MICU/CCU Survival Guide
Critical Care Concepts
Electrical Safety In The Critical Care Unit
A. Electricity presents a serious hazard in hospitals.
B. It is not possible to determine the incidence of fatal and non-fatal hospital electrical
C. Estimates vary from 1200-1500 per year.
D. Accidents generally unreported.
E. ICUs presents serious hazard due to:
1. Number of electrically powered machined
2. The number ofconductors in, on, ad mound patients. Such as 80 catheters, wet
dressings, CVP lines, Pacemakers.
3. Times when unsafe conditions a present: fluid or blood on the floor, bed, or
F. Must have a knowledge of electrical safety to protect the
patient, others, and yourself
G. Electric current consists of a flow of electrons through a conducting pathway or circuit.
The circuit must be closed with a difference in potential existing between two points.
Current must be continuous flow in one direction (DC) or reverse its direction fiequently
H The amount of current flowing between two points of different electrical potential vdes
inverseb with the intervening resistance. Resistance is the impedance to flow. When
resistance is low lmge amounts of current flow and inversely when resistance is
I. Electricity is carried into the hospital via a hot line and is carried back to the power
source via a neutral line. this is a 2-wire system.
J. When a 3-wire system is used a ground is used. A ground works to transfer all excess
leakage of current to the ground. Ah electrical current leaks. The mnount of current is
reeulated and is hannless ifthe eouinment is nronerlv mounded.
K. Electric shock refers to the effects and reaction produced by passage of an electric current
through the body. the effect varies with the amount of current delivered, its duration,
pathway through the body, al of exposure, and the tissues lying in the pathway of the
ELECTRIC SHOCKS CAN BE LETHAL WHEN THE HEART IS A COMPONENT
OF THE CIRCUIT.
L. Skin provides a high-resistance barrier to the transit of current through the body of
externally applied current. The resistance to flow is greatest when the body surface is dry.
Skin of the palnar surface offers the highest resistance. Sweat or saline, application
of BCO jelly, or cleansing with soap reduces this resistance.
M. VERY SMALL CURRENTS CAN BE LETHAL WHEN CURRENT FINDS A LOW
IMPEDANCE PATHWAY DIRECTLY TO THE HEART!!
N. The chief danger to a patient in contact with electrical equipment is the initiation of
ventricular fibrillation by electric shock.
O. hocks from large counts of electricity, perhaps me full line of current of 1 10 volts
EXTERNALLY applied are referred to a MACROSHOCK.
P. MICROSHOCK is dangerous only if apphed directly to me myocardium or internally
through a intracardir catheter, probe, pacing wire, or needle. Microshocks are
impercepaible and have no effect on ahe outside ofthe body.
Q. Applied to mucous membranes or to a break in the skin, both which offer less resistance,
the game amperage crates a more intense sensation.
R. Heart muscle is particularly sensitive to electrical stimulation, the cause of death fiom
electrocution is most often ventricular fibrillatoon.
1. Perception of shock is i warning to the operator and patient alike of a possible electrical
malfunction. DO NOT IGNORE!
2. All equipment should be grounded. Never use a a-wire system.
3. Never adapt a 3-wire to a 2-wia outlet.
4. Never use a frayed or broken cord.
5. Do no use equipment the patient has brought fiom home.
Unless instrumentation has
approved it. Use battery powered equipment when possible.
6. All new equipment is to be checked by instrumentation.
7. Rubber gloves should be placed over the pacer terminal.
8. Wear rubber gloves when working with the pacer generator or wire.
9. Keep the patient and paaient area dry in case electrical
equipment (defibrillator) needs to
10. An electrical equipment must be checked at lest every 6
months. Remember that
equipment still operates wiah defective ground connection.
11. Turn equipment off before unplugging to prevent arching.
12. If HAZARD alarm sounds, investigate by unplugging
equipment to identi$ source.
Notify biomedical department.
13. When checking defibrillator, do not hold the paddles
together a do not hold them facing
each other but not touching.
14. When defibrillating, do not touch the paddle to the electrode.
16. Never plug, unplug equipment, turn on a hght, etc. while
your hand or other part of your
body is in contact with water, steam pipes, radiators, or plumbing fixtures.
17. Do not intentionally ground the patient by letting him
come in contact with or touch any
metal object, switch, or device which ma provide an alternate mute of low resistance.
19. Most shocks are due to improperly grounded equipment.
20. Clean electrodes after used to prevent corrosion. Carefully store, to prevent breakage.
Reference: National Standards Electrical Code
Fundimentals of Nursing 5th Edition, 1995, Chapter 28.
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