Anyone working with, or around machinery needs to be alert to potential dangers at all times. As machines continue to become more high-tech and complicated, we must also keep up to date on new advances in Industry 4.0, and how best to protect ourselves. For this reason, you should make sure that all your staff and employees are familiar with machine safety rules, and hold regular training sessions to update and reinforce them.
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The following are our top ten Machine Safety Rules:
There are many rules and regulations governing machine safety and the installation of proper safeguards. Where machine operators are concerned, it's the responsibility of a business owner to follow these, and also to ensure that all employees who are working on or around machines do so in complete safety. Machine operators should know how to recognise the required machine safeguards, and how to tell if there's a problem with them. Training programmes should emphasise that all legally required safeguards must be correctly installed and adjusted before the equipment can be operated.
It's very tempting for a machine operator to remove an annoying safeguard, or attempt to bypass it, if it's preventing them from getting on with the job. This is one of the most dangerous things to do around machinery, since the safeguards are obviously there for a reason and should not be removed on any account.
It's also possible that unauthorised safeguards may have been installed that don't comply with existing regulations. Machinery should not be operated in such circumstances, or where the properly authorised safeguards are in a damaged condition.
Machine operators must immediately report any damage or safeguard failures to a supervisor, whose responsibility it is to resolve any safety issues. Only when all problems have been resolved may operation of the machinery be resumed.
Some machines can be accessed for lubrication purposes without removing their safeguards, via oil reservoirs that may be located outside the guard. If access is not possible with the safeguards still on, the machine must first be switched off and locked out before guards are removed.
If the safeguards need to be removed for any reason, such as maintenance or replacement, this must only be done after lock-out, tag-out or isolation of the equipment. This applies also to all machine maintenance, whether scheduled or reactive.
Hazardous pinch points are likely to be found around various types of roller and gear assemblies, couplings, flywheels, spindles and drive drums. Junctions, terminals and convex curves on conveyor belts offer nip hazards, as well as locations near skirt plates, feed hoppers and tracking. Any object that is intentionally or accidentally dropped into a machine may also create a new pinch point. It may also cause damage not only to the equipment itself, but possibly also to its operator, from, for example, a ricochet.
A pinch point may also be defined as any point where the whole or part of a person&#;s body is at risk of being caught in machinery. This doesn't only mean between a machine's own moving parts, but also between its moving and its stationary parts, and between any part of the machine and other materials. These include falling objects, or materials attached to the machine operators themselves.
Loose clothing, long hair or dangling jewellery also, therefore, constitute a nip hazard, as these items might be caught up into the machine's moving parts and so cause additional safety hazards. Employees must always wear the required PPE in the workplace, including where necessary masks, gloves, glasses, aprons, boots, and hats.
It's important to demonstrate during employee training that a machine is not necessarily at rest just because it's been switched off. Some parts continue to move, such as fans, cooling elements, rollers, gears and rotating parts, and may constitute a hazardous pinch point. No machine should be left unattended while there is any part still moving.
Machine operators who are in any doubt about the safety of a machine, or who have questions regarding its safe operation, must always refer these concerns to their supervisor immediately. They should not in any circumstances attempt to deal with the issue themselves.
These top ten machine safety rules are designed for the protection of your employees while working around machinery. Machine safety is a wide-ranging and important topic, however, and embraces many aspects such as health and safety at work and prevailing standards. You can read more about those here.
ECG interpretation, using a step-by-step process, ensures we always provide the best patient care. Since no two emergency scenes or patients are the same, it&#;s imperative to be methodical about the elements of the call that we can control.
ECG tracings &#; the diagnostic tool that analyzes the electrical function of the heart and measure voltage (vertical measurement) versus time (horizontal measurement) &#; can be confusing, so here are the ten steps I follow on every ECG (or EKG) to ensure I correctly identify the rhythm.
