Principles involved in the management and use of equipment

Abstract

INTRODUCTION The management of equipment in the operating department is a demanding task that should involve both the medical and non-medical members of the theatre team. If operating theatres are to be run in a safe and efficient manner, management structures must include the policies and protocols needed for the dayto- day management of equipment as well as long-term strategies. Equipment is constantly introduced into hospitals for a variety of reasons, such as new equipment replacing that which is old and worn out, the development of new technology and, of course, the new devices that improve our working lives. Manufacturing companies may promote them as being more user friendly, time saving, cost efficient or safer but the theatre user must become familiar with all equipment and learn how to use it safely and wisely. The introduction of equipment to a hospital is a complicated process and involves many different groups of people, i.e. the manufacturers, engineers, servicing departments, repair specialists, departments within the hospital and the individual user. MANAGING THE USE OF EQUIPMENT WHAT IS MEDICAL EQUIPMENT? Medical equipment is equipment intended to diagnose, treat or monitor the patient under medical supervision and which makes physical contact with the patient or conveys energy to or receives energy from the patient. The type of protection that equipment provides against electric shock is classified as follows: • Class 1 equipment relies on protective earthing mechanisms. • Class 2 equipment relies on sturdy insulation. • Internally powered equipment is classified separately. DESIGN OF MEDICAL EQUIPMENT AND THE MANAGEMENT OF RISK Medical equipment must not only be safe to use but also inherently safe. Although this chapter primarily deals with the management and use of equipment, it is important to have a basic understanding of how medical equipment has evolved in terms of safety. When anaesthetic machines were first introduced, it was not possible to accurately control the concentration of anaesthetic vapour that the patient received and even today many anaesthetic machines are incapable of preventing the delivery of a hypoxic mixture of gases to the patient.