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Electrical Safety

Electrical safety is very important in hospitals as patients may be undergoing a diagnostic or

treatment procedure where the protective effect of dry skin is reduced. Also patients may be
unattended, unconscious or anaesthetised and may not respond normally to an electric
current. Further, electrically conductive solutions, such as blood and saline, are often present
in patient treatment areas and may drip or spill on electrical equipment.
Electric Current
Leakage Current
Etension Leads
!ouble Adaptors
Equipment Classification
o Class "
o Class ""
o !efibrillator#$roof
$rotective !evices
o %esidual Current !evices &%C!'
o Line "solation (onitors &L"(s'
o Equipment Earthing
Area Classification
o )ody $rotection Area
o Cardiac $rotected Area
*ther Electrical "ssues
o Etension Leads
o !ouble Adapters
o (ain Etension !evices
o $ower )oards
o "nstallation of Additional $ower $oints
Electric Current
"n+uries received from electric current are dependent on the magnitude of current, the
pathway that it takes through the body and the time for which it flows.
,he nature of electricity flowing through a circuit is analogous to blood flowing through the
circulatory system within the human body. "n this analogy the source of energy is represented
by the heart, and the blood flowing through arteries and veins is analagous to current flowing
through the conductors and other components of the electric circuit.
,he application of an electric potential to an electric circuit generates a flow of current through
conductive pathways. ,his is analogous to the changes in blood pressure caused by
contraction of cardiac muscle that causes blood to flow into the circulatory system. For electric
current to flow there must be a continuous pathway from the source of potential through
electrical components and back to the source.
Leakage Current
Electrical components and systems are encased in nonconducting insulation, to ensure that the
electric current is contained and follows the intended pathways. "f the insulation cracks or
deteriorates current will leak through the insulation barrier and either flow to earth through
the protective earth conductor or through the operator.
(edical equipment and clinical areas are fitted with a number of protective devices to protect
the patient and operator from harmful leakage currents.
Extension Leads
Etension leads are not permitted in -C. organisations. ,hey may cause ecessive earth
leakage current, high earth resistance and can allow equipment to be powered from areas
other than the relevant protected treatment area. As the connection between the etension
lead and the equipment mains cable is often on the floor there is greater danger from fluid
spills, tripping and damage by trolleys when an etension lead is used.
Double Adaptors
!ouble adaptors should not be used in -C. organisations. ,hey may not sit securely in a wall
outlet, may not be able to provide adequate earth protection and may cause overloading, local
heating, fire or loss of supply.
,here are several methods of providing protection for operators and patients from electrical
faults and harmful leakage current.
Class I
Class " equipment is fitted with a three core mains cable containing a protective earth wire.
Eposed metal parts on the equipment are connected to this earth wire. .ence, should a fault
develop inside the equipment and the eposed metal comes into contact with the mains these
metal parts become alive, in the event of equipment malfunction, the earthing conductor will
conduct the fault current to ground. %egular testing procedures ensure that earthing
conductors are intact, as the integrity of the earth wire is of vital importance.
Class II
Class "" equipment is enclosed within a double insulated case and does not require earthing
conductors. Class "" equipment is usually fitted with a /#pin mains plug. An internal electrical
fault is unlikely to be ha0ardous as the double insulation prevents any eternal parts from
becoming alive.
Class "" 1ymbol2
1ome medical equipment within the hospital is defibrillator proof. ,hat is when a defibrillator is
discharged through a patient connected to this equipment, the equipment will not be damaged
by the defibrillator3s energy. Equipment that can remain connected during defibrillation is
identified by one of the following symbols.
!efibrillator proof symbols.
(ost patient care areas in the hospital are fitted with protective devices. ,hese devices are
regularly tested, in accordance with the relevant guidelines published by 1tandards Australia.
,he level of protection provided is dependent upon the device and the area in which it is
%esidual Current De'ices (%CD)
%C!3s are used in patient treatment areas to monitor the mains supply. ,hey sense variations
in current flow caused by leakage currents flowing to earth from the equipment connected to
it. "f a significant leakage current flows, the %C! will detect it and interrupt the power supplied
to the equipment within 45 milliseconds.
$ower outlets supplied through an %C! have a 31upply Available3 lamp. ,he lamp will
etinguish when the %C! trips due to ecessive leakage current.
%esetting a %C!
Lamp indicates supply is no longer available
!isconnect all equipment from the supply
*perate the reset button or lever on the supply panel and the 31upply Available3 lamp
should illuminate. "f not, contact )iomedical Engineering.
Connect an item of equipment. "f the %C! trips again, then this is the faulty item and
should be labelled and sent to )iomedical Engineering.
