Yes, hospitals still use pneumatic tubes!

 

Earlier this year the technology magazine WIRED had a ground-breaking story - hospitals still use pneumatic tubes! I was reminded of how my fascination with pneumatic tubes began over 10 years ago now, by realising, that yes, hospitals use pneumatic tubes!

WIRED reports that the technology may seem "wonky and antiquated" but is surprisingly used in hospitals across the US. Just like other technologies, they state, the systems are prone to hacking. We've seen other cases of that in this blog, such as robbers trying to steal money from pneumatic tube cash points (and getting their arms stuck in the attempt). 

The threat of the hacks has been taken seriously because of the vital role that pneumatic tube systems play in modern day healthcare, moving the increasing number of tests and samples taken around hospital buildings. The hacks on the system could be on digital infrastructures guiding the tubes or on the hardware systems through the online manipulation of robotic arms or blowers.

The pneumatic tube systems and hospitals are on to it, looking into how to avoid such cyberattacks on these important infrastructural systems, systems that can work smoothly and so well that it is easy to forget the potential weaknesses in them as well.

Photo: my own, from one of my first visits to a hospital pneumatic tube system in Melbourne, Australia

hospital maintenance and flying coke bottles

It’s lunchtime and across the hospital foyer doctors and nurses are hurrying to eat, patients are wandering around in back-less gowns gripping IV poles and white-coated staff are wielding trolleys of biological samples. I find Cees where he said he would meet in the central hall and introduce myself. Cees is a Dutch engineer with over 30 years of experience working with pneumatic tubes (currently at Swisslog). He has offered to give me a tour of the hospital’s pneumatic tube system, which he is currently working on. I have to thank Ilona from Swisslog for setting this meeting up, a connection made after we started corresponding about casino systems.

Cees is intrigued as to why I am blogging about pneumatic tubes and we soon enter into an animated discussion, as we make our way down a hospital corridor, of their many fascinations. He tells me that the system has now been closed at the hospital for almost two weeks while they have been doing some checks and updating the system (replacing circuitory boards, changing diverters, adding further maintenance stations and software updates). As a result the hospital has had to hire eight people during the day, five in the evening and four at night to transport blood and other tissues around the hospital. At a substantial cost. Pneumatic tubes it seems, saves this hospital a lot of money when they are in use.

Soon we veer off the busy corridors and stairwells into the loud hum of the service room on the 4^th floor (close to the laboratory on the 5^th). Whoosh, a capsule whizzes by overhead. We head over to the pneumatic tube system blowers, which wheeze and spin. A few more capsules arrive and are sent out again. 1200 – 1400 a day Cees tells me, when the system is fully operational, which is a lot for a relatively small system. We meet some other members of the repair team and together we head off to the cafeteria where we drink Coca Colas with our names on them and eat sandwiches. The team once worked together for Coca Cola, designing a system which would deliver drinks to customers at the front of stores by a tube (straight from the sky, Gods Must be Crazy style). The system was never rolled out on a large scale but a proto-type was installed in Copenhagen airport. You can watch the video of them installing the system here.

Over lunch we talk about how different hospitals use pneumatic tube systems differently. In some places there are few repairs needed, in others many. Mostly related to human error. They laugh over the story of a nursing student who was told to send some documents by pneumatic tube and put them straight into the system, without a capsule. Breakdowns can happen at any time, the engineers are on call. Their job is also to do preventive maintenance, which is why they are in the hospital. They are using a well-fitted-out capsule which tests g-forces, speed and shake, all factors which might disrupt the samples being carried. This special capsule replaces the samples of blood which were previously used to test the system, a problematic practice as Cees pointed out: not only expensive but ethically complicated considering the circumstances of donation.

