In an office setting, it is unlikely that there are building-wide safeguards as rigorous as in a hospital, according to the Society for Ambulatory Anesthesia. For example, the building may not provide any source of back-up electrical power and only emergency lighting is required for the safe and orderly exit of occupants from the building and not to continue powering life-saving instrumentation. The Society offers the following checklist to help ensure equipment safety in offices.
1. Anesthesia and life support equipment should be fully factory-supported. Full factory support includes having current factory technical support, parts availability and continued factory service training. For example, a bio-medical technician or equivalent should annually inspect all of the equipment and report in writing that it is safe and operating according to the manufacturer's specifications. Preventative maintenance records should be kept at least for three years. A bio-medical technician or the equivalent should perform all the repairs.
2. Anesthesia machines should not be obsolete. The American Society of Anesthesiologists provides guidelines for determining obsolescence of anesthesia equipment.
3. Have backup power systems in place for life-support equipment. The National Fire Protection Association continually updates its codes and documents. Facilities should determine if they require a Type I or Type III Essential Electrical System, which describe systems to ensure continuity of electrical power during disruption of normal power. The office must have a minimum of two independent sources of power. An emergency backup power unit should provide at least 90 minutes of power to all life-safety devices and resuscitative equipment.
4. Periodically inspect and test emergency power systems. The practice should test each generator 12 times a year with each test 20-40 days apart. Conduct tests for at least 30 minutes under a dynamic load that is at least 30 percent of the nameplate rating of the generator.
5. Use ground fault circuit interrupters if there are no line-isolation monitors. Electrical shock hazard is a concern. Since an office-based site probably won't have isolated power supplies, it won't have line isolation monitors. In the absence of isolated power systems, use ground fault circuit interrupters. If the ground fault indicator is triggered by an errant current, all current will cease until the fault is corrected and the device is reset.
From Office-Based Anesthesia, Society for Ambulatory Anesthesia.