivia help you?

Olivia Athersych, Areas Sales Manager for the North and Scotland

If you are a UK hospital interested in trialling some free samples of our absorbent mats, feel free to contact us.

For Ruth Palfreyman email ruth.palfreyman@cairntechnology.com or for Olivia Athersych email olivia.stokes@cairntechnology.com and they will be happy to help you.

Or call the team on 0333 015 4345.

 

 

 

Helping you towards Net Zero with medical devices

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Are you aiming to reach Net Zero with the medical devices that you use in your hospital? Do you know that you can cut costs, waste and carbon emissions with Stille’s handcrafted surgical instruments?

Swedish surgical instrument brand, Stille, is renowned for its durability, precision and handling. In fact, Stille is so sure of the quality of its products that every instrument is warrantied for 30 years.

But how can handcrafted instruments made from high quality stainless steel and titanium be more cost-effective than cheaper reusable instruments, or even disposable ones?

The answer is revealed by analysing Cost-per-Use. Take a pair of Stille scissors costing £150 that is used for 30 years and another brand costing £80 that is used to its maximum warranty of 10 years. You can quickly calculate how much cheaper Stille instruments are per use. Just see below.

Reusable surgical instruments made by Stille offer reduced lifetime cost and carbon emissions,

Further cost savings

As Stille instruments last for a minimum of 30 years if used, cared for, and serviced correctly, you will also save on the cost of purchasing a greater volume of instruments over that 30-year period.

So, if you are considering buying a cheaper instrument that is half the price of a Stille one, but is only warrantied for 10 years, you will end up paying a third more over the 30-year period than by investing in Stille instruments. In other words, £240 for three £80 instruments, instead of £150 for one Stille equivalent.

Environmental Benefits

Every surgical instrument that is made takes its toll on the environment through extraction of materials, manufacturing and shipping. By using Stille instruments instead of shorter-lasting reusables or disposables, you can significantly reduce the carbon footprint of your surgical instrument inventory.

What’s more, you will not only be reducing the number of surgical instruments that need to be disposed of at the end of their useful life, but you will also be able to minimise the carbon emissions associated with the disposal of the instruments used in your hospital.

To view our 2024 Carbon Reduction Plan, click here.

 

Do you want to view the Stille range?

To see the Stille range of instruments, just click here to browse our website.

Or if you would like to handle the instruments to get more of a feel for them, just call 0333 015 4345 to speak to our team or email us at info@cairntechnology.com.

If you can’t find what you need in the Stille range, we also offer other quality instrument brands for such things as laparoscopic surgery. Just contact us to let us know what you are looking for.

 

4 Reasons to Choose Hupfer Instrument Baskets

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If you are looking for instrument baskets for your sterile services department, it can be difficult to discern the quality of one brand from another.

So we were very pleased to become a distributor for a brand that is manufactured to a high standard by a company which is deeply conscious of the environmental impact of its products.

Here are just 4 reasons why we think you will find Hupfer instrument baskets are worth a look:

  1. Versatile to use

You can use Hupfer baskets in autoclaves or washers specifically designed for medical equipment.

The baskets are built to withstand stringent sterilisation methods and high temperatures of up to a maximum of 150 degrees Celsius. They are also compatible with detergents formulated to clean medical instruments.

You can choose from a wide range of sizes and configurations to help organise your medical supplies and reduce search time. Alternatively, you can opt for Hupfer’s stackable baskets to save storage space in crowded medical environments.

  1. Designed for optimum performance

Hupfer’s instrument baskets are robotically made from high-quality electropolished stainless steel.

This provides a smooth surface that:

  • avoids the risk of snags to hands, soft packaging and instrument surfaces,
  • makes cleaning and sterilisation easier through decreased likelihood of bacterial adhesion and improved fluid flow over the surface,
  • improves corrosion resistance and reduces wear so optimising the product lifespan.
  1. Focussed on Quality

Hupfer takes quality control seriously to deliver the very best products for your needs. Its quality management system is certified as compliant with DIN ISO 13485 and its products comply with the current European Regulation on medical devices, MDR 2017/745.

  1. Considerate to the Environment

Hupfer’s ‘End-of-Life Buy Back Scheme’ helps hospitals to reduce waste and cost when it comes to investing in instrument baskets.

As soon as Hupfer stainless-steel instrument baskets come to the end of their working life, Hupfer deducts their scrap value from the hospital’s new quote and recycles them.

Or if the hospital doesn’t want to order any more new baskets, Hupfer will help the hospital to find a local recycling company to ensure recovery.

To find out more about the Hupfer instrument basket Buy Back Scheme click here.

Interested in seeing Hupfer instrument baskets?

Just give us a call on 0333 015 4345 or email us at info@cairntechnology.com and we can arrange to come and show you some samples of Hupfer baskets. Or we can just provide you with a quote if you are already familiar with the brand.

Cairn sees record year for Stille surgical instruments

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Sales of Stille surgical instruments rocketed for Cairn Technology in 2024, up by over 70% on the previous 12-month period.

