# redundant grounding (RG)



## skyhook (Jun 9, 2010)

First time post, would grealty appreciate thoughts.

Private college nursing program, tenant improvement.

Skills labs, simulation labs, "mock-dummy" patients, (9) hospital and exam beds, live students, real equipment.  No piped medical gas.

I've call for RG for mock treatment areas, leaning on the side of caution to protect the student nurses and or a wayward bunch who might hook up a live body for kicks.

CM is trying to cut costs.

Am I over thinking this ? Thanks.


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## north star (Jun 9, 2010)

**    *    **

*skyhook,*

*Welcome to The Codes Forum!  *

*I would err on the side of safety and the NEC ( `08  edition ) and require RG*

*in the patient exam areas, especially sense these are ' real ' simulated*

*exams and ' real equipment ' will be used to come in to contact with patients.*

*See Article 517 in the `08 NEC.  Specifically, Article 517.10 -*

*APPLICABILITY.*



**    *    **


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## FredK (Jun 9, 2010)

Good call.


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## fatboy (Jun 9, 2010)

I agree.......we feel it's not only for the protection of the patient.


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## chris kennedy (Jun 10, 2010)

I have to ask how the OP's situation meets either of the following definitions? BTW, welcome to the Forum.



> Health Care Facilities. Buildings or portions of buildings in which medical, dental, psychiatric, nursing, obstetrical, or surgical care are provided. Health care facilities include, but are not limited to, hospitals, nursing homes, limited care facilities, clinics, medical and dental offices, and ambulatory care centers, whether permanent or movable.
> 
> Patient Care Area.
> 
> ...


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## north star (Jun 10, 2010)

** * **

*Chris,*

*IMO, I would say both!  Albeit, simulated.  An electrical shock; on an ungrounded*

*circuit, can still send a student to the [ real ] morgue.*



> Skills labs, simulation labs, "mock-dummy" patients, (9) hospital and exam beds, live students, real equipment.


 ** * **


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## raider1 (Jun 10, 2010)

chris kennedy said:
			
		

> I have to ask how the OP's situation meets either of the following definitions? BTW, welcome to the Forum.


I agree with Chris.

The reason for the bonding requirements of 517.13 is due to invasive procedures and the possibility of electric shock during those invasive procedures.

The unbroken dry sink of the human body has a relatively high resistance. This resistance is greatly reduced once the skin is penetrated. So in a procedure a patient may be vulnerable to smaller amounts of fault or leakage current. This is the reason that a metallic wiring method must be used as the equipment grounding conductor for patient care areas of a health care facility. EMT (properly installed) is a much better fault current path then is an insulated copper wire. In addition to the metal wiring method as the EGC an additional EGC of the insulated copper wire type is required.

Now with that said if this is a private college nursing program that does not preform any real medical procedures I don't believe that this would be a heath care facility.

Chris


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## raider1 (Jun 10, 2010)

north star said:
			
		

> ** * ***Chris,*
> 
> *IMO, I would say both!  Albeit, simulated.  An electrical shock; on an ungrounded*
> 
> ...


We are not taking about an ungrounded circuit here. What we are talking about is a circuit that does not consist of both a metallic wiring method as an EGC with an insulated copper EGC. The circuit would be grounded.

There is no added shock hazard just due to having the equipment there. The hazard exists due to the actual medical procedure, not a simulated one.

Chris


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## skyhook (Jun 10, 2010)

To all, I appreciate the input (I'm going to like this place). perhaps bringing more questions than answers.

My gut feeling is that dummy patients still qualify as patients, considering the type of training activity involved.  The RG component is to protect staff as well, correct ?


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## skyhook (Jun 10, 2010)

Yesterdays response from AHJ:

Per 2007 CEC, 517.11 FPN, the redundant grounding shall be maintained.  Although

the code refers to a patient, and your e-mail indicates that a mannequin will be

utilized, there is always the potential that a live body could be used for

training purposes.

I asked the Tenant for a letter stating no human patients and the response was non-commital as well, though interested in removing RG for budgetary reasons.

Interesting topic.


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## steveray (Jun 10, 2010)

raider1 said:
			
		

> I agree with Chris.The reason for the bonding requirements of 517.13 is due to *invasive procedures* and the possibility of electric shock during those invasive procedures.
> 
> The unbroken dry sink of the human body has a relatively high resistance. This resistance is greatly reduced once the skin is penetrated. So in a procedure a patient may be vulnerable to smaller amounts of fault or leakage current. This is the reason that a metallic wiring method must be used as the equipment grounding conductor for patient care areas of a health care facility. EMT (properly installed) is a much better fault current path then is an insulated copper wire. In addition to the metal wiring method as the EGC an additional EGC of the insulated copper wire type is required.
> 
> ...


Chris,  you mention "invasive procedure" which makes sense to me, but what is the invasive part of psychiatric care(sp)? I was under the understanding that it was anywhere you might have a patient hooked to any electrical equipment?

I always appreciate your (and everyone else's) knowledge and input!


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## raider1 (Jun 10, 2010)

steveray said:
			
		

> Chris,  you mention "invasive procedure" which makes sense to me, but what is the invasive part of psychiatric care(sp)? I was under the understanding that it was anywhere you might have a patient hooked to any electrical equipment? I always appreciate your (and everyone else's) knowledge and input!


