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ELECTRICAL SAFETY


The patient is often entirely dependent on equipment that ensures their vital functions. A patient undergoing an operation is more infirm than usual and therefore more susceptible to complications. Because of anaesthesia or strong medication, the patient may not be able to react to dangerous situations caused by electric current. For example, the patient may have damp skin, wounds or subcutaneous sensors, which enhance electrical conductivity. An electrical shock may result from


direct contact with a live component or live wire, or a part of a device may become live and then be connected to the patient. Electrosurgical instruments pose a particular risk because their functionality is based on electric voltage. Relatively small amounts of current are


enough to cause physiological effects. For example, it takes a thousand times more current to trip a 16-amp circuit breaker than it takes to cause respiratory arrest. Therefore, a circuit breaker and residual current are not satisfactory solutions to prevent minor current hazards.1 Currents caused by even small voltages


are dangerous when the current flows directly through the heart. In principle, 6V AC is sufficient for a fatal electric shock. Furthermore, when contact occurs close to the heart, the skin’s resistance cannot restrict current. Problems and malfunctions in electronic medical devices should be detected early before serious hazards such as electric shock, fire or the breakdown of a vital medical device.


A medical IT system with a modern insulation monitoring system protects people in an OR The electrical safety of an operating room is taken care of in very different ways globally. There has been pressure to develop patient safety worldwide, and electrical safety is indeed a significant factor. Therefore, the demand for a so- called medical IT system with an insulation level monitoring system has increased. The system isolates an operating room


from the national power grid, and an attached insulation monitoring system monitors all the electrical devices connected behind this transformer. Thus, the system indicates the faults and problems before dangerous situations arise.


Figure 2. The control panel indicates which socket (F15) the faulty device is in. All medical devices used in an


operating room must be connected to a network isolated by medical isolation transformers. A separate socket may be available for cleaning and maintenance work. The socket must be directly connected to the national grid, not to the insulated network. Medical devices must not be plugged into this socket, and they must be used for their assigned purpose only, excluding any patient treatment. The socket must be equipped with a sign labelled ‘Not for medical devices’ or ‘Maintenance socket’. Local legislation may not require an


IT system and insulation-level monitoring in G2 facilities, but it is seriously worth considering. Hospitals may have a simple residual-current device in use, which unfortunately reacts when the damage has already occurred and cuts the electricity of all devices connected to its fuse group. The good thing is that advanced systems became more common in the 2010s. Still, very few hospitals use the most advanced new generation solution. In practice, solutions are often designed based on an old electrical plan using old and familiar technology.


OR staff do not need to understand IT system technology in depth, but they need to respond to an alarm and replace a faulty device with a new one. That way, it is possible to maximise safety


IFHE DIGEST 2022


Developing new-generation safety systems As early as the 1970s, international studies highlighted the poor level of OR electrical safety. Since then, we have been developing IT systems for 40 years in cooperation with the hospital technical staff. We invented the first-generation insulation level monitoring system in Finland in 1981. The system became mandatory in Finland in 1983 and in Europe in 2015. Our newest, fifth- generation equipment with unique features meets all the regulatory requirements and technical standards internationally. We started exporting our systems in


2019, when the fifth-generation solution was completed. Since then, we have cooperated with our international distributors, from whom we have received a lot of feedback. At the same time, we have developed new features according to the practices and standards of the destination countries. In addition, we have developed a support concept suitable for the COVID-19 era, providing support through electronic manuals, videos and e-meetings. The idea works and succeeds well, as all our distributors are professionals in our field. Our distributors serve our customers


in the destination country, providing information to the hospital technical engineers. They are responsible for IT systems and provide adequate information to the healthcare staff in hospitals. We provide operating room instructions, which will be placed on an operating room wall. The technical team may write their own instructions using our draft.


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