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ISMP Medication Safety Alert

Hold the Phone.there may be problems with cell phones in the hospital

Many consumers have heard of warnings regarding cell phone use at the gas pumps, but did you know that there are frequently warnings against cell phone use within healthcare facilities? Most hospitals ban the use of cell phones for safety reasons. It is possible that the radio frequency produced by the cell phone may interfere with other radio frequencies used for electronic medical devices. In theory, this could cause a problem with important medical equipment such as heart monitors, medication infusion pumps, and radiology equipment. Though the risk of an actual problem occurring is thought to be small, any malfunction could be serious for patients.

It was recently reported that a cell phone at a patient's bedside was linked to a problem with a mechanical pump used to administer medication directly into a patient's vein. This medical device was set to administer medication to a patient at a slow rate, however, it delivered an overdose of medication to the patient in a short period of time. When the pump in question was tested later in a laboratory setting, it was found to be in good working order. When a cell phone turned on to the "stand-by" mode was placed near the pump, the device automatically began to deliver a rapid dose of medication, far above the amount set on the pump. Fortunately, the patient recovered from this mishap.

It is important that patients, families and visitors to healthcare facilities understand the basis for the "no cell phone" rule and follow the rules of the facility. Remember, even idle cell phones left "on" have the potential to be dangerous to patients. "Power-off" mode is the only way to carry your cell phone within a healthcare setting. Please take note next time you are asked to "Hold the phone".

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