The handmade instruments are becoming a much more established and well-know brand amongst consultant surgeons in the UK who are looking for high performance instrumentation that will last for at least 30 years of service.

“Our Stille surgical instruments are particularly popular with consultant surgeons specialising in plastic/reconstructive, cardiothoracic and orthopaedic surgery”, says Sharon Evans, Product Sales and Marketing Manager at Cairn Technology.

“At exhibitions, we often come across theatre staff and surgeons that have been using Stille for decades and are very familiar with the brand. We have also had a lot of interest from new clinics setting up. They want to deliver the very best for their customers and recognise that using Stille instruments can be an important part of that.”

What sets Stille surgical instruments apart

As Stille instruments are handcrafted in Sweden through 70 stages from high quality stainless steel or titanium, they deliver exceptional durability, precision and handling.

Designed for optimal cleaning and maintenance, they come with a 30-year warranty, with some instruments still in use in some hospitals after 50 years.

Watch this video to see how Stille instruments are manufactured and repaired by skilled craftspeople.

Interested in Stille instruments?

If you would like to see or handle any Stille instruments, or get a quotation for them, just call the Cairn Technology surgical instrument team on 0333 015 4345 or email us at info@cairntechnology.com

You can also click here to find out more about our Stille surgical instrument range

Cairn’s Carbon Reduction Plan shows sharp fall in emissions

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Medical product and service supplier to the NHS and private hospitals, Cairn Technology, has completed its Carbon Reduction Plan for its base year, 2023.

Although 2023 is the first year that the company has actively calculated its carbon emissions, it already has an ethos of trying to minimise its impact on the environment.

This has included suppling reusable surgical instruments that come with a 30-year warranty to superabsorbent theatre mats that can significantly reduce the volume of less absorbent mats going into clinical waste.

2023 saw Cairn Technology also focus on reducing carbon emissions relating to its operations. Whilst it already sources products from Europe to minimise delivery miles travelled, it has significantly reduced carbon emissions in two other key areas:

1. Scope 1 emissions have been slashed by almost 30%

2023 saw Cairn Technology make a 29.9% reduction in carbon emissions from the company cars used by some of its staff, including its consultants who deliver workplace exposure monitoring in hospitals across the UK.

This reduction was achieved by switching to lower carbon emission company cars, such as hybrid or fully electric.

2. Employee commuting emissions have been cut by 45%

Post pandemic, Cairn gave its office staff the choice to work flexibly with a split of home and office-based working.

By implementing this hybrid working structure, we have lowered our scope 3 category 7 employee commuting emissions by 45%.

Carbon emission reduction aims for the future

The company aims to become Net Zero for Scope 1 for the reporting year 2024 through carbon offsetting schemes.

Its longer-term commitment is to achieve Net Zero across all relevant scopes and categories by 2050, at the latest.

Director Peter Binns says: “Cairn Technology began in 1999 as an environmental consultancy that helped companies to reduce their emissions to atmosphere through continuous monitoring and manage the environmental impact of chemical spills. So environmental performance is deeply ingrained in Cairn’s identity.

“Our yearly Carbon Reduction Plans are a useful way to show our NHS and private hospital clients how we are supporting them in their own plans towards Net Zero.”

Read our full 2023 Carbon Reduction Plan

To find out about other ways in which we have reduced our carbon emissions, click here to read our full Carbon Reduction Plan for 2023.

If you would like to see the independent audit of the plan email info@cairntechnology.com for your copy.

 

Diisocyanates in the Healthcare Setting

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As healthcare settings are moving away from plaster of Paris products to synthetic products there is an increased risk to staff exposure to diisocyanates, which are present in the resins and other products used within departments such as fracture clinics and prosthetic laboratories.

The British Orthopaedic Association (BOA) has adopted guidance from the European Union which introduced mandatory training for workers from August 2023.

The BOA Casting Sub Committee recommends that all healthcare professional who use synthetic casting and splinting materials contact their casting material suppliers in order to undertake product safety and education training to comply with UK REACH regulations.[1]

Further to training, the law requires you to adequately control exposure to materials in the workplace that cause ill health. This is the Control of Substances Hazardous to Health Regulations (COSHH).

The DFG BAT Biological Tolerance Value for HDI is 15µg/g (approx. 15µmol/mol creatinine) and for MDI is 10µg/L (approx. 4µmol/mol creatinine). [2]

Monitoring for Diisocyanates

A case study carried out in in 19 French polyurethane industries has shown that total MDA in post-shift urine samples is a reliable biomarker to assess occupational exposure to methylene diphenyl diisocyanate (MDI) in various industrial applications. [3]

The Health and Safety Executive HSE and British Occupation Hygiene Society BOHS have each produced guidance on biological monitoring.

This is designed to ensure that even with adequate training and control measures in place, staff are not exposed to excessive levels of hexamethylene diisocyanate (HDI), methylene diphenyl diisocyanate (MDI), toluene diisocyanate (TDI) and isophorone diisocyanate (IPDI).

