Some time ago I asked for advice on the supply of coloured mains plugs. I have know been asked for information on the following from our critical incident forum. This is in response to an in house request that all life support ventilators may need to be fitted with a plug that identifies their connection from amongst a bank of maybe 12 plugs that are all connected closely together.
1. If colour coding is to be done, will there be a need for training to all users?
2. Will information charts be posted identifying what colour does what?
3. How will we ensure that when a plug top is changed the right colour is fixed to the correct piece of equipment?
4. Will a permit be required to ensure human error is minimised?
5. Is this practise carried out anywhere else?

Any constructive comments would be gratefully received. Especially if anyone has actually gone through this type of exercise and would be willing to share their findings / actions taken.
Bear in mind the plugs on medical devices are checked / fitted by ebme, but not the plugs on tv, video, fans etc.

Here at Sandwell we fit all "Life support" with Red MK Plugtops
Marked up Hospital Equipment with a do not switch off sticker

(we normally fit white MK plugtops so the change to RED is quick and easy , only the top is red)

These are quite visible in a strip of white plugtops

All IT equipment is fitted with a special plugtop with a T shaped earth pin which cannot be plugged into the wall sockets.
These measures seem to work quite well

KM,
In my last job I was asked to fit coloured plugs to all essential equipment on an intensive care where there had been an incident. A nurse tried plugging in a syringe pump by unplugging the ventilator. At least we had got the "keep it on charge" message home.
I asked the sister for a list of "essential" equipment. It ended up as effectively all medical equipment which rather defeated the object of the exercise as that was virtually all the plugs at the bed head. So I suggested different coloured plugs for types of equipment and a priority list. The nurse said that her staff would not remember the colour code so they would end up not touching any coloured plug, i.e. all plugs at the bed head - back to square one.
The colour coding education would also have to be given to contract cleaners etc. - not easy as they are outside hospital controls and procedures.
Dedicated medical sockets were suggested but rejected on cost grounds. Extra outlets were also out as that meant shutting areas down to wire them in. How many do you need by an ITU bed? I have counted 17 pumps, let alone monitors etc on one occasion.
This was never satisfactorily sorted out. It was just left as "something" should be done but we could not sort out what.
Tracing a cable back before unplugging and more importantly not having a bird's nest of wires behind the bed are the simplest solutions. But their implementation......
Not a lot of help to you but it is not an easy problem to solve. Good luck.
Robert

Well, its a bit fiddly but this is what I do...
Any cable permanently attached to equipment gets its own label on the plug-top eg VENT 1 or HUMID 5. Cables that get swapped about get a two letter code taped to the plug and again near the equipment end; so you check behind your pump and find it's cable EN, you look for EN on the plug top. 'P-touch' tape covered with sellotape seems to resist cleaning long-term.

It's an old problem - and one with no easy solution. If you fit red plug tops to life support equipment, then in an ICU you would find a lot of red plug tops ! Another option is to fit red plug tops to equipment which does NOT have a battery, so unplug it and it stops. At least if you then unplug battery powered equipment it alarms to warn you it's lost it's supply.

Basically you have to make sure that there are enough sockets in critical areas - but then what is enough ?

Someone explained to me how their ITU dealt with the problem of tangled mains cables at the head of the ITU beds once - at a conference, I think. I have no reason to think he was pulling my leg ! Apparently they left all their detatchable mains leads plugged in to the walls and switched on at all times. When the nursing staff wanted to power a piece of equipment, they scrabbled around on the floor to find an unused IEC connector and plugged it in. When they had finished with a piece of equipment, they unplugged the IEC lead and dropped it back on the floor. No confusion - no problem !

We use red plug tops on ventilators only. IV systems have their own battery so it's less of a problem.

As for IEC connectors lying around on the floor plugged into the wall sockets it's positively dangerous and an accident waiting to happen ie electrocution. A burst saline bag liberally douses everything including the 'live' IEC connector lying on the floor and you have fried staff and possibly patient.

This is a practice that needs to be actively and if necessary forcibly discouraged.

