Extension Cords: Satans or Saviors?

Abstract

There is a much-discussed topic that seems to baffle many but I have discovered an easy cure for it that I would like to share with you. When you hear it, you’ll marvel at its simplicity. There is language in The Joint Commission’s standards concerning the prohibition of extension cords. This is a far-reaching issue because it applies to simple extension cord, outlet strips, and octopuses. These are all subject to failure or degradation. Outlets are checked periodically, but outlet strips and extension cords are never checked. Add to this that they are frequently subjected to rough treatment such as coiling, uncoiling, and getting stepped on. Extension cords (and similar devices) are used for three reasons in a hospital: First, there are often more things to plug in than there are electrical outlets to accommodate them. Second, in many hospitals, lots of medical devices in surgery are outfitted with explosion-proof plugs, which must be adapted for traditional straight-blade outlets. Special adapter-type extension cords meet this need. Finally, medical devices often come standard with sixor eight-foot power cords. These often just aren’t long enough to reach all the way from the equipment to an available outlet. Thus, an extension cord lengthens the standard cord to the needed length. There are several steps that should be taken to rid hospitals of these issues permanently. First, renovate all areas of the hospitals and add three or four times as many electrical outlets to equipmentintensive areas, such as surgery. This is expensive and involves ripping into the walls and sometimes adding more breaker boxes because of the need for more branches. As these additions are made, remove all twist-lock and explosion-proof outlets. Next, replace all existing power cords on every medical device used in surgery (including cath labs and special procedures) with 20-foot cords. This is time consuming, but well worth the effort in the long run. (You should also require long power cords on all new equipment, or be prepared to change them yourself.) There—problem solved! Simple...wrong. This is a very expensive and long-term project. We did it in a hospital with 28 operating rooms and about 1,000 items of equipment in surgery. It cost many thousands of dollars in parts, and many more thousands in afterhours labor for the biomeds who did most of the work, and yet more money for the electrical contractors. But in the end, we had a workplace where not a single extension cord was needed. Electrical branches were distributed so that breakers did not become overloaded. Nobody tripped over cords across the floor. But your chance of getting this magnitude of project approved in your hospital, especially in these tight economic times, is almost nil. So what do you do? Banning all extension cords is not practical or possible. This leaves us with only one alternative—use extension cords where needed, but control them. How? Let’s step back and examine an extension cord. It is, in reality, just a very simple medical device. It has only three components: a male plug, a cord, and a female receptacle (or two, or six). What is to prevent us from classifying any extension cord as a medical device, giving it an asset number, putting it into the computer system, and applying the same risk assessment criteria to it as to any other medical device? At the conclusion of the assessment, you should assign it a certain preventive maintenance (PM) interval based on the traditional criteria of use, risk, and failure modes. This approach has been used in many hospitals and has always been just fine with surveyors. I have seen many old and defective cords and outlet strips that failed the ground integrity test, the polarity check, or the tension test. Eliminating them is best, but treating them as medical devices is a good fall-back. n