ELECTRICAL SAFETY IN

HEALTHCARE FACILITIES

Presented By:
B.SOCRETES B.E, B.Tech, M.E M.Tech

Objectives:
To highlight:
Safety measures in healthcare facilities

recommended by various national and

international agencies
Guidelines for design, construction ,
maintenance and use of electrical medical
equipment and devices

Introduction
Most of the equipment used in healthcare facilities are
electrically operated, such as:
ECG machine,
bedside monitor,
anesthesia machine,
ventilators,
catheter machine,
suction machine ,
laboratory equipment,
radiology equipment (X-ray, C.T Scan, ultrasound,
mammography etc) ,
incubators, infant warmer etc.

Time / Current Zones of AC Effects

as per IEC 60479-1., Ed.4, 2005

AC-1: Perception
AC-2 :Involuntary muscular contractions
AC-3: Difficulty in breathing
AC-4: Serious Pathophysiological effects

AC-4.1: Probability of ventricular fibrillation increasing up to

about 5%

AC-4.2: Probability of ventricular fibrillation up to 50%

AC-4.3 : Probability of ventricular fibrillation above 50%

Time / current Zones of effects of AC currents ( 15 HZ to 100 HZ)

on Persons
__________________________________________________________________

It is seen that the real danger lies in zones AC-3 ( between curves B and
C1) and AC-4 ( located to the right of curve C1)
According to the gravity of the Electric Shock and its duration, a person
may experience:
Discomfort,
muscular contraction ,
a cardiac arrest (electrocution) .

Sources of Electrical Shock

Direct contact

e.g. the person is in contact with a live conductor

Indirect contact

e.g. the person is in contact with a metal part of an

electrical machine or device with an insulation
fault.

IMPORTANT
MEASURES
Selection of correct power supply system
TN-S System
IT System

Use of TN-S System:

Fixed equipment
Non critical equipment
The TN-S system in combination with a

Residual Current Device (RCD) must only be

used for following devices:
permanently installed or mobile x-ray

equipment
devices with a connected load > 5 KW
room lighting (not theatre)
operating theatre table

IT SYSTEM

Use of IT (Isolated Power)

System:
Recommended for Group 2 locations (IEC 60364-7-710)
- where discontinuity of supply can cause danger to life.
.eg:
Intra-cardiac procedures,
operating theatres and vital treatment

The Isolated Power Supply remains in operation in the event of

a single line - to -earth fault who may be more susceptible to
leakage and unable to move.
Definition of Group 0, Group 1 and Group 2 locations as per IEC
60364-7-710:
Group 0 is a medical location where no applied parts are intended to be
used.
Group 1 is a medical location where discontinuity of supply is not a

Isolated Power Supply

Improved reliability
Reduced leakage
currents
Reduced Touch
Voltage.

A touch voltage of
10 mV can be
sufficient to
trigger ventricular
fibrillation.

Monitoring Devices in IPS System

Monitoring of resistance with Insulation Monitoring Device

( IMD) - IEC requirement.

The IMD is able to sense a developing insulation fault at an

early stage and to provide an alarm at an adjustable set-point,

thus providing an improved level of safety. The alarm is raised
visually and via a mutable audible alarm at the patient location
Monitoring of impedance through Line Isolation Monitor (LIM) -

NFPA / UL requirement.
The LIM monitors the impedance of the conductors to earth and measures

the fault current in milli-Amp.The red LED alarm lights up and sounds an
audible warning signal as soon as the prospective fault current reaches the
threshold of 5 mA (2 mA in Canada).

Monitoring of load and temperature - IEC Requirement.

To protect the isolating transformer primary and secondary terminals
and the distribution bus from overloading or over-heating .

IEC vs. NFPA IPS Monitoring

IEC

NFPA

IEC
The A-Isometer is continuously
measuring the insulationresistance of an unearthed AC- or
DC-Network and will trigger a
visible and audible alarm at a
preset threshold value. It will
display the amount of insulationresistance in Ohm. It also monitors
the load- current and the
transformer-temperature.
Earth fault location is optional to
identify a faulty branch circuit.

