TRNG I HC BCH KHOA H NI

VIN IN T - VIN THNG

TIU LUN MN HC

AN TON IN TRONG Y T
TI: An ton in trong thit b thu nhn tn hiu in c
GVHD:
SV:
Lp:
SHSV:

Th.s Phm Mnh Hng

Hoang Ba Tu
in t vin thng 06 K55
20102132

Ha Ni, 05 2014

MC LC

MC LC ............................................................................................................................. 2
LI NI U ........................................................................................................................ 3
CHNG I: TC DNG SINH L CA DNG IN........................................................... 4

I. Tc dng sinh l ca dng in ............................................................................ 4

1.

Cac nguy c git in .................................................................................... 5

CHNG II: CC TIU CHUN AN TON TRONG Y T ................................................... 6

I. Cc ti liu v tiu chun cho y t ........................................................................ 6

II.

Phn loi cc thit b ......................................................................................... 6

1.

Class I ............................................................................................................ 6

2.

Class II ........................................................................................................... 6

3.

Class III .......................................................................................................... 7

III.

Cc loi thit b y t .......................................................................................... 7

1.

Thit b loi B ................................................................................................ 7

2.

Thit b loi BF .............................................................................................. 7

3.

Thit b loi CF .............................................................................................. 7

CHNG III: NHNG GI CHUNG TRONG THIT K .................................................. 8

I. Ni t cho tt c cc thit b ............................................................................... 8

II.

Gim thiu ti a dng r r .............................................................................. 8

III.

Hot ng in p thp .................................................................................. 8

IV.

Cch ly h thng in li ................................................................................ 8

CHNG IV: GII PHP CHO THIT B THU NHN EMG ................................................. 9

I. Bo v khi s dng my sc tim (Defibrillator Protection) ................................. 9

II.

Cc gii php cch ly ........................................................................................ 9

1.

Khuch i cch ly ........................................................................................ 9

KT LUN .......................................................................................................................... 10
TI LIU THAM KHO ....................................................................................................... 11

LI NI U
An toan in la vn rt quan trng i vi cc bnh vin cng nh bnh
nhn , nhng ngi trc tip tri qua qua trinh chn oan hay iu tr trong iu kin
m cao khin kh nng cach li ca da b suy gim. Ngoai ra, bnh nhn thng
khng c kh nng kim soat, bt tnh hoc khng c ap ng bnh thng vi dng
in. Hn na, cac gii phap dn in chng hn nh mau va nc mui thng xut
hin trong vic iu tr va chuyn r r hoc ri vao cac thit b y t la khng th tranh
khi.
Theo mt thng k, tai nn do in chim v tr th 5 trong cac tai nn ph bin
nht ti M. c bit trong lnh vc y t, hang nm trong s 10,000 v tai nn lin
quan trc tip n cac thit b chn oan va iu tr, tai nn v in chim s lng
khng nh. Vic hiu bit v nguy c va cac kch bn tai nn xy ra la cn thit, gip
chng ta hc cach ci thin cac thit k trong lnh vc y t.
Trong khun kh tiu lun nay, em xin trnh bay v cac gii phap an toan in
trong cac thit b y t ni chung va thit b thu nhn tn hiu in c (EMG) ni ring.

CHNG I: TC DNG SINH L CA DNG IN

Tc dng sinh l ca dng in

I.

Con ngi lun ng trn mt t tng ng vi vic tip xc vi mt im

gi la ground. Do , khi mt ngi tip xc vi mt im c in ap th thc t
ngi la ng dn gia hai im trn mch in. Dng in s to ra nh
hng sinh l n con ngi nu tha mn iu kin c chnh lch in ap, va ng
nhin dng in s i vao c th ti mt im va i ra theo mt im khac. V c bn
th dng in c th gy ra 3 tac ng:
-

Kch thch cac m d b kch ng (c, thn kinh)

Nhit in tr ca m
Bng in/ tn thng m

Di y la s tac dng ca dng in theo ln ca dng in, ti tn s

50Hz trong thi gian t 1-3s

1. Cc nguy c git in
Hu ht cac thit b y t u c v may bng kim loi, iu tim n nhng nguy
c, trong trng hp mt kh nng cach in hoc chp dy nng vi v may. Khi ,
s tn ti in ap cao t 115-230V gia v va mt t
Lp bo v u tin ca con ngi chnh la da, tuy nhin
trong iu kin m t ca bnh vin cng cac tac nhn nh
dch lng, gel , kh nng cach in ca da c th gim ch
bng 1% so vi da kh. Tr khang bn trong ngi khong
100 cho chn tay v khong 200 cho khoang bng, theo
tng tr ca c th khng qua 500.
-

Tr khang khi da kh:

Gel in cc trn da :
Tr khang khi m xuyn:

93k/2
10.8k/2
200/2

a. Git in khi dy nng b chm v

Di y m t hai trng hp khi dy nng b chm v:

Khi v may c ni t, dng in s chy theo ng c tr khang nh
hn, do khng xy ra git in.
Khi dy ni t b t hoc khng c thit lp, dng in s theo v may
chy qua c th xung t, gy ra git in.

b. Git in do dng in r r
Git in trong trng hp nay do t in k sinh va cht lng lp cach in
km, to nn dng in chy gia v may va t, gia tr c th nn ti 100A.

