AVOIDING ELECTROCUTION HAZARDS (HEALTHCARE) OSHA

There are several types of electrical hazards, all of which can cause injury or death.

For this reason, you need to be aware of the dangers involved with working around electricity.

Check switches and insulation:

Tools and other equipment must operate properly. Make sure that switches and insulating parts are in good condition.

. If you touch a power line, covered or bare, death is probable.

Touching or grabbing powerlines, even downed power lines, is not safe. If death does not result from touching a powerline, severe injuries are probable.

When the amount going differs from the amount returning by approximately ____ milliamps, the GFCI interrupts the current.

5

Overloads:

Do not overload circuits.

A Ground Fault Circuit Interrupter (GFCI) is designed to:

Protect people from severe and sometimes fatal electrocution by monitoring for electrical leakage to ground. Detect when the current leakage is greater than 5 mA. Interrupt the flow of electric current by tripping quickly enough to prevent electrocution from leakage.

This type of burn occurs when electrical current flows through tissues or bone, generating heat, and causing damage.

electrical burn

This is an essential safety procedure that protects workers from injury while working on or near electrical circuits and equipment by locking the device and/or power source to prevent anyone from turning on the hazardous power sources while someone is performing maintenance or servicing work:

lockout/tagout

Healthcare professionals should test GFCI's ___ using the "test" button.

monthly

Is placing a plug into a wall receptacle with your hand on the plug safe or unsafe?

safe

The ground-fault circuit interrupter, or GFCI, is a fast-acting circuit breaker designed to....

shut off electric power in the event of a ground-fault within as little as 1/40 of a second. It works by comparing the amount of current going to and returning from equipment along the circuit conductors.

All healthcare workers need training regarding electricity and electrocution hazards.

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The B in the BE SAFE acronym stands for Burns. Burns are the most common electrical shock-related contact injury resulting from electrical shock, arc flash, or thermal (heat) energy.

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In order for current to flow through a conductor, three things must be present:

1. A source of electrical current to flow -- AC electrical current comes from a power generating station, DC current comes from a battery. AC current cannot be stored in a battery like DC current, so there are electrical generators to replace current as it is used by consumers. 2. Something to transport the electrical current -- A conductor allows current to move through it. This statement applies to all current, whether it is AC or DC. An example is a metal wire. 3. Something that causes current to flow through the conductor. Voltage pushes current through metal wires in a circuit.

An electric shock can result in anything from a slight tingling sensation to immediate cardiac arrest. The severity depends on the:

Amount of current flowing through the body. Current's path through the body. Length of time the body remains in the circuit. Current's frequency.

The A in the BE SAFE acronym stands for arc flash.

An arc flash is the sudden release of electrical energy through the air that gives off thermal energy, or heat, and bright, intense light that can cause burns. Temperatures have been recorded as high as 35,000 °F. A lightning bolt is an example of an arc flash.

Arc or flash burns result from high temperatures caused by an electric arc or explosion near the body.

An example of an arc flash is a lightning bolt. The electrical current travels through air. This type of arc flash generates enough heat to melt metal. The same process can happen with any electrical device. In fact, cauterization tools are used to create arc flashes that the surgeon can use to intentionally fuse tissue. When an arc flash is not intended, a burn injury is the result.

Under which of the following circumstances would a person be shocked?

Becoming part of an electrical circuit will result in an electrical shock

The acronym BE SAFE is a reminder of the most common types of hazards or injuries due to electricity. An electrical hazard is defined as a serious workplace hazard that exposes workers to any of the following:

Burns, Electrocution, Shock, Arc flash, Fire, Explosions.

While most healthcare professionals think of shock as a decrease in blood or fluid supply (hypovolemic shock) that renders the heart unable to pump enough blood through the body, shock can also refer to the physiological reaction or injury caused by electric current passing through the human body.

Electric shock can have minimal effects or can be life threatening, depending on the amount of current encountered and the length of contact.

The most frequent cause of patient electrocution in the healthcare workplace has been due to...

connecting the lead wires of electrodes, and other medical devices, into energized sources like extension cords or other equipment, rather than into the appropriate device.