Biological monitoring for chemicals helps prevent unacceptable health risks by providing information on the control of occupational exposure.

It can give an indication of absorption by all routes of exposure. Consequently, it is often used to complement personal air monitoring (which measures the concentration of a chemical in the air in a person’s breathing zone).

Therefore biological monitoring may be particularly useful for those chemicals which are easily absorbed through the skin or taken in by ingestion, or where exposure is controlled by personal protective equipment. [4]

Cairn Technology Monitoring

Cairn Technology has adopted biological monitoring to assist our healthcare customers in assuring that they comply with COSHH as set out above.

If you require further information on how we can assist you please do not hesitate to contact us at info@cairntechnology.com or call one of the team on 0333 015 4345 who will be happy to help.

References:
(1) British Orthopaedic Association
(2) Research and guidance from HSE, Biological Monitoring Guidance Values.
(3) A. Robert, P. Ducos, +1 author P. Marsan. Published in International Archives of Occupational and Environmental Health, 28 February 2007.
(4) HSG167 (Second edition, published 1997)

Cairn Technology supports CHSF with Halloween Fundraiser

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Cairn Technology’s staff got creative in the kitchen this October and magicked up some amazing Halloween treats for a freaky fundraising fuddle.

All monies raised went to the Children’s Heart Surgery Fund (CHSF), taking Cairn Technology to a fundraising total of over £3,800 since starting to donate in November 2021.

We are very proud to be supporting this amazing charity, as it provides life-saving medical equipment for the Leeds Congenital Heart Unit (LCHU), as well as parent accommodation for families, and vital ward resources.

In addition, the CHSF also funds staff training, scientific research, and new clinical roles.

We have a particularly strong personal connection with the charity, as one of our staff members has a daughter who was treated at the Heart Unit.

Why help this children’s charity?

Every year the charity supports over 23,000 congenital heart disease patients, heart families and NHS Staff across Yorkshire, Humberside, Northeast Lincolnshire and North Derbyshire.

In addition, around 350 patients a year have open heart surgery at the Leeds Congenital Heart Unit and around 700 babies, children and adults have interventional procedures such as pacemakers, catheters and stents.

Every child who has open heart surgery at Leeds receives a teddy called Katie Bear, a medal and a certificate from CHSF.

So, if you are looking to support a children’s charity, this one should definitely be at the top of your list. And there are so many ways that you can get involved!

To get started, why not  order a free fundraising pack which will give you plenty of fundraising ideas.

You can also find out about the various scheduled CHSF fundraising events at this link: https://www.chsf.org.uk/events/

4 Reasons to Invest in Stille Cardiothoracic Instruments

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Cardiothoracic instruments need to be precise, durable and easy to handle in order to provide the consultant cardiothoracic surgeon with optimum support. Here, we look at four good reasons to invest in Stille’s offering:

1. Cardiothoracic scissors that provide the ultimate cut

Stille made the original SuperCut scissors combining one knife blade and one scissor blade for precise cutting to the very tip.

Stille’s vascular scissors and dissecting scissors embrace this design, giving the surgeon exceptional cutting performance in delicate procedures.

Stille’s SuperCut vascular scissors come with fine or extra fine blades at 25°, 45°, 60°, 90° and 125° angles.

Its wide range of Stille SuperCut Mayo and Metzenbaum style dissecting scissors include delicate scissors with diamond coated blades for extended durability, and ergonomic versions for reduced hand fatigue.

 

2. Micro instruments for fine work through to heavy duty

Stille’s range of micro instruments is ideal for cardiovascular and cardiothoracic surgery. From ultra fine scissors to heavy duty needle holders and atraumatic forceps, the surgeon has an extensive range to choose from.

For surgeons preferring to use titanium for reduced user fatigue during procedures, Stille also offers titanium models of its micro needle holders and micro forceps.

 

3. Reduced carbon footprint

As Stille’s instruments are handmade through 70 stages with high quality stainless steel or titanium, they come with a warranty of 30 years, provided they are used, serviced and maintained as advised.

This means that their use involves a much lower carbon footprint for NHS and private hospitals, compared to disposable instruments or reusable instruments that are only warrantied for a couple of years use.

You can find out more how Stille surgical instrument help hospitals reduce their carbon footprint by clicking here.

 

4. Ease of maintenance for SSD

During manufacturing, Stille pays particular attention to both to the quality of finish on the instruments and effective design for maintenance, making it the ideal choice for your Sterile Services Department.

Even when servicing Stille instruments, its craftsman can take used instruments apart for optimum refurbishing, bringing them back to their original condition, before sending them back to you.

You can click here to find out how used Stille scissors are brought back to top condition during instrument servicing.

Want to find out more about our cardiothoracic instruments?

To read about Stille’s range of cardiovascular and cardiothoracic instruments, including vascular forceps, vascular clamps, nerve hooks and retractors, click here.

Alternatively, call us on 0333 015 4345 to discuss your needs.