Natural speed please
Specific Electrical Problems
Apparatuses should be placed within a maintenance schedule to anticipate and prevent problems of grounding, current leakage or breaks in insulation, which otherwise may lead to artifacts.
Elimination of, or Conductive Pathway for, Static and Piezoelectricity
Prevention of the generation of static and piezoelectricity with the use of roller pumps needs technological innovation. In these conditions, provision of an electrically conductive pathway that prevents charge separation and accumulation is needed. Appropriate grounding of the fluid pathway in a patient undergoing continuous renal replacement therapy immediately eliminated pseudo– atrial flutter. During cardiopulmonary bypass, cool and dry conditions increase generation of static electricity, because charge does not dissipate easily. Spraying water, poly ethylene glycol, or silicone on the external surface of the cardiopulmonary bypass tubing improves the quality of electrocardiographic tracing. An alternative solution is to use electrically conductive and grounded cardiopulmonary bypass tubing, which, offering a low resistance pathway for static charge to dissipate, would effectively short-circuit any generated piezoelectric voltage. Alternatively, Metz67 used a static grounding lead between pump housing and the cardiopulmonary bypass circuit temperature port to remove electrocardiographic interference.
Other Common Measures
It is important to educate the patient receiving any nerve and muscle stimulating devices that electrocardiographic interference can result with the use of this device, and to inform other treating physicians. Sakiewicz et al. suggested that various electrical systems should be tested for compatibility before combined use. Whether there exists an optimal arrangement of electrical equipment to reduce artifact is unknown, but separation of devices can reduce both radiofrequency-induced and possibly static electricity–induced artifacts. Hazard warnings and explanations in the manufacturer’s handbook should be known to the users and clinicians. Manufacturers do issue warnings on electrocardiographic artifacts, associated with the use of their product.
Conclusion
There remains a need for continued technological improvement of medical equipment against the challenges of static, electromagnetic, and radiofrequency interference. These arise from existing and developing medical technologies as well as communication devices used in patient care areas. Diagnosis of artifact demands the same attention to detail as does the diagnosis of disease. If not done correctly, both present adverse implications for pathology and patient care. However, systematic appraisal of the presentation, with a thorough knowledge of patient history, correlation with other monitors, and appropriate investigation of surrounding equipment usually allows swift determination of the cause and appropriate action for resolution.
