By: Kelly D. Ogle, BSDH, MIOP, CMPM, CHOP®
Director of OSHA and HIPAA Services
Healthcare workers may use electrical devices on a daily basis without thinking of the potential hazards. Even the low-voltage medical equipment used in outpatient settings can create dangers such as—
- Electrical shock
Extension cords may be the most common electrical hazard found in healthcare. OSHA offers the following recommendations to reduce or eliminate this problem:
- Ground all electrical equipment and circuits.
- Do not remove ground prongs from cords.
- Do not modify cords or use them incorrectly.
- Use factory-assembled cord sets and only extension cords that are the 3-wire type.
- Use only cords, connection devices and fittings that are equipped with strain relief.
- Remove cords from receptacles by pulling on the plugs, not the cords themselves.
- Visually inspect electrical equipment and cords before use.
Electricity travels in closed circuits, usually through a conductor. Sometimes a person’s body, which is an efficient electrical conductor, mistakenly becomes part of the electrical circuit. Shock occurs when the person’s body completes the current path, especially if the skin is damp or wet.
Electrical shock happens when a person’s body completes the path of the current with:
- Both wires of an electrical circuit;
- One wire of an energized circuit and the ground;
- A metal part that accidentally becomes energized, perhaps due to a break in its installation; or
- Another conductor that is carrying a current.
Electricity flows between parts of the body or through the body to a ground or to the earth, causing a shock.
EFFECTS OF SHOCKS
Electrical shock effects can vary, from a slight tingling to cardiac arrest, depending on the amount of current that flows through the body, the path the current takes through the body, the length of time the body is in the circuit, and the frequency of the current.
- Less than 1 milliampere is generally not perceptible, while up to 5 milliamperes may cause a slight tingle.
- Five milliamperes create a slight shock that is not painful but certainly gets the person’s attention. Most people are able to release the source of the shock at this point.
- Over 5 and up to 25 milliamperes cause a women a painful shock and loss of muscular control. She may even be thrown away from the power source.
- For a man, 9-30 milliamperes will cause muscle extension that will prohibit the individual from releasing the source and might result in his being thrown from the source.
- Higher levels of electricity cause extreme pain, respiratory arrest, severe muscular contractions, cardiac arrest, severe burns, and death.
BURNS CAUSED BY SHOCK
Burns are the most common shock-related injury. There are several types:
- Electrical burns are the most serious and require immediate medical attention, They happen when electric current flows through tissues or bones.
- Arc or flash burns are caused by high temperatures caused by an electric arc or explosion near the person’s body and require prompt treatment.
- Thermal contact burns are caused when skin touches hot surfaces of overheated electrical equipment or when clothing catches on fire. Clothing may catch on fire when an electrical arc is produced.
Sometimes an electrical shock causes muscles to contract, causing the person to “freeze.” This increases the danger because the individual is unable to release or get away from the electricity, increasing the time of exposure. This can also cause falls, bruises, bone fractures and even death.
If a person “freezes” to a live electrical current, shut off the current immediately. If this is not possible, use a tool made of non-conducting material such as wood to push or pull the person from the contact. Act quickly but protect yourself as well.
Electrical Safety Checklist
- Do you require compliance with OSHA standards for all electrical contract work?
- Are all employees required to inspect electrical equipment and cords prior to use?
- Are all employees required to report an obvious electrical hazard as soon as possible?
- Is lockout or tagout used when equipment or circuits are to be maintained or serviced?
- Are all electrical appliances (including vacuum cleaners and vending machines) and devices grounded?
- Do extension cords have a grounding conductor?
- Are multiple plug adaptors prohibited?
- Are multiple extension cords used together?
- Are ground-fault circuit interrupters installed on each circuit with receptacles near sinks or other large sources of water, such as aquariums?
- Are damaged cords replaced or professionally repaired promptly?
- Are all receptacles and junction boxes provided with tight-fitting covers or plates?
- Are any receptacle plates missing or damaged?
- Are electrical panels accessible?
- Do all workers know where the electrical panels are located?
- Do you have an AED or someone trained in CPR should electrical shock happen?
- Do you have a written electrical safety policy?
- Does your annual employee safety training include electrical hazards?