The next edition of NFPA 99 will likely require new or significantly renovated operating rooms to be classified as “wet procedure locations” unless, “…a risk assessment conducted by the health care (organization’s) governing body determines otherwise.” PerryCrabb is a strong proponent of isolated power systems and their LIM alarms which act as the “warning voice” of the anesthetized patient. This blog provides commentary in support of this pending change.
Our opinion is this change will imply a defacto standard for the installation of isolated power systems (isolation power panels with LIM alarm) in all operating rooms. This change will help clarify the ambiguity of what is a wet location and, “are isolated power systems necessary?” Clarity is needed because there are knowledgeable, well-intentioned, partisans on both sides of the issue. The pending change clearly intends to say an operating room is a wet procedure location…unless the hospital risk assessment task force determines otherwise. The pending change will put an extra burden on facilities wanting to opt out of putting isolation panels in their new or refurbished O.R.’s. It tips the scale even further toward isolation panels in all operating rooms. PerryCrabb welcomes this change for improved patient safety and staff safety provided by the isolated power system and its LIM alarm audible warning. It is our opinion the safety benefits of isolated power outweigh the negatives (higher first cost and increased maintenance cost).
Current codes do not require isolated power anywhere in hospitals, BUT codes say hospitals are responsible for designating if there are any “wet locations” within their facilities. If the hospital designates a space as a wet location then it has two choices for all receptacles (120V, 208V, etc) in that space: 1) serve from an isolated power system; or 2) use GFCI type receptacles. GFCI receptacles in any clinical space are objectionable due to nuisance-trips impacting patient safety and nuisance trips cost maintenance time . Isolated power systems are our preferred design practice for many good reasons that will be discussed more in a future blog. PerryCrabb recommends providing isolation panels in any invasive procedure room including an inpatient or outpatient O.R., cath lab, specials room, pacemaker room, invasive image room, C-section room, and even endoscopy. We do have clients that choose not to and we respect their decision.
In the past, isolated power systems were mandatory in operating rooms due to explosive anesthesia gas. This is no longer a threat, but the threat of electrical shock has increased due to the increasing prevalance of electro-medical devices in and around patients. Because of this increased threat we recommend them in all invasive procedure rooms. Faulty electro-medical devices pose a risk even remote from the patient and staff if body fluids or other liquids are drenching the area in quantities sufficient to create a low-conductive pathway from a remote electrical current source (such as faulty wiring in a medical device) finding its way to the patient or through staff. Even without drenching wetness, shock hazard from faulty electro-medical devices pose the greatest risk to invasive procedure patients because they can be inadvertently placed inside their body near or on their heart.
Isolated power systems provide the highest level of protection (the highest standard of care) from electrical shock hazards to staff and patient within invasive procedure rooms currently and practically available. Isolated power systems are prudent in the spaces listed above for this reason alone, but there other reasons to be discussed later. An unbiased risk assessment task force should consider these risks and their liability in its discussions regarding wet procedure locations and the use of isolated power systems.