This type of burn results from high temperatures caused by an electric arc or explosion near the body.

arc or flash burn

What is a ground fault?

occurs when there is a break in the low-resistance grounding path from a tool or electrical system. The electrical current may then take an alternative path to the ground through the user, resulting in serious injuries or death.

Which factor increases the risk of injury if a person is shocked?

sweat

Electrical circuits must be locked-out/tagged-out before electricians work on any equipment. Is this true or false?

true

Is it safe or unsafe to pull on a cord to remove plug from a wall receptacle?

unsafe

Is using a three-prong plug with a missing ground post safe or unsafe?

unsafe

How can you be protected from electrical hazards?

using tools and power cords safely, understanding how a GFCI can protect you, and following lockout/tagout procedures.

Electrical burns are among the most serious burns and require immediate medical attention. They occur when electric current flows through tissues or bone, generating heat, and causing damage.

Entrance Wound: Because skin is an insulator, it transforms electrical energy into heat, which produces burns around the entrance point (dark spot in center of wound). Exit Wound: Current flows through the body from the entrance point, until finally exiting where the body is closest to the ground. This foot suffered massive internal injuries, which weren't readily visible, and had to be amputated a few days later.

The second E in the BE SAFE acronym stands for explosions.

Explosions can occur when electricity ignites explosive gases in the air, such as pure oxygen, methane, or natural gas.

The F in the BE SAFE acronym stands for Fire.

Fire can be caused by fixed wiring—electrical wires inside the walls of buildings—especially when the wires are old or the outlets are faulty. Fire can also be caused by flexible wiring such as extension cords, appliance cords, or by plugs, receptacles, and switches.

A source of an arc flash in a workplace setting is the circuit breaker box. If a circuit is tripped in the breaker box, DO NOT attempt to reset it - rather, immediately contact a supervisor to report that situation.

If a switch is flipped to the off position, someone may be working on an electrical device located in that specific circuit, or there may be an electrical short or exposed wire that could potentially create an arc flash. To avoid accidental electrocution, never attempt to open a breaker box: always contact a supervisor.

Electrical circuits must be locked-out/tagged-out before electricians work on any equipment.

If a switch is not in the "on" position, ALWAYS ask a supervisor if it is safe to turn the switch on. Never attempt to flip a tripped switch especially if it is tagged. Leave this task for trained electricians.

The GFCI is rated to trip quickly enough to prevent an electrical incident. If it is properly installed and maintained, this will happen as soon as the faulty tool is plugged in.

If the grounding conductor is not intact or of low voltage, the GFCI may not trip until a person provides a path. In this case, the person will receive a shock, but the GFCI should trip so quickly that the shock will not be harmful.

Consider all the exposed or operating elements in an electric installation:

Lighting found throughout the healthcare environment. Equipment such as electric hand tools in a dental office or an oxygen machine that checks blood pressure, pulse, and oxygen saturation. Motors found in patient lifts, beds, or in a laboratory centrifuge. Machines such as mobile X-ray, ultrasound devices, autoclaves, etc. Appliances such as freezers or refrigerators used in clinical practice for ice therapy, etc. Switches used with the hospital generator. Controls on equipment and machinery in the healthcare environment. Enclosures or boxes found in specialty areas such as emergency.

Examples of conductors:

Metal, wet skin, and water with small amounts of salt or other minerals.

Three-pong Plugs

Never use a three-prong grounding plug with the third prong broken off. When using tools that require a third-wire ground, use only three-wire extension cords with three-prong grounding plugs and three-hole electrical outlets. Never remove the grounding prong from a plug! You could be shocked or expose someone else to a hazard. If you see a cord without a grounding prong in the plug, remove the cord from service immediately.