"f the %C! does not trip, continue connecting equipment until the %C! trips. ,he last
piece of equipment connected to the supply is most likely to be faulty as it will have
caused the %C! to trip. %emove the faulty item from service, label it and send to
)iomedical Engineering as mentioned above.
Line Isolation Monitors (LIM*s)
"n life support applications where loss of power supply cannot be tolerated, isolation
transformers are installed. As neither side of the isolation transformer is earthed, Line
"solation (onitors are required to continually monitor the system and indicate that isolation
from the earth is maintained. "f a fault develops in a medical device connected to an isolation
transformer, the L"( will alarm and indicate the level of leakage current, but will not interrupt
the supply.
,he faulty equipment can be identified by un pluging one item of equipment at a time from the
supply until the alarm stops sounding. Equipment that is not faulty may be reconnected.
Faulty equipment should be appropriately labelled and sent to )iomedical Engineering for
E+uipotential Eart,ing
Equipotential earthing is installed in rooms classified as 3Cardiac $rotected3 electrical areas.
Equipotential earthing in treatment areas used for cardiac procedures is intended to minimise
any voltage differences between earthed parts of equipment and any other eposed metal in
the room.
,his reduces the possibility of leakage currents that can cause microelectrocution when the
patient comes into contact with multiple items of equipment, or if the patient happens to come
into contact with metal items in the room whilr they are connected to a medical device.
All conductive metal in an equipotential area is connected to a common equipotential earth
point with special heavy duty cable.
-ody Protected Area
,hese areas are designed for procedures in which patients are connected to equipment
that lowers the natural resistance of the skin. Applied parts such as electrode gels,
conductive fluids entering the patient, metal needles and catheters provide an easy
pathway for current to flow.
,he main occurrence of in+ury from )ody#,ype procedures is from high current levels
causing electric shock. A direct connection to the patient3s heart is not present so the
risk of 3(icroelectrocution3 # fibrillation from minute current levels # is reduced.
%esidual Current !evices &%C!' or "solation ,ransformers and Line "solation (onitors
&L"(6s', are used in )ody $rotected areas to provide protection against electrocution
from high leakage currents. )ody#$rotected Areas are identified with this sign.
Cardiac Protected Area
-here the procedure involves placing an electrical conductor within or near the heart,
protection against fibrillation induced from small leakage currents is required. Electrical
conductors used in these procedures include cardiac pacing electrodes, intracardiac
EC7 electrodes and intracardiac catheters.
Equipotential earthing in con+unction with %C!3s or L"(3s provides protection against
microelectrocution in Cardiac#,ype procedures.
Fault currents are reduced to magnitudes that are unlikely to induce fibrillation. 8sed
in con+unction with %C!3s or L"(3s, the magnitude and duration of any fault currents
sourced from equipment are limited.
Cardiac#$rotected Areas are identified with this sign.
#t,er electrical issues
,his policy aims to provide guidance to those who find that they need more electrical outlets
than those available, or that the eisting electrical outlets are inconveniently located.
As etension leads and multiple outlet power boards can introduce additional ha0ards into an
area the following procedures should be observed.
Extension leads
Approved etension leads &A1 9:;5, <==;' may be used in some areas within the hospital but
(81, >*, )E 81E! "> $A,"E>, A%EA1. All electrical etension leads must be tagged with an
Engineering !epartment maintenance tag, and require a yearly safety inspection and test, via
the Engineering !epartment.
Double adapters
Double adapters .ay cause o'erloading or e+uip.ent eart,ing
proble.s and are not to be used in /C0
Mains extension de'ice
,he only mains etension device that is to be used in ?$atient care areas? is the 4#way or @#
way portable Core )alance 8nit.
,he )iomedical Engineering !epartment must approve all units prior to use. ,hese units can
detect ecessive leakage current and disconnect the power in the event of a ha0ardous
Care must be eercised in the use of a portable Core )alance 8nit. "t should be located off the
floor and in a position that will protect it from physical abuse and possible entry of fluids.
,hese devices are epensive and easily damaged. ,he device must be sent to )iomedical
Engineering every ; months for safety testing.
Po1er boards
Approved multiple#outlet power boards can be used across -C. but must not be used in
patient care areas, ecept areas approved by the )iomedical Engineering !epartment.
,he power boards must have overload protection, be fitted with internal safety shutters that
protect unused outlets and be fitted with an onAoff switch for each outlet.
Installation of additional po1er points
All of the above mentioned devices are intended to overcome a temporary inadequacy in the
electrical installation. "f a !epartmentA8nit is likely to have a long term need for such mains
etension devices a $ro+ect "nitiation %equest should be submitted to the Engineering
!epartment for the installation of additional power points.