As you look at the rhythm, locate the QRS segment which represents the depolarization (the electrical charging of cells) within the ventricles, the two lower chambers of the heart that gather and expel blood towards the body and lungs. Within the QRS, identify the R wave, the positive wave above the isoelectric line (baseline). Using a six-second strip, measure the R to R intervals between QRS segments and determine if the rhythm is regular or irregular.
If you discover an abnormality or irregularity here &#; or in any of your subsequent findings on the ECG &#; ask your patient if this is normal for them and look for any associated symptoms such as CHAPS: chest pain, hypotension, altered mental status, poor perfusion, or shortness of breath.
Take a radial pulse at the patient&#;s wrist, confirm it with the number displayed on the cardiac monitor or print a six-second strip of ECG paper and count the number of QRS complexes and multiply by 10 to arrive to a minute heart rate. From there, decide if the patient&#;s heart rate is bradycardic (less than 60 beats per minute); within a normal range (60-100 bpm); tachycardic (100-150 bpm) or a potentially dangerous rhythm above 150 bpm such as supraventricular tachycardia or ventricular tachycardia with a pulse.
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At this stage of ECG interpretation, be careful not to jump to a quick interpretation. Instead, note the information you find and continue with the subsequent steps.
The P wave represents the depolarization of the atria, the two upper chambers of the heart, which receive blood from the vena cava and pulmonary veins. When searching for P waves: Ask yourself, are the P waves present? Are they upright in Lead II on the cardiac monitor? And are they followed by a QRS segment? If the answer is yes to all, it is likely the electrical impulse began in the sinoatrial (SA) node, the normal pacemaker of the heart.
The PR interval is the time interval between the P wave (atrial depolarization) to the beginning of the QRS segment (ventricular depolarization). The normal PR interval is 0.12-0.20 seconds, or 3-5 small boxes on the ECG graph paper. A prolonged PR interval suggests a delay in getting through the atrioventricular (AV) node, the electrical relay system between the upper and lower chambers of the heart.
The normal QRS segment has three graphical deflections &#; the first negative wave (Q wave); the positive wave above the isoelectic line (R wave) and the negative wave after the positive wave (S wave) &#; and the normal time duration is 0.04-0.10 seconds. If you notice a prolonged QRS segment, it might be due to a bundle branch block which could be relatively benign or a sign of underlying heart disease.
The T wave represents repolarization (recovery) of the ventricles and should be upright in Lead II and appear after the QRS segment. Any variations in the T waves are important to note. Inverted T waves could be due to a lack of oxygen to the heart; too much potassium (hyperkalemia) could cause peaked T waves; flat T waves may be due to too little potassium and a raised ST segment the end of the QRS segment to the beginning of the T wave &#; might be due to a heart attack.
An ectopic beat is a change in a heart rhythm caused by beats arising from fibers outside the SA node, the normal impulse-generating system of the heart. If you notice ectopic beats, determine if they are premature atrial contractions (PACs); premature junctional contractions (PJCs) or premature ventricular contractions (PVCs). Also, note how many ectopic beats are present in the ECG, the interval at which they are appearing, their shape, and if they arise singularly or in groups.
The last step before correctly indentifying your ECG is to determine where the rhythm is originating. Here are some key elements to look for:
Now that you&#;ve methodically analyzed the rhythm, you should be able to easily identify it. Once you do, consider your ECG interpretation in the context of the other information you&#;ve gleamed on the call &#; the patient&#;s chief complaint, mental status, OPQRST/SAMPLE histories, and vital signs &#; and then decide upon a correct treatment plan. When in doubt, always treat the problem you assess not the cardiac monitor.
If you&#;re still learning or want an additional reference on that 3 a.m. call when you&#;re mind is a bit foggy, don&#;t be afraid to create a job aid on a notecard, listing the key steps to analyzing an ECG rhythm.
Also, stay current on your ECG skills by using Skill Stat&#;s free, online ECG simulator, reading about clinical cases in Life in the Fast Lane&#;s informative ECG Library, and check and trying out these EKG challenges.
This article, originally published November 09, , has been updated.
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