Should your facility ban the use of cell phones?
(Editor’s note: In this second part of a two-part series on electromagnetic interference, we discuss the potential problems involving cell phone interference with medical equipment. Last month, we discussed a designated radio spectrum for telemetry equipment and the need to re-place or upgrade medical monitoring equipment.)
A patient was burned when an electrosurgical device was automatically and unintentionally activated. A sales representative was using a cell phone in a hall near the operating room. The Food and Drug Administration wasn’t able to link the two events, but was it a coincidence?
It’s well-established that wireless devices, including cell phones, have the potential to de-grade medical equipment, including heart monitors, drug-delivery systems, defibrillators, and infusion pumps. The result can be false readings, equipment that resets, rates that change, or equipment that fails to operate or alarm.
The electromagnetic interference (EMI) is more likely to occur when the wireless device is within 3 feet of the medical equipment. And you might be shocked to learn that EMI can travel through walls, windows, and floors. And here’s another bit of news: The person doesn’t have to be using the phone for the interference to occur. If the phone is on in standby mode, it can cause interference.
So what should you do in response to these potential problems? Consider these suggestions:
• Examine the impact on current and future medical monitoring equipment. Be cognizant of the potential problem with EMI and work with your equipment manufacturers and your biomedical department, suggests Ramona Conner, RN, MSN, perioperative nursing specialist at the Association of periOperative Registered Nurses in Denver. While some of the newer technology is shielded from EMI, "many of the older pieces of equipment have been reported to have some interference problems." Find out what EMI shielding is built into the equipment, Connor suggests.
Make sure the equipment has been formally tested for emission levels and immunity to EMI, and require manufacturers and vendors to certify the immunity level of the device, engineering experts recommend, experts suggest.1
• Have a ban in selected areas. Experts recommend that cellular telephones should be prohibited in ORs, post-anesthesia care units, critical care units, diagnostic imaging areas, clinical laboratories, and emergency departments, Conner says.
Joseph P. McClain, PhD, FASHE, FACCE, director of clinical engineering at Walter Reed Army Medical Center in Washington, DC, says, "It’s ludicrous to try to ban cell phones or wireless devices from the entire hospital. You’re just not going to be able to do it." McClain is also a member of the American Hospital Association/American Society for Healthcare Engineering Task Force for Wireless Medical Telemetry Systems.
David Baron, PE, vice president of Holaday Industries in Eden Prairie, MN, says, "Cell phones are so ubiquitous. Everyone has them. They are much harder to control." Holaday markets CellAlert, which monitors cell phone use.
At Walter Reed, cell phones are banned in locations where interference with medical equipment could cause serious injury or patient death. For example, cell phones are banned in the postoperative recovery area because cardiac monitors and defibrillators are used in that area. The only exception to the ban is security staff and engineers who have been taught not let their cell phones get too close to the equipment, McClain says.
Staff were educated about the cell phone ban, he says. Signs were posted on the intensive care floor to alert patients and visitors to the cell phone ban. Some facilities post signs about cell phone restrictions at the entrances. To allow physicians to keep cell phones in their offices, some facilities allow easy access to telephones in areas that are restricted to cell phones. Also, some facilities provide a doctors’ lounge that is separated from restricted areas where they can make cell phone calls.
• Use technology to enforce a ban on cell phones. There is technology available to monitor cell phone use. The technology operates like a police scanner to monitor frequencies at which cell phones transmit. "It detects an operating cell phone and gives a verbal warning: Please turn the cell phone off for the safety of our patients,’" Baron says. Some products provide a bright flashing light and a series of beeps to get the attention of the caller. Some products are available in languages other than English.
Reference
1. Kelly S, Ravindran AR, Grant H, et al. Electromagnetic Interference Management in the Hospital Environment — Part 1: An Introduction. EMC Report 1996-1. Center for the Study of Wire-less Electromagnetic Compatibility: Norman, OK; 1996.
For more information on cell phone interference, contact:
• Joseph P. McClain, PhD, FASHE, FACCE, Director of Clinical Engineering, Walter Reed Army Medical Center, P.O. Box 59215, Washing-ton, DC 20012. Telephone: (202) 782-3514. Fax: (202) 782-8158. E-mail: [email protected].
To report electromagnetic interference with medical monitoring equipment, call the Medwatch program at (800) FDA-1088.
For more information about technology to detect cell phone transmission, contact:
• David Baron, PE, Vice President, Holaday Industries, 14825 Martin Drive, Eden Prairie, MN 55344. Telephone: (952) 934-4920. Fax: (952) 934-3604. E-mail: [email protected].
• Zetron, P.O. Box 97004, Redmond, WA 98073-9704. Telephone: (425) 820-6363. Fax: (425) 820-7031. Web site: www.zetron.com.
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