Hi there: does anyone remeber a SAB/HN from the MDA about the use of extension leads for Patient Connected Equipment. I seem to remember they were frowning on this practice. Any help would appreciated as I am getting earache from Staff who wish to use them.

Yes, there was some advice from the MDA about using extension leads. It was quite a while ago and I can't remember the details, but try the MDA Web site - or quicker still, give them a ring !

Our electricians will not supply any extension leads for theatres, ICU, HDU, or anywhere there is a risk of liquid being spilt onto the sockets.
We have been working with a local engineering firm who have produced a small stainless steel "pod" on castors with double 13 Amp sockets mounted on the vertical sides and protected from spillages by an overhanging top. They intend to market this in the very near future, so if you would like me to get them to contact you, send me an e-mail giving your telephone number.(and your name etc ofcourse !)
It is CE marked, by the way.

Roy
How much do they charge?

You might like to look at BS EN 60601-1-1:2001
'Safety requirements for medical electrical systems'or you might not

John - I'll ask the guy to phone you and you can discuss your requirements !

Jon. Surely any requirements would have to be met to achieve the CE mark ? It's not our design - we've just suggested some refinements !

We have been supplying 'ELD' extension leads to our users for very many years. They are robust multiway extension leads incorporating an earth leakage monitoring circuit. The circuit alarms if more than 500 microamps flow through the earth wire.
The demand for them is very high...

We have been unable to find a commercial partner over the years though several companies have expressed interest.

Mark

I'll ask our chap to contact you ! There's plenty of room in the stainless steel box to b uild in an alarm circuit. What a good idea ! :p

I RECENTLY HAD A DISCUSSION WITH RICHARD MELLISH @MDA ON THIS SUBJECT.
HE AGREED THAT AD HOC COMBINATIONS OF ASSEMBLIES CONNECTED BY USERS WITHOUT REGARD FOR THE TOTAL LOADINGS, LEAKAGE CURRENTS ETC MAY NOT PROVIDE AN ACCEPTABLE LEVEL OF SAFETY TO A PATIENT CONNECTED TO THE DEVICE / DEVICES.
OBVIOUSLY BOTH WE (EBME) AND THEY (MDA) HAVE TO BE VERY CAREFUL ABOUT ANY AIDING AND ABETTING IN ANY SUCH SETUPS JUST IN CASE OF PATIENT / STAFF INJURY.
AGAIN HE SUGGESTED THAT THE RELEVANT STANDARDS ALREADY MENTIONED NEED TO BE REFERRED

Mark - if you haven't received an e-mail from me (sent 7th Oct) regarding the extension leads & alarm circuit, please can you contact me.

Karl, sweet ostentation my friend, your technical offerings are simply, ostentatiously first class my friend. Gentleman, listen to Mr. Mundys heralding's, I think you'll find that when you integrate a number of systems onto a single “Spur” i.e. in this case a single routed mains extension, this then becomes “one complete system” and must be tested as such, hmm sum up these leakages and as Karl says they may well exceed the limits. Ostentation my dear Karl, ostentation.

The problem is that the design of the "standard" theatre doesn't take into account all the varied equipment different specialities trundle into them. Then there's the different layouts people have to use because some operations require access for the surgeon at the side of the patient - others at the head - and others between the legs

So how do the theatre staff overcome the problem ? With an extension lead they've bought from Woolworths because the Estates people won't supply one. And where do they put it ? On the floor - in 1/2 inch of spilt saline solution etc !

They're going to use extension leads in theatres no matter what we tell them or what the regulations say - because it's the only way they can make it work - so we might as well try and supply them with something safer than the six-way block at the end of the 5 Amp cable.

It's a tricky situation Roy, yes they need to have points to plug in the equipment, but what happens the time they can't get access to type of protected mains block that I think you normally use there.
Do they use the "Woolies" one because of the custom and practice they are use to, or do they have the intelligence to not use something "dangerous" but would do the job anyway.
I fear it would be the latter.

I have seen many theatre designs that give adequate use of mains sockets, scavenging and piped medical gasses.
Does the problem boil down to money and closing the theatre down to bring it up to an acceptable standard.
Surely planned maintenance by the Estates Dept. should take into account renovation and improvement.
Most hospitals I know have a program for continual theatre up-grade.
At this time this is surely when these problems can be addressed and rectified.

