ELECTRIC EQUIPMENT 4 Care of equipment(low voltage)

Care of Low Voltage Equipments

In order that an extra low-voltage circuit may function well all connections must be kept clean, dry and free from corrosion.

•     After sterilization, heat processed apparatus must be dried before storing away.

•     Good contact of the connections must be maintained and loose contacts repaired immediately by the electrician when they are detected.

•     Lamps must be tightly screwed in position.

•     And the current source should, if possible, remain fairly constant. Therefore, batteries must be replaced before they are exhausted. Batteries left too long in the metal case tend to sweat, especially in humid atmospheres, causing corro-sion and the discharge of power. All batteries not in actual use should be stored under dry conditions.

Rechargeable Battery Packs

Rechargeable nickel-cadmium batteries are being used as accessory of medical equipments. These are expensive and have a limited life, although are electrically safe.

•     Rechargeable batteries are capable of delivering a very high current on discharge, so should not be shorted, as this might result in sparking. Another feature is that their life is extended by regular discharging and recharging

•     Thus, any piece of equipment containing rechargeable batteries should be regularly switched on and regularly recharged

•           They can fail without warning, back-up batteries for essential pieces of equipment are required.

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ELECTRIC EQUIPMENT 3

•     Electronic microchips and integrated circuits are generally very hard wearing and will withstand rough handling; they also operate at low voltages so are relatively safe, but they respond badly to high temperatures. Overheating should therefore be avoided, and ventilation openings left uncovered  with these safeguards, they should give good service

•     Low-voltage battery equipments are generally safe and may even be designed to work in damp or humid conditions.

      A considerable amount of electric equipments in the operat-ing department use extra low-voltage current. These include :

•     Laryngoscopes,

•     Bronchoscopes,

•     Cystoscopes and

•     Head lamps.

•     Generally, an extra low-voltage circuit
used in apparatus for use in theater may range from 1.5 V for endoscopes to 10 V for a surgeon’s headlamp.

•     The electric current may be supplied from batteries or a transformer which reduces the mains voltage to the required level.

•     The transformer may be a separate item of equipment or may be incorporated in the equipment such as in diathermy machines (high-frequency electro-surgical units). To a great extent extra low-voltage illumination is being replaced by fibre optics.

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ELECTRIC EQUIPMENT 2

Care of Electrical Equipments

•     Many modern instruments and pieces of equipment operate from mains voltage 110 or 240 V/AC. All electrical instruments have been tested for safety after manufacture and if not damaged in transport can be assumed to be electrically safe on delivery.

•     With use, cables are damaged, earth connections can get loose or break, internal components can move with vibration/ accidental damage. An incorrect alteration during repairs to the circuit or safety fuses can result in dangerous voltages and currents reaching the patient.

•     Simple checks of plugs, fuses and cables should be made regularly by the OT staff in charge of the electrical equipments and routine maintenance checks performed by a qualified person at fixed intervals as recommended by the manufacturer

•     Earth connections and safety fuses should be regularly checked, making sure that the correct loading fuses are being used

•     Damaged cables should be replaced and any loose components such as switches and sockets repaired

•     All equipments working from mains voltage should have a circuit breaker in the supply lines

•     All mains electrically powered instruments should be kept dry

•     Cardiac defibrillators deliver a high voltage of several thousand volts, together with a relatively high current, making a lethal combination to operator if any serious electrical fault should occur, it is thus even more important that servicing and maintenance of these instruments be entrusted to a qualified electrical engineer

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ELECTRIC INSTRUMENTS 1

ELECTRICAL INSTRUMENTS

Much of the equipment in the operating theatre is powered by electricity.

      Most of the main connections are of Alternating Current (AC) and the frequency is 50 Hz.

Hazards

With AC a person who touches a live conductor and the earth will complete the circuit. 

The current will thus flow through this person and any one of the two possibilities can occur:

•     Electrocution

•     Local burns.

Loose electric connections can also start sparking, and this can lead to ignition of inflammable material (gases) in the OT.

Failure

•     The mains voltage in the India is at 220 V, 50 Hz

•     Emergency lighting and power for the operating theatre is provided by an emergency generator at the standard mains voltage

•     Or from batteries at 12-24 V

•     Or a combination of both

•     It is likely that the generator will supply the emergency electrical needs of the operating theatre through the existing wiring and socket outlets

•     Or some of the electric socket outlets may be connected to the generator.

      The planning of the design must take into account that the emergency generator output should be sufficient to supply the demand likely to be required.

•     However, it is wise during failure of mains supply to limit the demand and use lights and equipment that are essential for the operation in progress.

•     With mains failure, there could be a delay before a generator comes into action.

•     Preventive care must be taken with the use of electro-medical equipment in the vicinity of anesthesia apparatus if flame-able anaesthetic agents are likely to be used (cyclo­propane, ether).

•     There is potential risk of sparks originating from switches or motors igniting flammable anesthetic gases which may
leak from anesthesia breathing tubes.

•     This danger exists within a 25 cm area from the points where leakage occurs.

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Infection Control Recall review 3

QUESTIONS FOR SELF EVALUATION (Sterilization)

    1.   What does sterilization mean as it applies to equipment used in Surgery?

    2.   What is the difference between a gravity steam sterilizer and a high vacuum sterilizer?

    3.   Why is it important that all air be evacuated from the steam sterilizer?

    4.   Name the four phases of a steam sterilization cycle.

    5.   Discuss the proper method of preparing stainless steel instruments for sterilization?

    6.   Why must linen be freshly laundered before it is used to wrap goods for steam sterilization?

    7.   What bacterium is used to monitor a steam-sterilized load?

INTERNET website

1.   Association for Practitioners in Infection Control (APIC). http/www. apic.org   .

2.   Association for Advancement of Medical Instrumentation (AAMI). http/www.aami.org   .

3.   Centers for Disease Control and Prevention. http/www. cdc.gov  .

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RECALL REVIEW 2 self evaluation

QUESTIONS FOR SELF EVALUATION (Disinfection)

    1.   What is the difference between disinfection and sterili­zation?

    2.   What is the difference between disinfection and antisepsis?

    3.   What is a bactericide?

    4.   What is the difference between a bacteriostatic agent and a bactericide?

    5.   What disinfectant is used in your operating room to clean the floors and walls? What type of disinfectant is it?

    6.   Why must hospital equipment be decontaminated?

    7.   What is meant by cleaning?

    8.   How does one handle an instrument that has fallen from the surgical field during surgery?

    9.   Discuss the duties of the scrub technologist immediately following a surgical case.

  10.   Describe the proper decontamination process for surgical instruments.

  11.   What is cavitation?

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RECALL REVIEW 1

sterilization DEFINITIONS

Cobalt 60 Radiation

A method of sterilizing pre-packaged equipment by ionizing radiation.

Ethylene Oxide Gas

Highly flammable, toxic gas that is capable of sterilizing an object.

Glutaraldehyde

Chemical capable of rendering objects sterile.

Gravity Displacement Sterilizer

Type of sterilizer that removes air by gravity.

High Vacuum Sterilizer

Type of steam sterilizer that removes air in the chamber by suction vacuum.

Shelf Life

The amount of time a wrapped object will remain sterile while stored on a shelf after it has been subjected to a sterilization process.

Steam Sterilizer

Sterilizer that exposes objects to high pressure steam.

Sterilization Control Monitor

Method of determining whether a sterilization process has been completed; does not indicate whether the items subjected to that method are sterile.

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