Dear All

The colour coding of plugs is historical and was divised by Estates to denote which sockets were on Essential supply (i.e. those which are connected to the generator in the event of power failure)

i.e. Red sockets or red inserts were for essential medical equipment i.e. connected to the back up generator

Black sockets or black inserts were for all other essential equipment i.e. connected to the back up generatoe

And white sockets or white inserts were for domestic or non essential equipment, i.e. socket not connected to the back up generator

This was done to ensure that the load to the generator is kept as low as possible.

RS supply plugs marked for Hospital Use in three colours, Red, Black and White for this reason. Speak to your Estates of even NHS Estates before adopting any other colour code as you could going against the NHS agreed policy.

I recall MDA had a notice many years ago reinforcing this colour coding for essential mains outlets.

Does anyone have any idea where the above mentioned docs can ve found, easily.

Surely there's not much point in colour coding the plugs, since in my hospital IEC leads get swapped all the time, despite our best efforts to keep them with the equipment, so coloured tops wouldn't have any use.

Any particular colour for mains extension-blocks with ventilator, humidifier, monitoring and other stuff plugged in, on the floor, swilling around with mop-water and sitting under a catheter-bag?

All of the equipment involved is either vents or
anaeshetics workstations (theatre anaesthetic machines + vent + aagss + suction + vaporiser etc as a unit) all of the machines have hard wired mains leads or captured iec leads therefore there is no user involvement in the actual mains lead transferel.

Keep it simple. Red for DANGER, so anything that is going to cause immediate injury to the patient e.g. disconnection of a ventilator or equipment to which a ventilator is associated then by all means use a RED plug top, all others white.

It's a good job the EEC are constantly striving to safeguard it's citizens and periodically introduce such innovations as the "detatchable IEC mains lead" - then make it mandatory - even on critical medical equipment.

Result ; -

It removes confusion about different coloured mains plugs to identify critical items - because the leads can get swapped between pieces of equipment making the exercise futile.
It makes it possible for nurses to connect patients directly to the mains supply by plugging ECG electrode leads into the end of the IEC lead.
It allows people to pinch the 3 metre long mains leads required for the safe connection of pressure relief mattresses on the end of the beds and replace them with the standard 1.5 metre ones.
People can leave the lead plugged in and switched on with the IEC connector lying loose on the floor for anyone to spill theit tea over.

I heard that there is a move to get all medical equipment fitted with hard-wired mains leads.

It'll never catch on !

Wouldn't it be easier to colour code the nurses.

We would have all the stupid ones who are likely to disconnect equipment willy-nilly wearing red uniforms.

No, on second thoughts bad idea, we'd have too many people wearing red, it would hurt your eyes walking on to the ITU, bit like a scene from a Sam Peckinpah movie.

Ouch , Where Louis works we have colour-coded nurses I'm sure the ex-expats will get on that;) Roy, scoff not my hairy tech but Louis heard a rumour that Brussels are trying to impose the Euro Mains Socket on to you lot. I hope for your sake this is a hoax, have you ever endured this pathetic beast. Its simply crap

L3

We use Black RS prefabricared leads with moulded plugs.
They pass the electrical safety, you don't have to wonder whether the last guy wired it up right, and they don't waste valuable manhours on fitting and checking plugs.

The original thread was about colour coding of plug tops to identify critical equipment supplies amongst a bank of sockets. In particular, KM was asking if anyone had done this and if they had procedures in place to ensure everyone understood the system.

I wonder if KM thinks he's had a satisfactory response ?

Michael referred to special plugs for I.T. equipment (with T shaped earth pin) - so presumably they have designated sockets for supplying I.T. equipment ? How is that organised ? Is all I.T. stuff supplied from a UPS ? Why was it felt necessary to go to the expense of fitting dedicated sockets for this equipment ?


So many questions, so little time.

I agree Roy, its a terrible situation when our fellow biomeds show they have a sense of humour

Are these not good answers to KM's question .Though I suppose in all of your 513 posts you have never strayed off the subject, have you sir?