Another more radical solution would be to get the theatre staff to disconnect their "boogie box" thus freeing up vital socketry.
Another pitch, if money was tight, would be to have the budget for theatre maintenanve spent on these above mentioned renovations instead of kitting out the coffee room with TV's, fridges, microwaves, coffee machines and better creature comforts than in most 4 star hotels.

Come on Dave me olde wok smugglin mate.
Surely ye not suggestin that the hard workin,
under staffed, under paid, over stressed theatre
operatives should have all their goodies taken away.
That will mean they have to use the canteen with the rest of the plebs.

I'm afraid Karl me old pop-tastic mate I've progressed on to smugglin' nose cones off Jumbo jets instead now.

Theatre staff use the canteen with the rest of us plebs
Surely I have been mistaken then when I notice would be Dr Green/Kildaire look-a-likes flying down the corridor attired in full blues/greens, clogs, facemasks and hats.

Of course they have already that morning swallowed their "anti infection control pill" and liberally sprayed onto themselves "germ guard".

That would be the only reason I gather that when I pass my head in forward waiting I am screamed at for bringing my obnoxious bugs with me into a sterile environment.

The only other answer of course is all said theatre staff who stand in the queue in the canteen, at the WRVS kiosk and outside "having a fag" all change into their alternative/sterile theatre clothes before going "back inside"

I remember once sampling the delights of the canteen at a local hospital that shares it's name with a racecourse; outside the control of infection team were doing a big "sales pitch" as to hospital cleanliness standards and "controlling infection" within their Trust.

When I pointed out that that numerous "theatre types" were swanning past in their "pyjamas" and surely they were "transporting" bugs and spreading germs, her answer was that of course they all get changed " as soon as they get back to theatre". :p

I don't know many theatre staff who have numerous pairs of clogs to swap, I fear the squashed chip from the sole of the said clog probably found it's way into that "sterile environment"

When she became a little more chatty what she actually said was " ..what can you do with Doctor's, who's going to tell them off.."

And therein lies the problem with most problems within the NHS. Such people as the deity groups mentioned by your good self are above and beyond the latching on and carrying of such bugs. Sadly we think we are of the same clone and therefore think we to can carry on in such a way. That is why the gods have appointed their angels (infection control etc)so ensure that we dont get out of control.

Ive also witnessed the immigration control problems involving chips from canteen to theatre, one can only assume that someone has told them the grass is cleaner there, or is it the bugs using the chips as a cover to get into a more favourable envoirement without being seen.
:p

Ah, gentlemen, these are our godly intemperance's, our medical untouchables hmm, one day, whilst walking through the Bamber Bridge Mews Louis wandered upon a grave stone that read…
In memory of my father: gone to join his appendix, his tonsils, his olfactory nerve, a kidney, an eardrum, and a leg prematurely removed by an intern who needed the experience.
I mock not gentleman. These people are not gods; they may think they are, but my fellow brethren, we all know better, don't we. As my American cousin Floyd Lyniswern told me :-

There was this city doctor who started a practice in the countryside. He once had to go to a farm to attend to a sick farmer who lived there. After a few housecalls he stopped coming to the farm. The puzzled farmer finally phoned him to ask what's the matter, didn't he like him or somethin'. The doctor said, "No, its your ducks at the entrance... Every time I enter the farm, they insult me!"

Says it all my friends, says it all

Very Good.
Heres one for ye.
Engineers work on devices.
Doctors work on the human body.
If engineers had been given a device to work on over 2000 years ago would we still be saying we are not sure of how to fix it
Does ye see where Im acomin from.

Ostentation, my dear Karl, ostentation. So very true, oh how Louis laughs, ha ha ha.
Try this:-

Five surgeons are discussing who makes the best patients to operate on.

The first surgeon says, "I like to see hospital accountants on my operating table, because when you open them up, everything inside is numbered."

The second responds, "Yeah, but you should try biomedical electronics engineers! everything inside them is color coded."

The third surgeon says, "No, I really think medical librarians are the best;
everything inside them is in alphabetical order."

The fourth surgeon chimes in: "You know, I like anesthetics engineers ...those guys always understand when you have a few parts left over at the end, and when the job takes longer than you said it would."

