1 - AS/NZS 2500:2004 GUIDE TO THE SAFE USE OF ELECTRICITY IN PATIENT CARE
4 - PREFACE
6 - CONTENTS
8 - FOREWORD
9 - SECTION 1 SCOPE AND GENERAL
9 - 1.1 SCOPE
9 - 1.2 APPLICATION
9 - 1.2.1 Establishments
9 - 1.2.2 Personnel
10 - 1.3 REFERENCED DOCUMENTS
10 - 1.4 DEFINITIONS
10 - 1.4.1 Applied part
10 - 1.4.2 Patient environment
11 - 1.4.3 Patient location
11 - 1.4.4 Patient area
12 - SECTION 2 NATURE OF ELECTRICITY
12 - 2.1 NEED FOR CARE
12 - 2.2 SUPPLY SYSTEMS
12 - 2.3 FUNCTION OF FUSES AND CIRCUIT-BREAKERS
14 - 2.4 SOCKET-OUTLETS
15 - 2.5 BASIC EQUIPMENT SAFETY
15 - 2.5.1 Forms of construction
17 - 2.5.2 Classification of applied parts
17 - 2.6 LEAKAGE CURRENT
18 - SECTION 3 NATURE OF HAZARDS
18 - 3.1 GENERAL
18 - 3.2 ELECTRIC SHOCK
18 - 3.2.1 Causes of electric shock
19 - 3.2.2 Contributing factors
19 - 3.2.3 Levels of susceptibility to electric shock
21 - 3.3 THERMAL HAZARDS
21 - 3.3.1 General
21 - 3.3.2 Electric burns
21 - 3.3.3 Thermal burns
21 - 3.3.4 Temperature of infused fluids
22 - 3.3.5 Fire and explosion
22 - 3.4 RADIANT ENERGY
22 - 3.4.1 General
22 - 3.4.2 Ultrasonic energy
22 - 3.4.3 Laser radiation
23 - 3.5 ELECTROMAGNETIC INTERFERENCE
23 - 3.6 ELECTROSTATIC HAZARDS
23 - 3.7 LOSS OF ELECTRICAL POWER
24 - SECTION 4 COMPATIBILITY OF MEDICAL PROCEDURE, EQUIPMENT AND PATIENT AREAS
24 - 4.1 SAFETY TRIANGLE
24 - 4.2 MEDICAL PROCEDURES
24 - 4.2.1 General
24 - 4.2.2 Inadvertent contact with live conductors
25 - 4.2.3 Body-type procedure-applied parts not involving the heart
25 - 4.2.4 Cardiac-type procedure-applied parts involving the heart
25 - 4.3 ELECTRICAL WIRING AND PROTECTION OF patient areas
25 - 4.3.1 Protection levels
27 - 4.3.2 Components of protective wiring system
28 - 4.4 APPLIED PARTS OF MEDICAL ELECTRICAL EQUIPMENT
28 - 4.4.1 Classification
28 - 4.4.2 Protection in fault conditions
29 - 4.4.3 Type B applied parts
29 - 4.5 FLOWCHART (SUMMARY) FOR THE SAFE APPLICATION AND USE OF MEDICAL ELECTRICAL EQUIPMENT
29 - 4.6 USE OF SOCKET-OUTLETS IN CARDIAC-PROTECTED patient areas
29 - 4.7 TEMPORARY ARRANGEMENTS FOR UNDERTAKING CARDIAC TYPE PROCEDURES
30 - 4.8 HOME DIALYSIS
31 - SECTION 5 ADMINISTRATION
31 - 5.1 RESPONSIBILITY
31 - 5.2 RECOGNITION AND LOCATION OF PATIENTS RENDERED ELECTRICALLY SUSCEPTIBLE
31 - 5.2.1 General
31 - 5.2.2 Design of patient areas
31 - 5.2.3 Design of equipment
31 - 5.3 TRAINING
32 - 5.4 DOCUMENTATION
32 - 5.5 MEDICAL ELECTRICAL EQUIPMENT
32 - 5.5.1 Purchase of equipment
32 - 5.5.2 Demonstration equipment
32 - 5.5.3 Operator instructions
32 - 5.5.4 Life-supporting equipment
32 - 5.5.5 Mains power supply failure
32 - 5.5.6 Back-up equipment
33 - 5.6 MAINTENANCE OF MEDICAL ELECTRICAL EQUIPMENT AND PATIENT AREAS
33 - 5.6.1 Equipment maintenance
33 - 5.6.2 Maintenance of electrical systems of patient areas
33 - 5.6.3 Maintenance of distribution equipment and switchboards
33 - 5.7 NON-MEDICAL ELECTRICAL EQUIPMENT
33 - 5.7.1 General
34 - 5.7.2 Cleaning equipment
34 - 5.7.3 Entertainment equipment
34 - 5.7.4 Patient-comfort equipment
34 - 5.7.5 Cosmetic equipment
34 - 5.7.6 Patient-supplied equipment
35 - 5.7.7 Mobile communications
35 - 5.8 FAULT REPORTING
35 - 5.8.1 General
35 - 5.8.2 Fault tags
36 - 5.8.3 Incident reports
36 - 5.8.4 Equipment reports
36 - 5.8.5 Modification of equipment
38 - SECTION 6 GENERAL USER PRACTICES
38 - 6.1 GENERAL
38 - 6.2 RESPONSIBILITY
38 - 6.3 USER OBSERVATION AND CHECKS-BEFORE USE
38 - 6.4 PRECAUTIONS TO BE OBSERVED DURING USE
39 - 6.5 USER PRECAUTIONS/PRACTICES TO BE OBSERVED AFTER USE