You are correct, there is nothing in Article 517 that limits a patient care area to "invasive procedures".

My point with that post was to try to relay that the reason for the enhanced grounding and  bonding requirements in health care facilities is due to the possibility of a reduced resistance of a patient to electric shock. Most likely this reduced resistance will come from an invasive procedure but some electrical equipment such as electro-muscular stimulation or other electrical equipment may also cause the same effect.

I will stand by my assertion that what the OPer describes is not a health care facility by the NEC Article 517 definition.

Chris


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## chris kennedy (Jun 10, 2010)

raider1 said:
			
		

> I agree with Chris.


How about that, I agree with the other Chris and here is a little Handbook commentary to back up the following point.



			
				raider1 said:
			
		

> The reason for the bonding requirements of 517.13 is due to invasive procedures and the possibility of electric shock during those invasive procedures.The unbroken dry sink of the human body has a relatively high resistance. This resistance is greatly reduced once the skin is penetrated. So in a procedure a patient may be vulnerable to smaller amounts of fault or leakage current.





> This fine print note recognizes the possibility of increased sensitivity to electric shock by patients whose body resistance may be compromised either accidentally or by a necessary medical procedure. For example, incontinence or the insertion of a catheter may render a patient much more vulnerable to the effects of an electric current. Therefore, it is essential that those responsible for the design, installation, and maintenance of the electrical system in patient care areas be well acquainted with at least the rudiments of the hazard as explained in this note.


Thats the commentary following 517.11. I find it hard to believe a student would be subjected to a practice procedure that would expose him/her to the dangers 517 is trying to prevent. If I was in medical school and someone wanted to practice putting catheters in me I would be looking for another school.


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## pyrguy (Jun 10, 2010)

Back in he dark ages, 1999, when I went back to get my EMT-I Certs we used both kinds of dummies.  

Some skills (procedures) were better served on plastic and others on the other students.


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## EPrice (Jun 11, 2010)

I agree with Chris (both of them).

The training facilities do not meet the definition of health care facilities in the NEC, so Section 517 does not apply.  Others have raised good arguments for why these requirements _should_  be applied to the training facilities, and these arguments would serve as good justification for a code change proposal, but until the code is changed, applying 517 to the training facilities is going beyond code requirements.

If we put our heads together, I'm sure we could come up with other situations where people may be put in a position of possible higher risk to electric shock, but until these other situations appear in the code, there is no code backing to support the application of 517 to them.

Edit to add: For example, tattoo parlors... tattooing breaches the resistance barrier of the skin.  Anybody here applying 517 to tattoo parlors?


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## peach (Jun 11, 2010)

it's a short trip from treating dummies to converting to real patients.. "well, we treated patients here at the school.. so it's ok to convert to a neighborhood clinic"... if there is no institutional knowledge to the contrary, it's easy to allow a non-code compliant, well, not even change of use (B and B)..


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## EPrice (Jun 14, 2010)

peach said:
			
		

> it's a short trip from treating dummies to converting to real patients.. "well, we treated patients here at the school.. so it's ok to convert to a neighborhood clinic"... if there is no institutional knowledge to the contrary, it's easy to allow a non-code compliant, well, not even change of use (B and B)..


Very true.  Not only in a case such as you describe, but other buildings/suits that are B occupancies.   Maybe an insurance agency moves out and a doctor moves in.   We try to catch these things through the business license process.  Every new business license gets a fire marshal's inspection prior to the license being issued.  We try to keep the fire marshal aware of things, such as what we are discussing here, that should raise a red flag and prompt a call to the building department.


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## skyhook (Jun 14, 2010)

There is a vast pool of legit expertise on this Forum.  For me, the tenants reluctance to provide a definitive letter stating "no live mock patients" is driving my intention to maintain RG.  The school administrators are smart enough to avoid authoring such a letter, I assume for good reason.  Thanks to all who commented.


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## peach (Jun 15, 2010)

I'm dealing with one right now.. creating new PCA's  in areas that used to be offices.. and now I know exactly what to look for..

Thanks Greg


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## peach (Jul 15, 2010)

would you accept all receptacles in PCA's to be GFCI protected as equivalent to the redundant ground?


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## pyrguy (Jul 15, 2010)

Not I. The two are similar but not the same.

The redundant ground path is required by most medical equipment manufactures. If the installation instructions call for a 'hospital grade' receptacle then the redundant ground is pretty much required. IIRC as the NEC is back at the office.


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## raider1 (Jul 16, 2010)

peach said:
			
		

> would you accept all receptacles in PCA's to be GFCI protected as equivalent to the redundant ground?


Nope, a GFCI receptacle is in no way shape or form an acceptable substitute for the required grounding and bonding in 517.13.

The purpose of the grounding and bonding in 517.13 is to create a ground fault current path with the least amount of impedance as possible. This will help reduce the possible amount of fault current that may flow through a patient in the case of a ground fault in a piece of medical equipment connected to the patient.

Chris


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## peach (Jul 16, 2010)

what I thought.. this place has both.. weird..


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