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

The role of discharge variability in the formation and preservation of alluvial sediment bodies

Extant, planform-based facies models for alluvial deposits are not fully fit for purpose, because they over-emphasise plan form whereas there is little in the alluvial rock record that is distinctive of any particular planform, and because the planform of individual rivers vary in both time and space. Accordingly, existing facies models have limited predictive capability. In this paper, we explore the role of inter-annual peak discharge variability as a possible control on the character of the preserved alluvial record. Data from a suite of modern rivers, for which long-term gauging records are available, and for which there are published descriptions of subsurface sedimentary architecture, are analysed. The selected rivers are categorized according to their variance in peak discharge or the coefficient of variation (CVQp = standard deviation of the annual peak flood discharge over the mean annual peak flood discharge). This parameter ranges over the rivers studied between 0.18 and 1.22, allowing classification of rivers as having very low ( 0.90) annual peak discharge variance. Deposits of rivers with very low and low peak discharge variability are dominated by cross-bedding on various scales and preserve macroform bedding structure, allowing the interpretation of bar construction processes. Rivers with moderate values preserve mostly cross-bedding, but records of macroform processes are in places muted and considerably modified by reworking. Rivers with high and very high values of annual peak discharge variability show a wide range of bedding structures commonly including critical and supercritical flow structures, abundant in situ trees and transported large, woody debris, and their deposits contain pedogenically modified mud partings and generally lack macroform structure. Such a facies assemblage is distinctively different from the conventional fluvial style recorded in published facies models but is widely developed both in modern and ancient alluvial deposits. This high-peak-variance style is also distinctive of rivers that are undergoing contraction in discharge over time because of the gradual annexation of the channel belt by the establishment of woody vegetation. We propose that discharge variability, both inter-annual peak variation and “flashiness” may be a more reliable basis for classifying the alluvial rock record than planform, and we provide some examples of three classes of alluvial sediment bodies (representing low, intermediate, and high/very high discharge variability) from the rock record that illustrate this point

Studying the Probability of EMI through Time-Variance Behavior of Environment on Medical Devices

The electromagnetic environment in buildings is complex and fluctuating in time. We can distinguish three time scales: short, mid and long term time-variance. In this paper we measure the time-varying behavior of a complex electromagnetic environment over the course of a 24-hour period. We show that this measurement provides extra information on top of short time-variance data, necessary to assess the risk for EMI in a complex EM environment; the risk-based EMC approach

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

Bar dynamics and bifurcation evolution in a modelled braided sand-bed river

Morphodynamics in sand-bed braided rivers are associated with simultaneous evolution of mid-channel bars and channels on the braidplain. Bifurcations around mid-channel bars are key elements that divide discharge and sediment. This, in turn, may control the evolution of connected branches, with effects propagating to both upstream and downstream bifurcations. Recent works on bifurcation stability and development hypothesize major roles of secondary flow and gradient advantage. However, this has not been tested for channel networks within a fully developed dynamic braided river. A reason for this is a lack of detailed measurements with sufficient temporal and spatial length, covering multiple bifurcations. Therefore we used a physics-based numerical model to generate a dataset of bathymetry, flow and sediment transport of an 80 km river reach with self-formed braid bars and bifurcations. The study shows that bar dissection due to local transverse water surface gradients is the dominant bifurcation initiation mechanism, although conversion of unit bars into compound bars dominates in the initial stage of a braided river. Several bifurcation closure mechanisms are equally important. Furthermore, the study showed that nodal point relations for bifurcations are unable to predict short-term bifurcation evolution in a braided river. This is explained by occurrence of nonlinear processes and non-uniformity within the branches, in particular migrating bars and larger-scale backwater-effects, which are not included in the nodal point relations. Planform morphology, on the other hand, has predictive capacity: bifurcation angle asymmetry and bar-tail limb shape are indicators for near-future bifurcation evolution. Remote sensing data has predictive value, for which we developed a conceptual model for interactions between bars, bifurcations and channels in the network. We conducted a preliminary test of the conceptual model on satellite images of the Brahmaputra