Hospital care without electricity

meowzbark · Dec 30, 2013

If an emergency center/hospital had no access to electricity (or backup generator), how would they perform routine care on a patient with a head injury?

Do IVs bags work without electricity? Would medication be administer via syringe or IV? How often would blood pressure and temperature be checked? What signs/symptoms would staff be on the lookout for?

I'm fairly ignorant on procedures, so I'm not sure what other questions to ask.

EDITED: Story relevance: character has a "gift" of [an anti-magic tech field, as someone put it, rather than an EMP] which would make electric objects useless in his hospital room but the range is not strong enough to effect objects outside of the room. Gift is only active when the character is conscious. When unconscious, electronic devices can be used without problems.

Thanks for all the help thus far!

Chris P · Dec 30, 2013

Lots of clinics here don't have electricity. I don't work in a clinic, and have only visited them on a few occasions, but for the most part they use equipment common in the US twenty or more years ago: blood pressure cuffs with either a dial or a mercury gauge, mercury or alcohol thermometers, and IV bags work just fine under gravity feed.

The limitation in your story's case might be that newer members of the staff might not have experience with non-automated equipment.

Once! · Dec 30, 2013

These might help ...

http://en.wikipedia.org/wiki/Electromagnetic_pulse

http://en.wikipedia.org/wiki/Electromagnetic_pulse_in_fiction_and_popular_culture

Note that it is "electromagnetic pulse" not "electric magnetic pulse". If the author(s) of these articles is right, the idea of EMP stopping all electronic equipment seems to be overstated.

As I understand it, EMP tends to affect electronic equipment more than simple electric equipment. In layman's terms, it fries things with computer chips and circuits but doesn't do much to relatively unsophisticated household appliances with a wire and a plug.

Your laptop probably won't work but you will almost certainly be able to boil a kettle to make a cup of tea.

Cath · Dec 30, 2013

None of the things you've listed require electricity to work. An IV can be a simple gravity feed, blood pressure and temperature can be taken manually using equipment that doesn't require electricity. Darkness is going to be your biggest hurdle.

That said, an EM pulse is a pulse, kind of like a surge in power. If the emission is constant, your character is radiating an electromagnetic field (which can interfere with some equipment). Medical equipment has to meet certain standards for EMC (electromagnetic compatibility) as outlined in IEC 60601.

WeaselFire · Dec 30, 2013

meowzbark said:
... how would they perform routine care on a patient with a head injury?

Routinely...?

Seriously, what head injury? Medicine has worked without electricity for far longer than it worked with it. Have you ever seen a bulb thermometer for taking temperature? A standard blood pressure cuff and gauge? An IV drip without a pump? Are kids today really this hooked on electronics?

Jeff

meowzbark · Dec 30, 2013

WeaselFire said:
Routinely...?

Seriously, what head injury? Medicine has worked without electricity for far longer than it worked with it. Have you ever seen a bulb thermometer for taking temperature? A standard blood pressure cuff and gauge? An IV drip without a pump? Are kids today really this hooked on electronics?

Jeff

It's difficult not to get defensive when my question is answered with nothing more than more questions, but I'll give you the benefit of doubt.

Not necessarily "hooked" on electronics. I just have never been in a hospital when electronic devices weren't being used. Is it that much of a stretch to ask for some basic information?

ULTRAGOTHA · Dec 30, 2013

meowzbark said:
If an emergency center/hospital had no access to electricity (or backup generator), how would they perform routine care on a patient with a head injury?

Do IVs bags work without electricity? Would medication be administer via syringe or IV? How often would blood pressure and temperature be checked? What signs/symptoms would staff be on the lookout for?

As already said, none of these things require electricity. IVs work just fine by gravity. Thermometers usually work by batteries but there are still glass-and-mercury (or alcohol) versions that have worked just fine for decades without batteries. Blood pressure cuffs even now don't require electricity. Continuous automatic BP monitoring does, but a nurse can do it regularly with just the cuff and stethoscope.

meowzbark said:
Story relevance: character has a "gift" of EMP [electric magnetic pulse], which would make electric objects useless in his hospital room but the range is not strong enough to effect objects outside of the room. EMP is only active when the character is conscious. When unconscious, electronic devices can be used without problems.

You told us why it's important in your story! Yeah you! Lots of people don't say why it's important and then we all have to guess.

So, you have a character with a head wound but she is still conscious and you want to know what the medical people would do to treat her that doesn't require electricity, right?

What kind of head wound does your plot require? How long do you need your character to be laid up in hospital? How much crap do you want to put your medical people through? Do they know why the electricity is going out periodically?

