Mark L Callaghan Medical Equipment Service Unit

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SAFE USE OF MEDICAL DEVICES
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Objectives

• Introduce Basic Safety Concepts that apply to the
  use of all Medical Devices, covering
• Electrical Safety
• Infusion Safety
• General Device Safety
• Device Care
• Training
• General Information

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Introduction - MESU

• Medical Equipment Service Unit (MESU) is an
  in-house medical device management department
  based at the QMC
• MESU manage in excess of 17,000 assets deals
  with an average of 1350 work requests a month

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Introduction Medical Devices

• Medical Devices are used to diagnose or treat a
  patient
• Can range from very simple (stethoscope) to very
  complex (life support ventilator)

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Safety

• Safety is the freedom from danger or risk of
  injury
• Safety is important (especially where patients
  are concerned)
• Basic concepts can be relevant anywhere even at
  home

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Safe Use Of Medical Devices

• ELECTRICAL SAFETY

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Electrical Safety

• It is necessary to respect electricity its
  hazards
• Young old are at risk
• Patients are susceptible due to their reason for
  hospitalisation
• Most electrical safety hazards can be spotted by
  inspection before use

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Electrical Safety

• Inspect before use

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Effects Of Electricity

• Many people have received an electric shock at
  some stage or other through carelessness
• Main effects
• Neuromuscular (stimulation of nerves muscles)
• Heating (burns)
• Electrolysis (decomposition/chemical change)
• Heart (50 microamps can interfere with cardiac
  cycle)

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Hospital Electrical Safety

• Human susceptibility to electric shock varies
  from individual to to individual depends on a
  number of factors
• The patients general state of health
• The position of any electrodes on the patient
• The dampness of the patients skin
• Patients in a Critical Care environment are
  especially susceptible

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Extension Blocks

• The use of extension blocks can be dangerous
• Having many devices plugged into an extension
  block compromises safety
• A safety fault on one device results in the fault
  being present on all devices
• Any non-medical devices (tvs etc) can compromise
  the safety of medical device
• The use of extension blocks is discouraged

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Extension Blocks Worse Case Scenario
Consequence of Live-earth fault with type B
applied part
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Spot The Problem Moulded Plug
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Spot The Problem Moulded Plug 2
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Safe Use Of Medical Devices

• INFUSION SAFETY

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Infusion Safety

• Infusion Devices present a number of hazards
• Fluid spillage from bag/syringe (remember this is
  above the Pump)
• Dose errors (over/under infusion)
• Training (do you know how to use the device?
  Safely?)
• Infusion progress (check regularly, then no
  surprises!)

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Infusion Fluids

• Infusion Devices by their nature involve the use
  of fluids
• Be especially careful of the security of all
  connections in the fluid path
• Be aware that caustic solutions may be in use

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Infusion Device Dose Errors

• Over-Infusion or Under-Infusion may result from
  incorrect settings
• Be sure to double check any rates entered
• Ensure that giving-sets are primed correctly if
  not, there may be a delay before the infusion
  commences
• Check that infusions are progressing as expected
  at regular intervals

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Infusion Device Syringes

• Be aware of the differences between different
  manufacturers syringes (we use BD)

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Safe Use Of Medical Devices

• GENERAL DEVICE SAFETY

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General Safety

• Inspect all devices before use looking for any
  signs of wear or damage
• Most safety related problems appear on the mains
  part (particularly detachable mains leads)
• Be aware of any contra-indications or limitations
  of use
• Extra vigilance is required by users

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Errors/Messages

• During use, take note act upon any error codes
  or messages
• Be aware that not all messages relate to device
  failure, but may in fact relate to use

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Patient Transport

• When transporting patients ensure that
• Devices are fully charged before transport
• Devices are secured correctly
• Leads/probes are secured/supported
• Be aware of the risks of EMI from mobile phones

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Storage

• Store devices safely (ready for use)
• Keep devices on charge

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Risk Awareness

• Water electricity dont mix
• Damaged insulation
• Trailing mains cables are dangerous
• Mains extension leads are dangerous
• Understand how to use medical devices
• Use the correct accessories

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Safe Use Of Medical Devices

• DEVICE CARE

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Device Care

• Medical Devices are expensive look after them
  as though they are your own
• Store carefully
• Repairs can be expensive
• Take care of accessories

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Safe Use Of Medical Devices

• TRAINING

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Medical Device Training - Need

• Training is essential to avoid errors
• Promotes user confidence, improves patient safety
• Nurses are accountable for acts or omissions
• Devices should be set up by users who are
  competent confident

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Medical Device Training

• Before using a device ensure that you are
  competent confident in its use
• Follow local competence/training packages where
  available
• For any further training or advice contact MESU

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Safe Use Of Medical Devices

• GENERAL INFO

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Repairs

• Include a full fault description
• Would you send your car/television for repair
  without a full description?
• Include a Declaration Of Decontamination
  Certificate

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Incidents

• Report Incidents as per Trust policy
• Ensure all relevant information is included on
  incident forms
• Include all device settings
• Send any disposables

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Advice

• Contact MESU for any advice required relating to
  Medical Devices
• Check the Intranet

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Precautions

• If device gets wet, get it checked
• If cabling damaged/exposed, get it checked
• Do not replace fuses on medical devices
• If devices are damaged, get them checked
• DO NOT TAKE RISKS!

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How Can Users Assist?

• Check devices for damage before use
• Ensure there is no damage to mains plug
• Ensure there is no damage to mains cable
• Ensure there is no damage to device
• Do understand how to use the device safely
• Do NOT carry out any repairs yourself

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Conclusions

• Always use your common sense
• Do not end up like this person!

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