MF

Is anybody aware of any standards, recommendations, DOH or MHRA guidance that refers to the colour coding of plug-tops for medical applications? Further; has anybody assesed the actual risk of "unplugging" incidents? Does anybody have figures? Is it really an issue or do we just have odd anecdotes from here and there?

Under what circumstances would this type of incident be classified as reportable? Who decides to report this - the nurse or cleaner that removes the plug, inadvertently, perhaps? Do the staff even know there's a procedure? Who informs the staff that the colours actually mean anything? How does it become a standard between hospitals if we all have different ideas on the colours to be used?

Just that each hospital seems to do it's own thing - helped along by the good-intentions and goodwill of interested parties such as ourselves.

RL
We haven't had any unplugging incidents according to our risk department. I've not seen or heard anything.

I do not believe there are any guidelines on colour coding of cables plugs or sockets for standard medical electronic equipment, although specialist applications such as lasers do require the following of guidelines.

I must have caught Seymour on a bad day !

Thanks for pulling the relevant quotes together, though.

As for wandering off the thread - some of the most interesting discussions have developed out of totally unrelated topics.

Long live diversity !

Right-on Roy!

On this quiet Sunday morning (and having just comes across it by accident), perhaps it's worthwhile resurrecting this ancient thread!

May I suggest that y'all start by taking a look at the initial post, then working your way through.

... then, has anyone cracked this one yet, or (indeed) have anything further to add?

My money goes on something like this:- any critical piece of kit that is not already battery-backed gets its own UPS screwed to the back (or the trolley, cart, whatever), set to give a clear (that is, loud) alarm whenever the mains plug is yanked out the wall. Hopefully, such a UPS need not be required to provide back-up power for more than a minute at most!

Forgive my ignorance on this quiet Sunday morning (actually I am working today) I thought ALL critical care equipment are backed up by a battery system and they should be plugged into the emergency circuit, here we use RED sockets to indicate the emergency circuit.

Once again I must gently point out your apparent lack of experience of the Real World here, Neil. Or perhaps you have just been lucky!

Meanwhile, you had better define "emergency circuit". One that is supplied by the standby generator in the event of general mains failure? That is, within ten seconds of interruption, inshallah?

And ... still a quiet Sunday morning out there (at this time of year), surely?

The emergency circuit is indeed connected to the emergency generator and it had better cut-in in less than 4 seconds not 10, quiet all month so far, getting on with the difficult jobs and re organisation of the BME.

There is no guidance from the MHRA on the colour coding of mains plugs. The nearest you will get to it is that sockets supplied by an IPS should be colour-coded Blue.
If it was possible to get some sort of agreed colour coding for plugs then it would be possible to put it up for consideration, so can we try to come up with a scheme that would be acceptable with most users, and I will try to put it forward.

Oh ok Bam so you saying that is no colour coding for plug point and only blue use to refer as IPS,
But in malaysia we have red for emergency(essential) and yellow we refer as UPS, and is applied in MHRA colour coding pls advice.

OK guys ... here we go:-

Let's start by establishing which colour plug tops are available.

For instance, those marked "Hospital Property" from RS.

Ok Geoff is there any Standard are use in UK for each plugs points in UK hospital, and what is the standards.

It would seem that (after reviewing the earlier posts on this thread) the easy answer to that could be:- No.

But to be clear, are we talking about plug tops, or socket outlets?

7 years on and we appear to have resolved our problem. Bit extreme but we built a new hospital along side the old and transferred into that. UP/IPS coming out of our ears now.
To bays in units, within pendant assebly, on vents. Rumour has it that we can even get the nurses to peddle bikes on dynamo if need be.

Nice one, Karl. But what plug colour coding did you go for?

Previous hospital in Saudi we had:

White/Grey = Normal mains supply
Red = Generator standby supply
Blue = UPS

Yes, Angus ... but I believe that we are primarily talking here about the plugs (see the initial post) as an indicator of the type (or, if you like, criticality) of the equipment plugged in.