Almost none of what needs to be done for, for example, a concussion requires any electricity at all except for light. If even battery powered lights won't work around your character, then bring in a kerosine lamp or several candles.

If she's got a laceration, then she'll need stitches. Again, no electricity needed except for light. Good light. Strong light from a sunny window or tons of candles.

If she's kind of dicey and the doctor wants monitors on her and realizes she's the cause of the electricity being out, then the doctor could weigh the risks of not monitoring her against the risks of sedating her.

MDSchafer · Dec 30, 2013

Depending on the facility a good percentage of the staff would have done mission work abroad and done medical work in places that either don't have electricity, or don't have consistent power. The larger the hospital the better the staff will handle it better.I'd like to think most staff would be like, "Okay, well that sucks, moving on."

The bigger issue wouldn't be that specific patient as much as others on the wing, say if someone is on a ventilator. Which by the way, what happens when your character comes into contact with someone with a pacemaker or an insulin pump?

NeuroGlide · Dec 30, 2013

meowzbark said:
Story relevance: character has a "gift" of EMP [electric magnetic pulse], which would make electric objects useless in his hospital room but the range is not strong enough to effect objects outside of the room. EMP is only active when the character is conscious. When unconscious, electronic devices can be used without problems.

EMP does not work the way you think it does. It's not a magic anti-tech field. It is when a pulse of electromagnetic energy, i.e., radio waves, hits a metal object with enough energy to cause the outermost electrons to be kicked off the atom. These electrons then try to flow to ground. In trying to find someplace to go, they take any electrical short cut they can. Electronic circuitry is very sensitive to stray voltage, plain electrical far less so.

Effects: Anything using radio waves won't work near him, he's jamming them. GFI circuits will trip, repeatedly. Non-military electronics will shut down in close proximity to him, possibly being damaged. Military equipment is hardened and shielded to resist EMP effects. He will probably be slightly magnetic (actually very, but we'll down play this), he will emit detectable and traceable RF noise. He will light florescent bulbs on contact.

The biggest problem is the on/off with consciousness. Synchrotronic radiation, electrons spinning around magnetic field lines, is about the only way the character can emit enough RF energy to cause EMP effect while keeping the frequency band narrow. There is one specific frequency that must be avoided, and that's the one used in your microwave oven, otherwise proximity to your MC would cause burns. The energy levels to create a magnetic field for synchrotronic radiation, however, would fry said MC's brain. You might want to base it off of anxiety levels as regulated by his hormones to get it out to his body. It's still implausible, but at least you ain't cooking up some brain fry.

Oh, you're also violating at least the second and probably the first laws of thermodynamics. Don't worry about it. Any explanation would only be worse, just make everyone baffled by it.

ULTRAGOTHA · Dec 30, 2013

NeuroGlide said:
He will probably be slightly magnetic (actually very, but we'll down play this),

This might cause more problems than the lack of light. Suture needles, and parts of stethoscopes and BP cuffs are ferrous metal. A lot of the equipment used to stitch up wounds is metal. The IV is all plastic once it's in, but the needle to get it in is ferrous metal, too.

Not to mention tie pins, parts of pens, hair clips, parts of a lot of the equipment in the room, parts of the bed....

If s/he can't control hir electromagnetism when s/he's conscious, how does s/he deal with all the ferrous metal around hir all the time?

NeuroGlide · Dec 30, 2013

ULTRAGOTHA said:
This might cause more problems than the lack of light. Suture needles, and parts of stethoscopes and BP cuffs are ferrous metal. A lot of the equipment used to stitch up wounds is metal. The IV is all plastic once it's in, but the needle to get it in is ferrous metal, too.

Not to mention tie pins, parts of pens, hair clips, parts of a lot of the equipment in the room, parts of the bed....

If s/he can't control hir electromagnetism when s/he's conscious, how does s/he deal with all the ferrous metal around hir all the time?

I'm picturing a system where the magnetic field is strong deep in the body where the RF signal is generated, but counter fields near the skin contain it so at the skin, it's less powerful than a fridge magnet. There are certain types of magnetic arrays that are very one sided. Someone with a suture needle would notice a slight tugging, but wouldn't loose her grip. She might find her badge has been demagnitized, however. In truth, he (author specified gender) would be pumping out a magnetic field to rival a MRI and be killed by small bits metal piercing him like bullets, but makes for a dull story, so we'll improvise.

meowzbark · Dec 30, 2013

NeuroGlide said:
EMP does not work the way you think it does. It's not a magic anti-tech field. It is when a pulse of electromagnetic energy, i.e., radio waves, hits a metal object with enough energy to cause the outermost electrons to be kicked off the atom. These electrons then try to flow to ground. In trying to find someplace to go, they take any electrical short cut they can. Electronic circuitry is very sensitive to stray voltage, plain electrical far less so.

