Highly sophisticated electronic equipment is an integral part of today's ICU, but unless it is competently used it can endanger patients. Staff need training when they encounter new equipment and, if necessary, manufacturers should initially be invited to take on this responsibility. A designated member of staff should take on the continuing training role. As with all nursing/medical practice, staff should decline any duties or responsibilities unless they are able to perform them in a safe and skilled manner.

Alarms, for example on monitoring equipment, ventilators, or dialysis machines, are designed to keep the patient safe. They must be checked and set appropriately by the nurse at the beginning of each span of duty. Dangerous and possibly fatal situations can rapidly occur if it is assumed that the alarms have been set and they have not.

Equipment must be maintained to the best possible standard with agreed maintenance and cleaning routines. However, staff should not hesitate to stop using equipment if they suspect that it is not working properly. Where possible, such equipment should be replaced and checked thoroughly before further use. If doubt arises over the correct operation of a ventilator, the patient should be immediately hand-ventilated with 100 per cent oxygen whilst assistance is summoned and the suspected fault investigated.

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