Risk Management Plan For the Hospital Environment

A risk management plan is placed in ISO 14971:2019 standard for mitigating different kinds of risk related to the use of medical electrical equipment including the electromagnetic interference (EMI) risk in the hospital environment. However, EMI accidents in the hospital are still happening indicating that further improvement in the risk management plan is required. Currently, the risk management plan in the standard does not factor in the hospital environment realistically, leading to incomplete risk analysis, evaluation, estimation, and control methods. Due to the dynamic environment of hospitals, the rule-based EMC approach is insufficient and the risk-based EMC approach should be utilized in improving risk management plans. In this paper, we utilized several risk-based EMC approach techniques and measurements such as the foot-printing technique, for properly examining the hospital environment, source-victim matrix tool, to categorize the severity of EMI issue, statistical tools like probability density function, cumulative density function, etc., to calculate probability and predict any future EMI risk. These techniques assist in the zoning of the hospital environment into low-risk, medium-risk, and high-risk for which risk control methods can be established. Overall, we hinted toward improving the risk management plan, in terms of flexibility, accuracy, and reliability, using risk-based EMC approach techniques

Time-efficient EMI Risk Evaluation Method in a Hospital Environment

Hospitals are one of the most critical and sensitive environments where possible EMI issue may have life-threatening effects. Although the electronic equipment placed within satisfies various EMC standards, a risk of EMI still exists. Due to the high complexity and dynamics of this system, the electromagnetic environment substantially differs from the one of an EMC laboratory. A full risk-based EMC analysis can significantly help mitigate this problem but requires plenty of effort, time, and careful management. In this paper, we present a simplified but robust, time efficient method of evaluating the electromagnetic risks, as an intermediate step before implementing a full risk-analysis campaign. Such an analysis allows to get the first impression about the environment and its influence on the medical device within

Risk-based EMC Approach in Hospital Environment

A modern hospital has a wide range of medical devices that can be technologically very advanced and complex in terms of electromagnetic emissions and susceptibility. It is a public environment where people carry communication equipment and/or medical active implants. Therefore, electromagnetic interference among the devices in the hospital environment is not an unfamiliar topic. There is a misconception among engineers that if all medical devices comply with harmonized standards, then the installation of a large number of medical devices altogether would work absolutely fine. However, this is not always true, and so for complex systems, a smarter approach is necessary to assess and control the risks of electromagnetic interference. This paper emphasizes the importance of using the risk-based approach to deal with the often unpredictable factors causing electromagnetic interference in a complex hospital environment

Introduction of Wireless Services and Devices in a Hospital Environment Following a Risk-based EMC Approach

This paper emphasizes the need for a risk-based EMC approach in the hospital environment. A modern hospital with various kinds of wireless medical electronic equipment especially in the intensive care, operation theatre, neonatology, etc., pollutes the environment by creating electromagnetic interference with other equipment in the vicinity or even implanted equipment inside the patient. Even following the IEC 60601-1-2 product standard for medical equipment which is based on a rule-based approach, suppressing electromagnetic interference effectively is an arduous task. In the upcoming years, the number of wireless devices in a modern hospital will significantly increase and might cause EMC instability in this highly complex system. Hence, an urgent requirement for an advanced and smarter approach leads to the use of a risk-based EMC approach. The detrimental effect of intentional sources causing electromagnetic interference in the hospital environment is briefly discussed. The risk-based EMC approach has been applied in the Medisch Spectrum Twente hospital, where it was discovered that wireless devices such as digital mobile radio, cell phone, and radio frequency identification equipment critically affect equipment pumps and patient monitors

Siglec-1 is a novel dendritic cell receptor that mediates HIV-1 trans-infection through recognition of viral membrane gangliosides.

Dendritic cells (DCs) are essential antigen-presenting cells for the induction of immunity against pathogens. However, HIV-1 spread is strongly enhanced in clusters of DCs and CD4(+) T cells. Uninfected DCs capture HIV-1 and mediate viral transfer to bystander CD4(+) T cells through a process termed trans-infection. Initial studies identified the C-type lectin DC-SIGN as the HIV-1 binding factor on DCs, which interacts with the viral envelope glycoproteins. Upon DC maturation, however, DC-SIGN is down-regulated, while HIV-1 capture and trans-infection is strongly enhanced via a glycoprotein-independent capture pathway that recognizes sialyllactose-containing membrane gangliosides. Here we show that the sialic acid-binding Ig-like lectin 1 (Siglec-1, CD169), which is highly expressed on mature DCs, specifically binds HIV-1 and vesicles carrying sialyllactose. Furthermore, Siglec-1 is essential for trans-infection by mature DCs. These findings identify Siglec-1 as a key factor for HIV-1 spread via infectious DC/T-cell synapses, highlighting a novel mechanism that mediates HIV-1 dissemination in activated tissues