39 - 6.6 ADDITIONAL PRECAUTIONS TO BE OBSERVED IN THE USE OF HIGH-ENERGY APPARATUS
40 - 6.7 FLEXIBLE CORDS AND PLUGS
40 - 6.7.1 Inspections
40 - 6.7.2 Correct wiring
40 - 6.7.3 Faulty cords and plugs
41 - 6.8 DOUBLE ADAPTORS AND EXTENSION CORDS
41 - 6.9 MEDICAL SYSTEMS
42 - 6.10 APPLIED PART ADAPTORS AND ATTACHMENTS
42 - 6.11 PROTECTIVE DEVICES IN PATIENT AREAS
42 - 6.11.1 Introduction
42 - 6.11.2 RCD protected supply
43 - 6.11.3 Isolated supply
43 - 6.12 GUIDE TO THE USE AND REUSE OF STERILE DEVICES
47 - APPENDIX A - SUPPLEMENTARY EARTHING CONDUCTORS
47 - A1 INTRODUCTION
47 - A2 CONSTRUCTION AND PERFORMANCE
47 - A2.1 Insulation
47 - A2.2 Termination
48 - APPENDIX B - USE OF TEMPORARY TRANSVENOUS CARDIAC PACEMAKERS
48 - B1 GENERAL
48 - B2 EQUIPMENT
48 - B3 PROCEDURE
48 - B4 PATIENT SAFETY
48 - B4.1 Exposure to risk
48 - B4.2 Monitoring equipment
48 - B4.3 Pacing catheter terminals
49 - B4.4 Adaptors and extenders
49 - B4.5 Battery replacement
49 - B4.6 Use during defibrillation
49 - B5 CESSATION OF TEMPORARY PACING
50 - APPENDIX C - CONTACT INFORMATION FOR MEDICAL DEVICE INCIDENCE REPORTING
51 - APPENDIX D - USE OF CARDIAC D.C. DEFIBRILLATORS
51 - D1 GENERAL
51 - D1.1 Fibrillation
51 - D1.2 Types of defibrillators
51 - D1.3 Efficacy
51 - D1.4 Hazards
51 - D1.5 Performance and maintenance
51 - D2 MANUAL DEFIBRILLATORS
51 - D2.1 Use
52 - D2.2 Energy Settings
52 - D2.3 Electrodes
52 - D2.4 Application
52 - D2.5 Discharge of the Pulse
53 - D2.6 Particular Hazards
53 - D2.7 Use of Other Medical Electrical Equipment on the Patient during Defibrillation
53 - D2.8 Operation and Performance Checks
53 - D3 AUTOMATIC EXTERNAL DEFIBRILLATORS (AEDs)
53 - D3.1 Use
53 - D3.2 Energy Settings
54 - D3.3 Electrodes and Application
54 - D3.4 Discharge of the Pulse
54 - D3.5 Hazards
54 - D4 OPERATION AND PERFORMANCE CHECKS
55 - APPENDIX E - GUIDELINES FOR THE USE OF ELECTROSURGICAL EQUIPMENT
55 - E1 INTRODUCTION
55 - E1.1 General
55 - E1.2 Electrosurgery
57 - E1.3 Nature of risks
58 - E1.4 Equipment
58 - E2 ELECTROSURGICAL SYSTEMS
58 - E2.1 Electrosurgical generator
58 - E2.2 Active electrode
58 - E2.3 Bipolar electrodes
59 - E2.4 Dispersive electrode
59 - E2.5 Safety monitor circuit
59 - E2.6 Specialized accessories
59 - E3 NATURE AND AVOIDANCE OF HAZARDS
59 - E3.1 Types of hazards
60 - E3.2 High-frequency injury-Burns
65 - E3.3 Monitoring the connection of the dispersive electrode
66 - E3.4 Types of Applied Part safety monitors
67 - E3.5 Other risks
68 - APPENDIX F - GUIDELINES FOR THE USE OF ELECTRICITY OPERATED PHYSICAL THERAPY EQUIPMENT
68 - F1 INTRODUCTION
68 - F2 GENERAL PRECAUTIONS
68 - F3 DEVICES DELIVERING MECHANICAL FORCES
69 - F4 DEVICES DELIVERING ELECTRICAL ENERGY
69 - F4.1 General
69 - F4.2 Precautions against cardiac stimulation
69 - F4.3 Unwanted stimulation and burns
70 - F5 ELECTROMAGNETIC RADIATION
70 - F5.1 Low-frequency magnetic fields
70 - F5.2 Shortwave therapy
71 - F5.3 Microwave therapy
71 - F5.4 Infra-red radiation
72 - F5.5 Visible wavelengths
72 - F5.6 Ultraviolet radiation
72 - F6 ACOUSTIC ENERGY (ULTRASOUND)
72 - F6.1 General
72 - F6.2 Precautions
73 - APPENDIX G - STERILIZATION AND DISINFECTION OF ELECTRICAL EQUIPMENT
73 - G1 OUTLINE OF METHODS OF STERILIZATION AND DISINFECTION
73 - G1.1 Sterilization
73 - G1.2 Disinfection
74 - G2 HAZARDS
74 - G2.1 Nature of Hazards
74 - G2.2 Adverse effects of sterilization
74 - G3 GUIDE TO SELECTION OF STERILIZATION AND DISINFECTION METHODS FOR EQUIPMENT
76 - APPENDIX H - INDEX OF TERMS USED IN THIS STANDARD