Effects: Anything using radio waves won't work near him, he's jamming them. GFI circuits will trip, repeatedly. Non-military electronics will shut down in close proximity to him, possibly being damaged. Military equipment is hardened and shielded to resist EMP effects. He will probably be slightly magnetic (actually very, but we'll down play this), he will emit detectable and traceable RF noise. He will light florescent bulbs on contact.

The biggest problem is the on/off with consciousness. Synchrotronic radiation, electrons spinning around magnetic field lines, is about the only way the character can emit enough RF energy to cause EMP effect while keeping the frequency band narrow. There is one specific frequency that must be avoided, and that's the one used in your microwave oven, otherwise proximity to your MC would cause burns. The energy levels to create a magnetic field for synchrotronic radiation, however, would fry said MC's brain. You might want to base it off of anxiety levels as regulated by his hormones to get it out to his body. It's still implausible, but at least you ain't cooking up some brain fry.

Oh, you're also violating at least the second and probably the first laws of thermodynamics. Don't worry about it. Any explanation would only be worse, just make everyone baffled by it.

Ah, thanks for clarifying. EMP is the wrong word for it, as I was searching for a "magic anti-tech field". I'll make sure not to call it EMP in the book.

meowzbark · Dec 30, 2013

MDSchafer said:
Depending on the facility a good percentage of the staff would have done mission work abroad and done medical work in places that either don't have electricity, or don't have consistent power. The larger the hospital the better the staff will handle it better.I'd like to think most staff would be like, "Okay, well that sucks, moving on."

The bigger issue wouldn't be that specific patient as much as others on the wing, say if someone is on a ventilator. Which by the way, what happens when your character comes into contact with someone with a pacemaker or an insulin pump?

I plan to keep her isolated, though I'll be certain to have the floors cleared of other patients when she needs to be moved. Thank.

kaitie · Dec 31, 2013

Have you read the Dresden Files? They actually deal with this sort of question on a routine basis because the character's magic shorts out electric things (the more complex, the worse it is). I do think the biggest problem would be exposing other patients to your character. Do the hospital staff all know about the situation? I think it would be hard to isolate and clear out hospital wings for the character. In fact, it might be best to have someone go to him elsewhere so it doesn't put people in danger. For some patients, moving them alone could cause problems, and you're talking about moving them away from all the equipment they need so that this one person is safe. Granted I'm just randomly thinking here, so I could be wrong. I'm just thinking the easiest answer to the problem might just be to have someone go to him and not vice versa.

James D. Macdonald · Dec 31, 2013

Backwoods Medicine or Where There Is No Doctor will answer all your questions.

Aside from continuous monitoring, and diagnostic equipment like EKGs or xrays, almost nothing requires electricity. Even ventilators ... you can do that by hand too. The little lights on the blades of laryngoscopes are nice, but you can manually intubate someone, or use a blind-insertion airway.

For that head injury ... mostly what you'd do is Wait And See. If it turns out there's intercranial pressure, the treatment for that might be trephination, and that's cave-man level medicine.

meowzbark · Dec 31, 2013

kaitie said:
Have you read the Dresden Files? They actually deal with this sort of question on a routine basis because the character's magic shorts out electric things (the more complex, the worse it is). I do think the biggest problem would be exposing other patients to your character. Do the hospital staff all know about the situation? I think it would be hard to isolate and clear out hospital wings for the character. In fact, it might be best to have someone go to him elsewhere so it doesn't put people in danger. For some patients, moving them alone could cause problems, and you're talking about moving them away from all the equipment they need so that this one person is safe. Granted I'm just randomly thinking here, so I could be wrong. I'm just thinking the easiest answer to the problem might just be to have someone go to him and not vice versa.

I plan having the character moved, which will limit the scenes inside the hospital. This ability isn't noticed by staff until he awakes. Thank you for recommending the Dresden Files. I will check them out.

James D. Macdonald said:
Backwoods Medicine or Where There Is No Doctor will answer all your questions.

Aside from continuous monitoring, and diagnostic equipment like EKGs or xrays, almost nothing requires electricity. Even ventilators ... you can do that by hand too. The little lights on the blades of laryngoscopes are nice, but you can manually intubate someone, or use a blind-insertion airway.

For that head injury ... mostly what you'd do is Wait And See. If it turns out there's intercranial pressure, the treatment for that might be trephination, and that's cave-man level medicine.

Thank you. I will check out those books.

Hospital care without electricity

meowzbark

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