Trong trng hp c dy ni t, dng in chy qua dy t s ln hn rt

nhiu so vi dng in chy qua c th ngi. Mt s trng hp dng vn
chy qua ngi bnh nhn c lin kt trc tip gia tim va u thu tn hiu.
Trng hp khng c dy ni t, bnh nhn c th b git in nh dn
n c ch h hp.

CHNG II: CC TIU CHUN AN TON TRONG Y T

Cc ti liu v tiu chun cho y t

I.
-

II.

IEC: International Electrotechnical Committee

NFPA 99: Standard for Health Care Facilities
ANSI/AAMI ES1-1993: Safe Current Limits for Electromedical Apparatus
BS 5724: Electrical Safety of Medical Equipment

Phn loi cc thit b

1. Class I
La cac thit b ma trong bo v chng git in khng ch da trn cc
lam c bn ma cn thc hin ni tt c cac phn dn n cac dy t bo v
ca h thng chnh. Do cac thit b nay khng tr thanh nguy c khi mt
lp cach in. i vi ng dy c th thao di linh hot, tr khang R <
0,1 (mu vng, xanh l), tr khang ti a la 0.2

2. Class II
Vic bo v cac thit b lp II da trn vic b sung mt lp cach in th
2. Phng thc bo v nay da trn vic s dng 2 lp cach in bao quanh

bt c mt b phn dn in nao. Thit b thuc lp II c k hiu bng

hnh vung bao quanh hnh vung.
3. Class III
Lp I va II bo v da trn vic tranh nh hng t in ap hot ng ca
thit b. Trong khi lp th III da trn vic s dng mt in ap thp an
ton SELV (Safe Extra Low-Voltage) va theo th cac in ap cao hn
SELV u khng th c to ra. SELV c gia tr khng qua 25V(ac) hoc
60V(dc).

III.

Cc loi thit b y t

1. Thit b loi B
Thit b lp I, II, hoc III
K hiu:

2. Thit b loi BF
S dng phn cach ly tri, c thit k kt ni vi da bnh nhn nhng
c mch u vao tri. Khng s dng dy tip t cho bnh nhn.
K hiu:

3. Thit b loi CF
Lp I, II, hoc III yu cu tiu chun cach ly cao hn, s dng trc tip cho
cac ng dng cardiac. Tr khang ti thiu gia u thu va mt t la 20M
va 70M gia u thu chnh vi bnh nhn.
K hiu:

CHNG III: NHNG GI CHUNG TRONG THIT K

Ni t cho tt c cc thit b

I.

Thng qua tt c cac v d trn, vic ni t cho cac thit b r rang la rt cn

thit. S dng mt dy c tr khang nh ni gia v may va mt t.

Gim thiu ti a dng r r

II.

Dng r lun lun tn ti vi cng ti thiu c ghi nhn la 1uA, gii

phap c s dng la dng vt liu cach in tt nhm gim t k sinh gia v
may va dy dn.

III.

Hot ng in p thp

Hu ht tt c cac mch in u s dng in ap mt chiu. iu nay gip

gim thiu nguy c git in do chp dy nng, git in do dng r vn c th
xy ra nhng an toan hn.

IV.

Cch ly h thng in li

Nu nh thc hiu vic tip t i vi mt trong 2 bn may bin ap, s loi tr

in ap nguy him trn v thit b

CHNG IV: GII PHP CHO THIT B THU NHN EMG

I.

Bo v khi s dng my sc tim (Defibrillator Protection)

Zenner 9,1V
R1 20k 1W
R2 10k 1W
Neon Lamp (NE2 Series) shunts voltage above 70-80V

II.

Cc gii php cch ly

1. Khuch i cch ly
Mch khuch i cach ly nhm mc ch cach ly ngi bnh ra khi
ground khi tn hiu c ch ang truyn thng qua cu cach ly.

KT LUN
Qua trnh lam tiu lun gip em c thm c hi tm hiu rt nhiu v an toan
in trong cac thit b y t ni chung va trong thit b thu nhn tn hiu in c ni
ring. Em tin rng sm hay mun em cng ap dng c nhng kin thc tm hiu
c t bai tiu lun nay.
Em cm n thy hng dn cho em nhng hng tm kim thc hin bai
tiu lun nay.
Mong thy lun gi sc khe va cng tac tt!

TI LIU THAM KHO

[1] The Royal Childrens Hospital Melbourne website
www.rch.org.au/bme_rch/electrical_safety
[2] Electrical Safety of Medical Equipment Hasan Al-Nashash. School of
Engineering, American University of Sharjah (AUS)