Application of medical IT system in the operating room

Ren Yunye Ankerui Electric Co.
, Ltd.
Shanghai Jiading 201801 [Abstract] With the improvement of the economy and scientific and technological level, China's medical conditions are also constantly improving
.

People's attention to health is also constantly improving, medical conditions need to be further improved, this paper combined with the national standard atlas 19D706-2 "medical building electrical design and installation", the definition of the operating department, the operating room definition and design needs to refer to the specifications to be sorted out, the operating room power supply and distribution system IT system design and difficult problems analysis, the role
of medical IT system in the operating department power supply and distribution room.

【Keywords】Keywords: surgical department; Power supply and distribution; IT systems; 0 Preface The operating room of the hospital is an important area, and the environment of the operating room has an important impact on the quality of surgery, so it is necessary to optimize the design of the operating room to provide more favorable environmental conditions
for surgical work.

In the process of design, it is necessary to pay attention to the rationality of the power distribution scheme to meet the power demand of the operation, and at the same time to improve the safety
of the power distribution system.

1 The importance of reasonable power supply and distribution in hospital operating rooms With the development of medical undertakings, various advanced medical equipment and technologies have been widely applied to surgical treatment, providing patients with a higher level of medical conditions and improving medical results
.

The operation of various medical equipment is inseparable from the support of electricity, and some equipment has more stringent requirements for power supply, which requires reasonable optimization of the power distribution system of the hospital operating room to ensure the normal operation of the equipment and provide the necessary guarantee
for the safety of patients and the treatment effect.

In addition, the operating room has very strict requirements for the environment, and it is necessary to reasonably design the installation location of the power supply and distribution lines and power supply equipment, so as to prevent the installation and maintenance work from bringing bacterial contamination
to the operating room.

In addition, the lighting system and air conditioning system in the operating room also have certain requirements for power supply, so it is necessary to optimize the design of the power supply and distribution system, reasonable power supply, ensure the normal progress of surgical work, and promote the development of
medical undertakings.

Power supply and distribution is an important part of the operating room, and the new General Hospital Design Code stipulates that the operating room belongs to two types of places, namely: electrical installations that require contact with the patient's body (heart or near the heart) and power
interruptions that endanger the patient's life.

The time for automatic recovery from power failure in the event of a fault should be ≤ 0.
5 s, that is, the power failure time t≤0.
5 s
.

General hospitals are generally equipped with surgical departments, ranging from a few to dozens of rooms, and the trend of development is getting bigger and bigger
.

In addition, there are a large number of other important loads in the hospital, such as emergency disposal, rescue, critical care unit, DSA, hemodialysis, delivery room and fire alarm and fire extinguishing equipment, so the demand for electricity is very large, most of the surgery is irreversible, if there is a power outage or tripping phenomenon during the operation, the consequences are unimaginable, so the power supply and distribution of the operating department should be reliable and safe
.

2 The power supply and distribution design of the hospital operating room In the hospital operating room, the reliability of electricity is very important
.

Electricity
is required for lighting and related work during surgery.

First of all, in the design, a two-way power supply should be used, and a standby power supply should be set up to ensure that the power supply can be automatically switched in a short period of time, and the hospital should be equipped with a power supply line to ensure that the power resources can be continuously transported to the operating room, so as to avoid the phenomenon of power outage caused by power outage or accidental damage to the power grid, affecting the surgical work
.

In order to meet the power requirements of the operating room, IT systems and TN-S systems
are required.

Secondly, the requirements of the operating room for environmental quality are very high, in order to avoid external bacteria and viruses entering the operating room to cause cross-infection, the total distribution cabinet of the operating room should be set in an area
far from crowd activities.

Third, the lines of the operating room need to be separated from other rooms, and the trunk lines of each operating room should be set up separately and equipped with a special distribution box
.

The distribution box cannot be set up in the operating room, otherwise it is not easy to overhaul
.

Workers entering the operating room for overhaul will bring in bacteria and other contaminants, so the distribution box should be placed inside the wall outside the operating room
.

In the design process, pay attention to the design of the total power distribution load of the operating room, which cannot be less than 8kVA
.

The safety of electricity in the operating room is also very important
.

In order to improve safety, a leakage detection alarm device should be configured to alert when leakage is detected
.

Third, more than 3 socket boxes should be installed on each wall in the operating room, and grounding terminals should be installed on the socket box to ensure that the grounding resistance does not exceed 1Ω, so as to ensure the normal operation of
medical equipment.

If you want to install an outlet on the ground, do a good job of waterproofing
.

Fourth, the material of the distribution pipeline in the operating room should be carefully selected, and the pipeline parts through the floor slab and wall should be equipped with casing, and sealed
with non-flammable fuel.

The nozzle of the wire pipe entering the operating room should also be closed
with non-flammable material.

In order to prevent the occurrence of accidental fire damage to the circuit and damage the insulation to cause a short circuit, mineral insulation cables
can be applied.