But the fifth surgeon shut them all up when he observed: "You're all wrong. Estates Managers are the easiest to operate on. There's no guts, no
heart, and no spine, and the head and arse are interchangeable :p

Roy has sent me some more information on this...

<table><tr><td><img src="http://www.ebme.co.uk/gallery/mains/th_5x.jpg" border="1"></td><td><img src="http://www.ebme.co.uk/gallery/mains/th_ll2.jpg" border="1"></td><td><img src="http://www.ebme.co.uk/gallery/mains/th_trans1.jpg" border="1"></td></tr><tr><td colspan="3" align="center"> Click here for more details </td></tr></table>

Thanks Roy

Hi Roy

Your posting on Mobile Extension Unit may help some of us improve our theatre safety, particularly the example with the isolation transformer.

&#8220;Bringing the power to the table, extension box with 8 x 13 amp sockets. Power supplied via an isolation transformer for patient and operator safety, with a polycarbonate cover and safety locking device if required. Finished in satin polished stainless steel with antistatic castors.&#8221;

Can you provide additional info on supplier, price etc?

Bill

Hi Bill, Just click on the link beneath the photographs to get the feedback you need.

Hi Hew, Roy
Does this Company still exist, I have tried the link and it does not work and the phone number I have appears to be disconnected?

Does anyone know of a different company that supplies something similar?

Tom

The company still exists - just moved to bigger premisses !

The latest phone number I have is 07767268394 - the owner's mobile number.

They've developed the product and combined it with one of their drip stands so it's ideal for mounting infusion pumps, blood warmers etc

Tom

Let me know your e-mail address and phone number. The Isolation unit is the solution to your problem. I am the ops director for safety medical solutions ltd and can send you details via our brochure. Our website is http://www.safetymedical.co.uk

My mobile number is 07928 715048

Best regards

John
John Hesketh

We are also currently working on a resus trolley with an electrical isolation unit built in and also a smaller version of the safety isolation unit for use on the wards or general hospital use.

Your stuff certainly looks very nice, John. Obviously designed by someone who knows what s/he's doing (which is not always the case with theatre equipment, unfortunately). A bit pricey, though, I'll bet!

Thanks Geoff

Let me know your e-mail address and I will send you a brochure with prices.

John

Yeah, got it John. And thanks for that. It looks like good quality kit (and with prices to match, of course). I especially like the idea of the portable isolation transformer (with covered mains outlets etc.) encased in a stainless steel box. I imagine we have all seen some pretty appalling lash-ups in operating theatres, and it's nice to see a proper solution. Now I'm wondering who came up with that practical idea. Your own people, or a hospital biomed? Or was it prompted by theatre staff somewhere?

Thanks Geoff

We came up with the idea but in response to seeing patient intrusive equipment being used via non isolated sockets. (quite disturbing). The problem for us is as you say "spreading the word" as most theatre staff have no idea of the dangers, or indeed if the sockets in theatre are isolated. It appears that the ebme depts, and independent biomed guys like yourselves are the way in.

Regards

John

We just have to keep on evangelizing, John. Each new generation of nurses, theatre techs, anaethetsists and surgeons (especially the last two), have to be badgered just like their predecessors, or so it would seem.

As I may have remarked before, I always find it somewhat disappointing that the very place where electrical safety is most critical (ie, the theatres), is often where the worst offenders are to be found.

Oh yes, they all love their "extension leads". I've even seen a garden reel type (ie, big) in one well-known North London hospital. And many cheap reel types, of course. Plus all the Woolworths extension leads, as Roy has mentioned before. "Needs must" perhaps, but not very clever when you spill fluids into them, or step on (ie, break - as in smash) them!

Biomed techs spend hours and hours each year (month, week) carrying out electrical safety tests on well-made and perfectly safe equipment, whilst the real hazards we're talking about here tend to be overlooked. Why is that, I wonder?

Maybe we all need to be taking photographs (you know, of the "name and shame" variety) and post them in the Gallery section of this forum (which Huw has kindly provided, but which I see is still somewhat denuded).

Just a bit busy with other things at the mo' Geoff. I will get there... eventually.

Meanwhile, please feel free to use The Gallery. No ads, porn etc. usual restrictions apply

Actually, Mate, I was wondering when a few of the other 3,467 members were going to upload some of their pics!

Be patient grasshopper...