A brief perusal of LITFL has yielded a nice summary of this topic, most relevant to inteference with the function of pacemakers and AICDs.
In briefest summary:
- Mobile phones (don’t place over pacemaker)
- Peripheral nerve stimulators
- TENS machine
- Damage to the device
- Reprogramming of the device (usually they default to asynchronous mode)
- Induction currents in the leads, resulting in heat damage
- Interference with monitoring activity
- Stimulation of autimatic defib functions (embarrassing)
- Use of bipolar diathermy
- Placement of monopolar diathermy electrode pads to divert current away from the pacemaker
- Telemetric programmer and cardiac technician in theatre, or on standby
- Defib pads as far from pacemaker as possible
As far as electromagnetic radiation in the ICU is concerned, there are several points to note.
- 1990s cell phones were the first to cause observed interference with medical devices
- The range for interaction was about 2m
- Early analog devices were to blame; ventilator and neonatal incubator failures were observed
- Since then, improvement in technology has resulted in digitisation of signal and decreased transmission power requirements, with a resulting decrease in the incidence of RF interference.
- Additionally, shielding standards for medical equipment have escalated the mandatory level of RF protection.
- Modern cell phones are unlikely to cause significant interference unless they are in the immediate proximity of an unshielded device.
- WiFi and Bluetooth are generally held to be benign.
- Most hospitals have subsequently either suspended their mobile phone bans, or maintained them for the purposes of noise reduction.