Operational risk "Blackout

"It depends on what the extent of a power outage is. For example, how severe the regional power shortage really is." - Claudio Leitgeb, Head of Safety and Environment at the University Hospital Zurich

Power interruption in health care

In the operating room, or OR for short, of a hospital, an automatic power supply usually ensures that a power failure goes unnoticed. If the line voltage drops, a switch is automatically activated that connects batteries to the OR circuit. Today, such a battery switch-on takes only a few milliseconds. The situation would only become problematic if no device or battery service were operated.

Recently, Swiss hospitals were infected with DoS (Denial of Service) computer viruses that shut down hospital areas in a similar way to a blackout. The conditions that prevail after a cyberattack on sensitive facilities are illustrated by scenes like those in the book "Blackout: Tomorrow is too late" by Marc Elsberg are described.

With little effort, it is possible to cause serious, even life-threatening situations for patients, as research and studies underscore (see "Vulnerability of Swiss Hospitals to Cyber Attacks").

Claudio Leitgeb, Head of Safety and Environment at the University Hospital Zurich, explains on the subject of "blackout": "It depends on the extent of a power outage. For example, how high the regional power shortage really is." In this context, Leitgeb points to a main risk for intact hospital operations: "We don't know how much diesel will effectively be delivered for our aggregates after three to four days of emergency."

Quote: "Just getting food to the population is a huge challenge." - Toni Frisch, Head of the Safety Network Exercise SVU 2014

Public "vulnerability" increases many times over

A prolonged power outage would not only block businesses, but also paralyze public life as a whole: From supermarkets to public transport to ATMs, nothing would work. The increasing interconnection of logistics, transport and communication sectors increases public "vulnerability" many times over.

Both the national grid operator Swissgrid and the Federal Office for Civil Protection and Disaster Assistance (Babs) have addressed the issue of what it means to have to manage and live without electricity or with a power shortage. Only a few experts know which distribution approaches will still work in the event of a power blackout lasting several days. Toni Frisch, head of the SVU 2014 safety network exercise, emphasizes: "Just supplying the population with food is a huge challenge."

Redundant systems

In the city of Zurich alone, there are 14 sub-networks operated by the energy supplier EWZ. Important facilities such as the university hospital are connected in a redundant power circuit. In other words, if one network fails, it actually only takes two seconds to automatically draw power from another network. "So there would have to be a longer power interruption to cut off all electricity at the university hospital," says security chief Claudio Leitgeb. If a power shortage is expected to last longer than a day, the University Hospital crisis team would implement power management. Not only would the emergency power grid be controlled, but also the most important buildings, floors and equipment.

At Zurich University Hospital, the operating room facilities have been running on three redundant circuits for a few years. In the event of a power shortage, Leitgeb says, it seems important to the hospital's management to be able to service the medical care and operations of the approximately three dozen operating rooms. In order to be as economical as possible with the reserves, individual departments such as administration would be taken off the power.

Without emergency power, there would be profound consequences for widespread hospital operations. According to Leitgeb, the emergency power generators at the university hospital need only 15 seconds to start up. Because this power generation only works with diesel, the university hospital stores 90,000 liters, which, however, last for a maximum of four days in full operation.

"Without electricity, patients can't even be registered," Leitgeb says.

Logistical limits

If vital processes suddenly had to be reduced to a minimum, it would be drastic for hospital staff, doctors and patients. If batteries had to be used as a power supply in the operating room and intensive care units, there would be major organizational problems. "Without electricity, patients can't even be registered, " Leitgeb says. "The MRI, the X-ray and dialysis machines, even our hydraulic hospital beds, which weigh up to 250 kg, and operating vehicles need electricity." For up to 72 hours, the University Hospital could largely keep operations in check with the emergency generator. To ensure that hospital operations can be organized in the best possible way in the event of a crisis, those in charge have defined intervention units, all the way to alert runners with local knowledge, in the University Hospital's crisis plan. In addition, upstream pretriage and a triage operation would be set up, Leitgeb said. Patients and their families would be cared for in designated zones by pilots and care people.

"Of course, a 'medium-sized cosmos' like the university hospital needs protected surgical chains as well as sufficient supplies of medicines, water, food and appropriate maintenance of hygiene rooms," says Leitgeb. Actually, there should never be a blackout lasting several days.

By Michael Merz, Security Forum

Book tip https://bit.ly/29TSjJS

University Hospital Zurich https://www.usz.ch