In other words ... ways of reminding the cleaner not to unplug the ventilator, etc.

Logic dictates that both the plugs and sockets should be colour coded

But ... do they need to be the same colour? That is, only plug in a red top to a red outlet, etc. ... why?

After all, and as we have seen, the colours mean different things. The red plug could mean "Live Support Equipment" (or whatever), whilst the red socket may well simply mean "powered from the standby generator in the event of mains failure"!

To continue the "debate". This is a comment worthy of further consideration, I reckon:-


But (unless my own experiences have been less than the norm) surely this is the de-facto reality:-


Surely we have all come across "free" mains cables dangling from trunking and high-level outlets? I have seen whole platoons of them! As long as the cables don't actually reach the floor, and are all fused at the same (10 A?) rating ... what's the problem? Isn't this exactly how the so-called IEC cables are supposed to be used?

If it ain't got an internal battery then it ain't important.

The standard 13A, BS 1363 plugs come in four colours, Black, white, Red, and Orange. It is not a good idea to go for a more exotic colour, because if the right colour plug is not available, then you will end up with the old Bryant & May type plug. As far as sockets are concerned the only rule is that IPS sockets should be blue and engraved "Medical Equipment Only".

Better be clear there, Brian. IPS ... Isolated Power Supply?

And ... no blue 13A plug tops, then?

Geoff,
In answer to your question.
In the end we went for red plug tops for life support kit vents etc.
In answer to Neils quote unfortunately there are vents that dont have battery back up.

Geoff,
In answer to your question.
In the end we went for red plug tops for life support kit vents etc.
In answer to Neils quote unfortunately there are vents that dont have battery back up.

Hopefully, modern ventilators don't take too much power. That is, a UPS should be available to suit their needs.

OK, red plug tops it is then. Anybody else ...?

What Vents are they, all our vents have batteries and we still have some old ones, cos the old ones work better than the new ones.

Hey Neil, surely you remember the Cape-Waine?

No, was that something that Batman wore??

We have some Evitas and Catos.

Cape-Waine Anaesthetic Ventilators - memories!!!
They were built by Cape Engineering in Warwick. Originally as the Waine Ventilator and then Dr Waine, Consultant Anaesthetist (affectionatley known as Curly due to his lack of hair!!??) added an anaesthetic head to it for use in theatre.
They were very reliable machines mainly due to the bicycle chain that ran the internal bellows!!
Interestingly, Cape Engineering were mainly into building parts for tanks and armoured vehicles.

No battery (or UPS) then?

Be Serious!!!

If I remember rightly ... there was a cranking handle, to be used in case of failure!

The first real ventilator I worked on was an East Radcliffe. The Mk II, if I remember rightly.

And I believe I may have already mentioned the little ceremony we had when we decommissioned the last of the army's Dräger Iron Lungs (in 1981, it must have been).

Oh yes, those were happier days!

I remember the Easts, we had some with anaesthtic heads on them, cylinders yokes etc to make one of the first anaesthetic type combined machines.
But worked of a stermy Archer gearbox and chain set up not that diffrent to a Raleigh Chopper Bike.
Interstingly we had a white one which a consultant took on decommission and has it as a coffee table in his lounge.

OK, Karl ... just for you (scroll down to the bottom of the page).

Arrr they were the days. Ive come over all sentimental.
The machines had proper brake pads.
A service meant using oil and grease and proper tools (spanners etc).
Patient circuits lasted years and were cleaned in Cydex.
And engineers new what a Zeus chart is and how to use it.
None of your read the DVM and if it is out of spc turn a screw until it is.
You had to know about proper engineering thingies. James May could do a programme on that. It would be realy interesting.

Who needs James May?

Been holding off getting into this one 'cos it was interesting to watch but I thought I might just chuck in another idea even though it does not really address the reasoning behind the current discussion (which I think has merit, colour coding to function).

Here is Oz, medical power cord plugs are.......... transparent !

Why? so you can quickly and easily check if the earth conductor has come adrift.

Now, what do you think of that idea?