In addition, the lines in the operating room should not be exposed on the surface
.

3 IT System Design Points 3.
1 Where to Set According to JGJ 312-2013 No.
5.
4.
Article 4: In addition to operating table drive mechanisms, X-ray equipment, equipment with a rated capacity of more than 5 kVA, electrical equipment for non-life support systems, Class 2 medical establishments used for life-sustaining, surgical, real-time monitoring of critically ill patients and other circuits of medical electrical equipment and systems located in the patient area shall be powered
by local IT systems of medical places.

3.
2 The patient area is horizontally within the hospital's Class 2 medical facilities from the perimeter of the operating table 1.
5 m, height 2.
The area within 5 m is called the "patient area" as shown in
Figure 1.

According to the requirements of IT system setup and the schematic diagram of the "patient area", the crane tower, the electrical socket box for treatment, and the shadowless lamp in the operating room should be included in the IT system power supply
.

Operating room lighting, central intelligence panels, etc.
have nothing to do with "microshock" and may not be included in the IT system power supply, but in order to ensure the continuity of its power supply, it is recommended to include UPS power supply
.

Figure 1 "Patient Area" Schematic Figure 3.
3 Grounding Failure Analysis The power side of the IT system does not do system grounding, only protective grounding
.

A schematic of its ground fault, as shown in
Figure 2.

By isolating the transformer secondary loop conductor is not grounded, the exposed conductive part of the electrical equipment is connected to the PE line of the electrical installation, and an auxiliary equipotential connection is
set.

When a ground fault occurs, the fault current is only a very small capacitance current to ground flowing through a small non-fault segment between the self-isolation transformer and the surgical equipment, no greater than 50 μA
.

Therefore, the power supply can not be cut off when the fault occurs, so that the electrical equipment can continue to run, and the alarm can be issued by the insulation monitoring device and the fault can be eliminated in time, which greatly improves the reliability
of the system power supply.

Medical IT systems need to be used with insulation fault monitoring devices, when the insulation resistance value drops to 50kΩ to issue an alarm, sound and light alarm devices are set in nurse stations and other convenient monitoring places
.

The first ground failure, the IT system actually becomes a TN system to run, without cutting off the power supply
.

However, if the fault is not eliminated in time, when the second ground fault occurs, it is equivalent to the TN system ground short circuit and circuit breaker action
.

With medical IT systems, the normal leakage current value of electrical equipment is less than 10 μA, and when the first ground fault occurs, the fault current value is less than 50 μA, and there will be no "microshock" on the surgical patient; At the same time, when the first ground failure occurs, the insulation monitoring device only issues an alarm and does not cut off the power supply, which can fully ensure the continuous power supply of the electrical equipment of the life support system, thereby ensuring the operationElectricity safety
of the room.

Figure 2 IT system grounding fault schematic Figure 4 Acquaray medical IT system Introduction Acquaray medical IT system is mainly used in important medical 2 types of places such as operating rooms, ICU/CCU intensive care units, etc.
, to provide safe, reliable and continuous power
distribution for important equipment in these places.

Medical insulation monitoring and fault location device is developed by Acquaray Electric with many years of design experience in the power instrument industry, according to the special requirements of medical 2 types of
places for distribution system insulation monitoring and fault location.

The product can realize real-time monitoring of the insulation, load and isolation transformer temperature of the IT system, and has the functions
of system insulation fault loop positioning and centralized monitoring of multiple sets of systems.

The product complies with the provisions of
the enterprise standard "IT System Insulation Monitor".

Medical IT system insulation monitoring and fault location products (seven sets) include AITR series medical isolation transformer, AIM-M200 medical intelligent insulation monitor, AKH-0.
66P26 current transformer, AIL150-4/AIL150-8 insulation fault locator, ASG150 test signal generator, HDR-60-24 power module and AID150 centralized alarm and display, etc.
, the products are shown in Table 1
。
Table 1 Medical IT system insulation monitoring and fault location products 5 System application scheme 6 Conclusion Operating room power supply and distribution system design is different from the design of general places to distribute the power distribution system complex, the power supply safety, reliability requirements are higher, the electrical designers need to have a thorough understanding of the relevant national specifications and IEC standards, but also need everyone to continuously learn, communicate, discuss, update knowledge, understand the development of products and technologies, and provide hospitals with high-quality operating room power supply and distribution system design.
Better protect the safety of the majority of patients
.

References[1].
Building electrical installations Part 7-710: Requirements for special devices or places—Medical establishments GB 16895.
24-2005[2].
Civil Building Electrical Design Code JGJ 16-2016[3].
Technical Code for Building of Clean Operating Departments of Hospitals GB 50333-2013[4].
General Hospital Building Design Code GB 51039-2014Author's Profile:Ren Yunye, male, Acqua Electric Co.
, Ltd.
, the main research direction is IT insulation systems
.