Lockout/tagout is an essential safety procedure that:

Protects workers from injury while working on or near electrical circuits and equipment. Locks the device or power source and prevents anyone from turning on the hazardous power sources while someone is performing maintenance or servicing work. Requires workers to place a tag on the locked device indicating that it should not be turned on. When using a tag, other energy isolation techniques may be necessary to maintain worker safety. Prevents contact with operating equipment parts such as, blades, gears, shafts, etc. Prevents the unexpected release of hazardous gases, fluids, or solid matter in areas where workers are present.

Examples of insulators:

Pure water, plastic, and dry skin, rubber, wood, cloth, glass, and the earth.

Cords:

Remove cords from receptacles by pulling on the plugs, not the cords.

In a case where electrical current leakage from the circuit occurs, the GFCI would:

Sense the current leakage. Trip the circuit. Cut off the electricity.

Electrical shock is the body's reflex response when electric current passes through the human body. Electrical shock happens when electric current enters the body at one point and leaves through another.

The S in the BE SAFE acronym stands for shock.

Electrocution means to injure or kill with electricity and occurs when a person is exposed to harmful amount of electrical energy.

The first E in the BE SAFE acronym stands for electrocution.

How do OSHA's standards minimize electrical hazards? OSHA standards focus on the design and use of electrical equipment and systems.

The standards cover only the exposed or operating elements of an electrical installation such as lighting, equipment, motors, machines, appliances, switches, controls, and enclosures, requiring that they be constructed and installed to minimize workplace electrical dangers.

A client is undergoing therapy in a whirlpool unit that has been plugged into an extension cord.

The whirlpool therapy unit should be plugged directly into a receptacle with a GFCI.

Thermal contact burns are caused when the skin touches hot surfaces of overheated electric conductors, conduits, or other energized equipment.

Thermal burns also can be caused when clothing catches on fire, as may occur when an electric arc is produced.

There are biomedical equipment technicians whose job is to work on healthcare equipment and machines.

They have been trained in the safety aspects of the equipment and are responsible for their maintenance and replacement.

A worker carrying a long, metal pole accidentally makes contact with a power transmission line above his walking route.

Through the pole he is carrying, the worker comes into contact with an overhead power line.

Extension Cords:

Use extension cords properly. If an extension cord must be used, choose one with sufficient ampacity for the tool being used. An undersized cord can overheat and cause a drop in voltage and tool power. Make sure the insulation is intact. To reduce the risk of damage to a cord's insulation, use cords with insulation marked "S" (hard service) rather than cords marked "SJ" (junior hard service). Make sure the grounding prong is intact. In damp locations, make sure wires and connectors are waterproof and approved for such locations. Do not create a tripping hazard.

Becoming part of the circuit means that

a person will be shocked - whether it is intentional for medical purposes or accidental. An unintentional shock may result in injury.

What properties does a conductor have?

a substance that allows electrical current flow.

A worker standing on a freshly mopped floor is adjusting products on a metal shelf with which there is a bare wire in contact.

contact with an energized source because the bare wire is in contact with the metal frame - also a conductor - and the worker is touching it whilst standing on a wet surface.

After a strong storm, a worker does not realize that a power transmission line has fallen on his car and is electrocuted while opening the car door. What is this an example of?

contacting overhead power lines

These can occur when electricity ignites explosive gases in the air, such as pure oxygen, methane, or natural gas.

explosions

About 3 o'clock this morning, firefighters responded to a building fire. While the fire was limited to one room and there were no injuries, there was about $5,000 worth of damage to structures. It was determined that electrical wiring from the mini-refrigerator to the wall receptacle was the cause of the fire. The mini-refrigerator fire was most likely caused by what type of wiring?

flexible wiring

OSHA's standards require your employer to ensure that....

lighting, equipment, motors, machines, appliances, switches, controls and enclosures are constructed and installed to minimize electrical dangers.

The GFCI will not protect you from .... but does protect against the most common form of electrical shock hazard, the ground-fault. It will protect against fires, overheating, and destruction of wire insulation.

line contact hazards (i.e. a person holding two "hot" wires, a hot and a neutral wire in each hand, or contacting an overhead power line).

Employers should attach tags to identify equipment or circuits being worked on while any worker is exposed to contact with ________ parts.

live