I like it! But I like the "old fashioned" plugs tops even more. That is, where you can whip off the top to check that all is well. Regrettably, however, "moulded" plug tops seem to be becoming the norm these days.

Yes ... "colour coding to function" sounds good. But when are we going to come down firm and agree the colours of:-

1) The plug tops
2) The socket outlets

one other thing I forgot to mention (and again, slightly of the original subject) but Oz plugs are not fused. Mind you, RCDs are mandatory, even in the domestic situation.

Polarised? Line and neutral?

(dare I mention ... earthed?)

Link 1
Link 2

The trouble with taking the plug top off to check it is that you can take the plug top off to fiddle with it. At least with the sealed ones you know no one else has been in there.

I think the ones in the US are clear as well.

Robert

Sounds like a weird argument to me, there, Robert. You could use that idea on almost anything (eg, taking the covers off kit, and all the rest).

OK ... how about BS-1363-A plug tops with anti-tamper screws? Remember where you heard it first, folks!

"Hospital Grade" plugs in the US are sometimes transparent. Some are, some aren't. Perhaps there are some local policies to be followed about that. Who knows? You can also find see-through GameBoys if you look hard enough.

Meanwhile (but slightly off-topic), here's a nice one for you (I wonder if the guy got his PhD).

I meant that there are people out there who cannot wire up a plug safely and correctly. If I can tak the top off to inspect it, they can take the top of and not necessarily put it back together correctly.
Robert

Well, Robert ... I guess that's a risk that we'll just have to take.

In the meantime, hopefully Natural Selection will take its course!

The fuse in the adaptor does not seem to be an HRC fuse that is why it went with a big bang.
My father used to work for a company who tested plugs and fuses etc (and other things) At MK they showed him a test rig they had and for the fun of it put a non-HRC fuse in a plug with a short between live and neutral. It blew the top of the plug agros the room when they applied the power.

HRC = High rupture current. I.e. it can withstand the high energy of a high current just before it blows. The UK mains system can supply hundreds of amps out of a 13amp socket for a very short time and it does take a finite time for a fuse to blow.

240volts x lots of amps x a short time = a suprisingly high number of joules.


What ever colour the plug top is.....

Robert

... or, for that matter, the trousers!

It seems that this is starting to go the wrong way, there is already a standard for the type of plug, is too much to presume that there is a standard on the fuse rating for each equipment. All that remains is to have a standard colour coding for the plugs and sockets.

Opinions differ on UK plug fuse ratings (see earlier threads that discussed all that).

Yes ... this thread is (supposed to be) about meaningful colour coding of plug tops!

Link to earlier thread! Similar.

Hospital Property red ToughPlug.

Ahhhhhhh good old Blighty,come to the continent, just a short swim from Dover
Here in Italy we have 10amp,16amp and Schuko plugs and sockets and the infamous "BiPresa" that accepts all three of the above.

Needless to say, SH*T happens.

Malcolm.

I know a bit about Ticino plugs and sockets, Malcolm! Yes, the word you shouted there is exactly the one I would have used.

No doubt our "Masters" in Brussels will be imposing all that [censored] [censored] on us here in the UK shortly.



For those who don't understand what it is I'm ranting about ... try this.

Geoff, at least you cited a well respected make in Italy,the market is full of sub standard products(in the same vein, my brother in law purchased an adapter that allows you to screw the adapter into an Edison screw lamp fitting,screw the lamp into the adapter and also to connect two un-earthed plugs to the side of the adapter.......it was even CE marked,go figure!!)

Malcolm.

As I have said more than a few times before (although you may have missed them) ... in terms of safety, the CE mark is meaningless. I have a roll of CE stickers. How many would you like?

Sorry Mate, but the Southern Sector of the EUSSR will always be a bit mañana as far as I'm concerned.

Geoff, we may be a little "domani domani" but we are Masters of placing the blame,fault, responsability squarely on the shoulders of some other poor bugger(usually us Biomeds)

Malcolm.

Sounds very much in similar vein to bukrah, inshallah, then.

Now ... where have I heard that before?