In a special "Dear Colleague" letter aimed at risk managers and other hospital leaders, the Food and Drug Administration (FDA) warns that some electrically powered hospital beds may pose a risk of fire. The letter notes that the FDA has received 95 reports of fires involving electrically powered hospital beds since 1993.
To help prevent incidents of this kind, the FDA offers safety tips that apply to both electrically powered and manual health care beds and adjustable medical beds. The advice may be particularly useful for older-model beds, notes David W. Feigal Jr., MD, MPH, director of the FDA’s Center for Devices and Radiological Health. In the warning letter, he explains that the Safe Medical Devices Act of 1990 requires hospitals and other user facilities to report deaths and serious injuries associated with the use of medical devices.
Feigal reports that the FDA’s safety tips assume that normal behavioral policies such as prohibitions against smoking and lighting candles are already in place. The fire risks posed by oxygen administration to a patient in bed are not addressed in this list of safety tips.
Proper power supply is key
To address the fire concerns specific to electrically operated beds, the FDA offers this advice:
- Connect the bed’s power cord directly into a wall-mounted outlet. Make sure that the wall-mounted outlet will accommodate a heavy duty or hospital-grade plug and that the outlet is in good working order. The plug of the power cord should have two blades and ground pin that fit tightly into the wall outlet. Power cord plugs that have the ground pin removed should never be used.
- Do not connect the bed’s power cord to an extension cord or to a multiple outlet strip. Whenever possible, avoid the use of extension cords or multiple outlet strips in patient rooms for any medical electrical equipment since they are highly vulnerable to physical damage that can cause fires. If the use of extension cords or multiple outlet strips cannot be avoided, use only heavy-duty or hospital-grade connectors that are approved by the facility’s engineering department. Extension cords and multiple outlet strips only should be installed by properly trained electrical maintenance personnel.
- Visually inspect the bed’s power cord for damage. The bed’s power cord, as well as power cords from other medical electrical equipment, can sustain damage from crushing, pinching, shearing, cutting, or from being worn through from cleaning solutions. Bed movement, deterioration from use or aging, or human or equipment traffic, also can damage them.
Inspect bed for dust, lint buildup
- Do not cover the bed’s power cord or any power cord with a rug or carpet. Rugs or carpets can prevent normal airflow, which can lead to greater heat buildup. Covered power cords also are more prone to being walked on or having furniture placed directly on them. The bed maintenance staff should place the cord in a low- or no-traffic area.
- Ensure that appropriate staff inspects all parts of the bed frame, motor and hardware, mattress, and the floor beneath and near the bed for buildup of dust and lint.
- Test the bed to assure that it moves freely to its full limit in both directions. In many facilities, wall-mounted outlets are located directly behind the hospital bed. Be sure that the vertical motion of the bed does not interfere with the bed’s power cord or plug. In addition, the bed’s hand control cable and all other power cords should not be threaded through mechanical parts of the bed or bedrails where normal bed movement may damage or cut the cable.
- Test the bed’s hand and panel control, including the patient lockout features, to assure that the bed is working properly.
Report any problems to maintenance
- Inspect the covering of the bed’s control panel and the patient control panel to assure that the covering is not cracked or damaged. Cracked or damaged covers can allow liquids or other conductive material to penetrate to the switches.
- Check patient bed occupancy monitors and all other equipment in the patient’s room with plug-in power supplies for indications of overheating or physical damage. Make sure that the power supplies are plugged into a wall socket where they cannot be contacted by bedclothes, bedding, etc.
- Report to the bed maintenance personnel, any unusual sounds, burning odors, or movement deviations observed in the controls, motors, or the limits switch functions.
- Assure that all manufacturers’ recalls, urgent safety notices, etc., have been followed.
Additional, more detailed advice for maintenance staff is available on-line at www.fda.gov/cdrh/safety/bedfires.html.