title: Total electrical power failure in a cardiothoracic intensive care unit.
abstract: OBJECTIVE
  To describe the management of patients in an ICU during failure of both primary and backup electrical systems, resulting in nonfunctioning monitors, mechanical ventilators, and other life-support equipment.
  
  
  METHODS
  Case report of power outage and discussion.
  
  
  METHODS
  A 45-bed cardiothoracic surgical ICU in a tertiary-care teaching hospital.
  
  
  METHODS
  Postoperative cardiothoracic surgical patients receiving i.v. infusions of vasoactive medications and mechanical ventilatory support.
  
  
  RESULTS
  Support measures included the use of pneumatically powered mechanical ventilators, battery-operated transport monitors and infusion pumps, and recruitment of non-ICU personnel to assist with manual ventilation and patient care. Problems identified included communication difficulties caused by failure of electronic telephones, and physical access limitation due to failure of electrical door openers and security locks.
  
  
  CONCLUSIONS
  Total electrical power failure can occur even when an emergency power system is in place. Although the occurrence of such failure is unlikely, provisions must be made for its occurrence in order to avoid catastrophic patient injury. Such provisions include a mental plan of action, provision of emergency support equipment, physical plant changes, and the provision of power-independent communication systems. Power demands and battery backup capability of equipment should be considered in future equipment purchases. The ICU staff should be aware of the structure and operation of backup electrical power sources.
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic Foundation, OH.
authors.forename: J F
authors.initials: JF
authors.lastname: O'Hara
authors.forename: T L
authors.initials: TL
authors.lastname: Higgins
mesh_terms: D003325:Coronary Care Units; D011211:Electric Power Supplies; D004630:Emergencies; D004868:Equipment Failure; D006747:Hospital Communication Systems; D006801:Humans; D008021:Life Support Systems; D008284:Maintenance and Engineering, Hospital; D008991:Monitoring, Physiologic / Q000295:instrumentation; D009820:Ohio; D000078329:Workforce