After lunch we head back to the service room to see how the checks are going. There is a little storeroom out the back, stacked with capsules and sending and receiving stations. Cees shows me how they are updating the circuit boards, which now need to store a lot more information as tracking becomes more widely used. Everything he says needs to be traced, just in case there is “an incident”: not only where the capsule is but also what is in the capsule and who is sending it too. Barcodes are crucial in the tracing and one of the ways in which pneumatic tube systems are changing.

We talk for a while longer and Cees tells me a wonderful story about how engineers use the skill of listening to sound (one of my current research projects), what he called a “professional madness” in his field. If a capsule gets stuck Cees says, you can hear a particular sound, a sisssssss and you know where the blockage is. He had a colleague with a particularly “good ear”. During his visits to hospitals he would have his head cocked, listening for abnormalities in the system. The hospital staff wondered if he had escaped from the psychiatric unit. Things have changed now and the systems are more insulated, hidden away out of earshot.

Our tour is at an end and once again I am amazed and how this system continually adapts in each location and time period. Cees comments that he thought the industry might be finished with the invention of the fax machine, but here they still are. Pneumatic tube systems continually adjust to the market, changing it in the process. The need for this technology does not seem to be abating. Most new hospitals of a certain size have pneumatic tube systems installed. These systems need continual maintenance and repair, all happening in the service rooms and behind the walls of busy hospitals, the only sign of these systems in place being during moments of breakdown or stoppage, when the white-coated casual staff appear, wielding their rumbling trolleys with samples through the corridors.

Image my own.

birthday post

It's my birthday coming up soon and I've received an early present from a very thoughtful gift-giver:

Yes, I now have my own capsule! It sits on my desk at the moment. I can feel its worn-away felt ends, cold metal body, thready canvas details. I can look inside at its rusty insides. The little door squeaks as it moves, a satisfying suck of air and click as it closes completely. These are the sensory and material details of pneumatic tubes which I love.

If I look closely, engraved on the capsule are the words "The Grover Co. Detroit". My gift giver helps me to research the capsule's provenance. We find that the Grover Company was selling pneumatic tubes at the same time as Lamson, in the early 20th century, servicing department stores whose needs had extended beyond their cash railway systems. William and Clarence Grover founded the company in Woodburn, Michigan, but had branches in Detroit too. In the 1950s the Grover Company filed patents for pneumatic tube terminals. According to the Cash Railway site, Swisslog is the company's descendant. 

I am sure there is much more to discover of the history of my tube.

Image my own.

you can't fax a blood sample

Save space, save money, save time, and what's more, better patient care ... A new development at the University of Pittsburgh Medical Centre ticks off all of the reasons to install pneumatic tubes between their network of hospitals, and extend upon the existing lines. Pneumatic tubes are described this time, in the Pittsburgh Post-Gazette, as an "age-old technology that has disappeared from much of the business world", but one needed in hospitals because "you can't fax a blood sample". These Swisslog tubes extend far - almost two city blocks. The journalist describes the 3D plans for the installation as like a page from a Dr. Seuss book, interviewing a number of developers, including representatives at Swisslog and Pevco about the tubes. One states "as hospitals expand, they're rarely one building anymore", the new hospital one that requires a centralised lab connected easily to the different buildings. Space is about patient care, and the more you can hide away the better - pneumatic tubes are perfect for this, their metal pipes invisible to most who visit a hospital. It is not so invisible to many hospital designers and engineers however, who are designing the tubes in more and more hospitals, nor to the many lab staff whose positions now become redundant as the tubes do their work.

Image: Pneumatic tubes in a parking garage from the Pittsburgh Post-Gazette.

le bruit de choc

Paris in the 1890s, and a tubiste working in the Poste Pneumatique pulls a lever, cranks a steel door, exchanges cylinders and closes the door again. Sweat forms on his brow as he turns the wheel to create a vacuum and apply compressed air. He pauses to ring the bell so the next station knows of the coming delivery. A tubiste down the line rings his bell when he hears le bruit de choc as the tube arrives at his station.

