We thank Dr Scott for his letter [1] in response to the publication of our guidelines regarding fire safety and emergency evacuation of ICUs and operating theatres [2].

When preparing the information concerning the storage of medical oxygen cylinders in ICUs, high dependency units (HDU) and operating theatres, the intention was that the cylinders should be stored in a designated area; not necessarily a separate room away from the ICU or operating theatre. The important requirement is that the storage area(s) should be well defined and appropriately planned, and that everyone working in the area is aware of where cylinders are stored so that there is no delay in obtaining more cylinders if required.

For small cylinders, such as the CD medical oxygen cylinder, it is appropriate that cylinders could be stored within the ICU or operating theatre suite, for example, using individual cylinder holders that attach to the wall, which would allow sufficient cylinders to be stored in a clinical area (Fig. 1), but these racks need to be in a designated area where the precautions specified in the document are considered. Having a designated area also allows suitable signage to be used to meet the necessary safety requirements. This does not prevent individual cylinders being stored near the patient's bed to allow those patients who are more dependent on oxygen to have an 'independent supply source' from the pipeline supply, readily at hand to meet the potential requirements as described by Dr Scott.

However, where larger cylinders might be used in the ICU, these would normally be stored in a separate room adjacent to the ICU (along with 'additional' small cylinders over and above the number that would be needed for emergency supply) so as not to clutter the ICU and ensure the cylinders are stored correctly.

As with most advice of this nature, it needs to be interpreted based on risk management requirements, and the important things to consider are the safe storage of the cylinders as well as meeting the patient's needs.

The use of bed brackets arose from the investigation after the fire at Bath [3]; unfortunately, oxygen can be a dangerous gas if used inappropriately, and having an ignition source with a cylinder lying on the bed is something that needs to be avoided.

我们感谢 Scott 博士的信 [ 1 ]，以回应我们关于 ICU 和手术室的消防安全和紧急疏散指南的发布 [ 2 ]。

在准备ICU、高依赖病房（HDU）和手术室医用氧气瓶的存放信息时，意图是将气瓶存放在指定的区域；不一定是远离 ICU 或手术室的单独房间。重要的要求是应明确界定和适当规划存储区域，并且在该区域工作的每个人都知道钢瓶的存储位置，以便在需要时可以及时获取更多钢瓶。

对于小型气瓶，例如 CD 医用氧气瓶，气瓶可以存放在 ICU 或手术室套房内是合适的，例如，使用附着在墙上的单独气瓶支架，这将允许在其中存放足够的气瓶临床区域（图 1），但这些架子需要位于考虑文件中规定的预防措施的指定区域。指定区域还允许使用合适的标志来满足必要的安全要求。这并不妨碍将单独的气瓶存放在患者床边，以便让那些更依赖氧气的患者拥有来自管道供应的“独立供应源”，随时可以满足 Scott 博士描述的潜在要求。

但是，如果 ICU 中可能使用较大的气瓶，这些气瓶通常会存放在靠近 ICU 的单独房间中（以及超出紧急供应所需数量的“额外”小气瓶），以免将 ICU 弄得杂乱无章，并确保正确存放气瓶。

与大多数此类建议一样，需要根据风险管理要求对其进行解释，需要考虑的重要事项是钢瓶的安全储存以及满足患者的需求。

床架的使用源于巴斯火灾后的调查[ 3 ]；不幸的是，如果使用不当，氧气可能是一种危险的气体，并且需要避免将气瓶放在床上的点火源。