Alarm at < 50 kohms

NFPA
The Line Insulation Monitor
(LIM) is continuously
monitoring the leakage
impedance in an
ungrounded AC-Network.
Based on this information
the maximum Total Hazard
Current (THC) is calculated
and displayed. The LIM will
trigger a visible and
audible alarm at a preset
threshold (2 or 5 mA).
Monitoring of load and
transformer-temperature is
optional.

Alarm at > 5mA Total Hazard Current

EARTH RESISTANCE BAR

The use of an Earth Resistance
Bar and Equipotential Bonding
has been recommended for
Medical Location of Group 1 and
Group 2 by MEIGaN
( Medical Electrical Guidance
Notes of UK Dept of Health).
The resistance between the ERB
and all accessible conductive
surfaces of installed equipment
should be less than 100
milliohms. The resistance
between the earth point of all
mains sockets and the ERB
should also be less than 100
milliohms.

An IPS Panel as per NFPA/ UL/NEC

Main Components
Isolation

Transformer
Line Isolation

Monitor (LIM)
Circuit Protection

2-Pole breakers
Equipotential

Grounding System

IEC Standards

NFPA ( American) Standards

Relevant Standards for medical

Relevant Standards for medical applications:
applications:
IEC 60364-7-710
Electrical Safety for
NFPA 70
National Electrical
Hospitals and

Code
in medical Applications
IEC 60364-4-41 Protection for Safety and NFPA 70B Practice for Electrical

Equipment Maintenance
against Electrical Shock
IEC 60364-5-54 Earthing Arrangements NFPA 70E Electrical Safety in the
Workplace
IEC 60479-1
Effect of current on human
NFPA 99
Health Care Facilities
beings / livestock
UL 1022
Standard for Safety Line
Isolation Monitors
CSA Z32.2 Electrical Safety and
Essential Electrical
Systems in Health Care
Facilities
NEC Article 516
Hazardous
location
UL 1047
Isolated Power Systems
Equipment

SAFETY MEASURES FOR MEDICAL ELECTRICAL DEVICES:

Selection of Safe Electrical Device: The

electrical devices to be used in hospital must

be safe and tested as per IEC 60601-1 . The
following tests are required to be conducted:
resistance of protective conductor
earth leakage current
enclosure leakage current
patient leakage current and
patient auxiliary current .

SAFETY THROUGH REDUNDANT POWER

SUPPLIES

Utility Power
Emergency Generator / UPS Power
Whatever be
the circumstances ,
the electrical
installations
of the Hospitals must
help to

Improve
hospital
personn
el
efficienc
y

Ensure
patient
safety
Guarantee
electrical
service
continuity

SAFETY FROM EXPLOSION IN

HEALTHCARE FACILITIES
Avoid Explosion in flammable gas

environment

ELECTROSTATIC HAZARD IN
ANESTHETIZING LOCATIONS

Avoid electrostatic sparking hazard

Flooring to be of anti-static properties

The recommended limits of electrical resistance of antistatic floor, as recommended by

NFPA 99 , Standard for Healthcare Facilities 2005 Edition are as follows:
Upper limit: The average value shall not be more than be more than 1, 000,000 ohm,
measured in
accordance with NFPA 99 Article E 6.6.8.2. 7.
Lower Limit: The average value shall not be less than 25000 ohms measured in
accordance with NFPA99 Article E 6.6.8.2. 7.

ELECTRICAL HAZARD FROM LASERS

IN HEALTHCARE FACILITIES
The American National Standards Institute
Standard ANSI Z136.3 ( Safe Use of Lasers in
Healthcare Facilities) outlines electrical safety
procedures applicable to lasers equipment in
healthcare facilities.

CONCLUSION:
The highest degree of safety
for the patients, doctors and
staff can be achieved when
the recommendations of
various standards and
regulations are practically
applied in healthcare facilities
and the medical staff are well
trained in using electrical

THANK YOU
QUESTIONS?