Friday, July 21, 2006

Friday July 21, 2006
Prohibiting cell phones in ICUs - Are we over-reacting !

Truely speaking, there have been no studies to determine the harm or benefit of mobile/cell phones in ICUs. Generally, cell phones are prohibited in hospitals, particularly in ICUs and telemetry floors due to concern of EMI* with pacemakers, ventilators, infusion pumps and other electronic units. It became pretty standard with a report published about 12 years ago

* EMI = electromagnetic interference

At the 2003 meeting of the ASA (American Society of Anesthesiologists), 7878 five-questions survey, regarding modes of communication in the ORs/ICUs, were distributed. 4018 responses were received

  • 65% of surveyed reported using pagers as their primary mode of communications,
  • 17.5% of surveyed reported using cell-phones as their primary mode of communications and
  • 17.5% used overhead paging (or did not respond to this question)


  • Among the 2607 respondents using pagers, 1179 (45%) reported experiencing significant delays in communication and 407 indicated that these delays led to medical error or patient injury.
  • 31% of cell-phone users reported delays in communications.
  • Only 2.4% of the respondents indicated that they had ever experienced interference between a cell phone and a medical device.

It has been suggested that through proper policy controls, hospitals can provide a more safe environment taking advantage of this 2-way communication technology, with a reduction in the risk of medical error or injury resulting from delay !!.

It has been recommended that as far as cell phones be kept at least 1 meter away from medical equipment, they seems safe 3.

Similar theme was echoed in an editorial in BMJ about 3 years ago: Mobile phones in hospitals (BMJ 2003;326:460-461 - 1 March)

Related previous pearl:
Noise level in ICUs

References: click to get abstract/article
Mobile telephones interfere with medical electrical equipment - Australas Phys Eng Sci Med.1994 Mar;17(1):23-7.
Communication in Critical Care Environments: Mobile Telephones Improve Patient Care - Anesth Analg 2006;102:535-541
Modern Wireless Telecommunication Technologies and Their Electromagnetic Compatibility with Life-Supporting Equipment - Anesth Analg 2005;101:1393-1400

Thursday July 20, 2006

Q: what is "cryo reduced plasma"?

A; Yesterday we learned that: one unit of cryoprecipitate is derived from one unit of fresh frozen plasma (FFP). Left over FFP, after removal of cryoprecipitate is called supernatant plasma or CRYO-REDUCED PLASMA.

Clinical Significance:
Cryo-reduced plasma is used as a treatment in plasmapheresis for TTP, not responding to regular plasma exchange with FFP. Some physicians even use it as first line for plasmapheresis/Therapeutic Plasma Exchange (TPE) for a patient with Thrombotic Thrombocytopenic Purpura (TTP).