This section of text, adapted from Molly Wright Steenson's Cabinet article, is filled with sound. The soundscapes of these brass-age pneumatic systems evoke the work involved in sending pneumatic missives underneath the city. These historic sonic delights are however considered pollution in many modern day hospitals, with an increasing call to 'turn the sound down' in clinical work spaces.
  
Swisslog have responded to this drive with their patent-pending Whisper Receiving System, which minimises noise associated with pneumatic transportation. Recently installed in the positively named Le Bonheur Hospital in America, the system is said to enable employees to concentrate better on the patient care requirements of the hospital. I wonder how the tubistes were ever able to get their work done with all of that cranking, clanging and bell ringing!

Image from Scott Kostolni's Flikrstream.

pneumatic tube cartoons

There is a great collection of videos on YouTube put out by pneumatic tube company Telepost (see this previous post for a YouTube video by Swisslog). The cartoons are cute, the music catchy and they do a great job of illustrating the work of pneumatic tubes (their human-like attributes being key to actor network ideas about the social life of non-human entities).

This video is about hospitals but there are more set in supermarkets and other places where the company installs pneumatic tube systems.

wanted! vacuum burglars!

A recent article in The Sun shows that there is no end to the creative use of pneumatic tubes:

"A GANG of thieves armed with a powerful vacuum cleaner that sucks cash from supermarket safes has struck for the FIFTEENTH time in France. The burglars broke into their latest store near Paris and drilled a hole in the "pneumatic tube" that siphons money from the checkout to the strong-room. They then sucked rolls of cash totalling £60,000 from the safe without even having to break its lock. Police said the gang — dubbed the Vacuum Burglars — always raid Monoprix supermarkets and have hit 15 of the stores branches around Paris in the past four years. A spokesman added: "They spotted a weakness in the company's security system and have been exploiting it ever since. Since 2006 they have stolen more than 500,000 euros and caused damage to alarm systems and other property totalling thousands more. It is clearly time Monoprix addressed this loophole and changed the way it guards its money.""

Great use of the word loophole!

Could this spate of robberies spell the end for pneumatic tubes in supermarkets (see this video for a demonstration of how the system works in this setting)? What does it mean for banks, where telescreens and pneumatic tubes are being installed in 'remote teller stations' to increase efficiency and improve safety and security?

more tubes on the tube

I spent a little time, one evening, not so long ago, watching more YouTube clips about pneumatic tubes. I thought I'd share a few for those who might also want to while away some time in the rumbling whoosh of a few pneumatic tube systems.

Winner of the best catch-phrase went to Quick Tube System for their “If we can lift it, we can land it … and we can land it soft” film clip. The sequel proves it by landing a capsule on an egg. There are a few promotional videos, here and here, and several computer animated models, including this rather mesmerising one with a groovy soundtrack. There is a glass tube trip and an interview with Stanford Hospital’s Chief Engineer, Leander Robinson, who plants a videocamera into a capsule during the video. For a few seconds there is a wonderful split screen capture of the inside and outside of the tube, and then a tracking of the capsule simultaneously on a computer screen. Finally, who would have thought that there would be a film noir made about pneumatic tubes? Below is the film clip for “Through a tube darkly” produced in association with St Olav’s Hospital and Swisslog.

up the tubes

Hospital pneumatic tube systems are an intricate network of tubes and pipes hidden in the ceilings and walls of hospital buildings, through which blood samples and pathology request forms are transported via pneumatic pressure. In an era of electronic medicine, this 19th century based engineering is not only used everyday, but is also being designed in new hospitals, as one of the most efficient and reliable ways to transport material artefacts.

The most recent issue of Monocle (where the image above comes from) reports on the growth in the market of pneumatic tube systems in hospitals. The material version of the magazine has some brief interviews with staff at Swisslog (a large pneumatic tube provider), providing a 'behind the scenes' picture of the company. If only social scientists' interviews were as aesthetically presented!