Medical Equipment Buying Guide

Medical Equipment Buying Guide

MedWOW Ltd.

Smashwords edition, copyright 2012

License notes: ALL RIGHTS RESERVED. This book contains material protected under International and Federal Copyright Laws and Treaties. Any unauthorized reprint or use of this material is prohibited. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system without express written permission from the author / publisher.

Preface

As with purchasing any other pre-owned product, there are certain factors that you must take into account prior to purchasing used medical equipment. However, the responsibility that accompanies used medical equipment purchases is far greater than with purchasing products in other industries, since the equipment that you buy will eventually be used to monitor, diagnose, and treat patients, and in many cases, even save lives.

It is therefore essential to be aware of the particular elements, specifications, and common malfunctions of each medical device prior to making your purchase.

After receiving many requests from buyers like you, and realizing the tremendous information void in the used medical equipment market; we at MedWOW decided to take advantage of our extensive knowledgebase and produce the ultimate, accessible tool to close this knowledge gap. The Medical Equipment Buying Guide is a first-of-its-kind, comprehensive database, the result of extensive research by MedWOW’s affiliated team of medical equipment experts, doctors, technicians, and engineers from around the world.

Written as a guideline for device buyers involved in the purchasing of medical equipment, the guide provides: buying tips, recommended questions to ask the seller, and Inspections Forms for over 300 of the most common medical devices used in clinics, hospitals, labs, and other medical facilities. The tips emphasize the important features, specifications, and capabilities to consider for each device, so you will know exactly what to look for.

On each page you will find:

The Medical Equipment Buying Guide is updated frequently, and your input is important to us. Please send your comments, questions and feedback to: feedback@medwow.com

Sincerely, the MedWOW Team

Table of Contents

A

Air Cleaner

Air-Purifying Respirator

Alternating Pressure Bed

Alternating Pressure Mattress

Ambulatory Infusion Pump

Amino Acid Analyzer

Anaerobic Chamber

Analytical Scale

Anesthesia Cart

Anesthesia Machine

Apheresis Machine

Apnea Alarm

Apnea Monitor

Argon Coagulator

Arthroscope

Arthroscopic Pump

Artificial Heart Valve

Aspiration Pump

Aspirator, Emergency

Aspirator, Surgical

Aspirator, Ultrasonic

Atomic Absorption

Audiometer

Audiometric Booth

Auditory Function Screening

Automated Coagulation Analyzer

Autopsy Table

B

Bed Alert System

Bed Head System

Bed, Pediatric

Beta / Gamma Counter

Bilirubinometer

Biochemistry Analyzer, Automated

Birthing Bed

Blood Bank Information System

Blood Centrifuge

Blood Gas Analyzer

Blood Gas Analyzer, POC

Blood Grouping System

Blood POC Analyzer

Blood Pressure Holter

Blood Pressure Monitor

Blood Warmer

Blood-Bank Refrigerator

Bone Densitometer, Dual Energy

Bone Densitometer, Single Energy

Bone Densitometer, Ultrasound

Brachytherapy System

Breast Biopsy System

Breathing Monitor

Bronchoscope

C

C-Arm

CAD Mammography

Cardiac Ablation System

Cardiac Catheterization Monitor

Cardiac Echo

Cardiac Electrophysiologic Monitor

Cardiac Output Computer

Cardiac Stress Test

Cardiac Video System

Cardiology Information System

Cataract Surgical Unit

Cath Lab

Cautery Unit

Cell Saver

Cell Washing Centrifuge

Centrifugal Laboratory Analyzer

Centrifuge

Centrifuge, Table Top

Chemistry Analyzer, Manual

Chest X-ray

Choledochoscope

Cine Camera

Cine Projector

CO2 Monitor

Cobalt Linear Accelerator

Colonoscope

Computer Assisted Surgery

Contrast Injector

Corneal Topography System

CPAP

CR System

Cryostat

Cryosurgical Unit

CT Phantom

CT Scanner

Cytological Centrifuge

Cytometer

D

Data Management System, Anesthesia

Daylight Film Processor

Densitometer, Laboratory, Scanning

Dental X-ray

Dental X-ray Scanner

Diathermy Unit, Physical Therapy

Digital Angiography

Digital Mammography Unit

Digital Radiography Upgrade Adapter

Duodenoscope

E

Ear Thermometer

ECG

ECG Holter

ECG Scanner

EEG Monitor

EEG Unit

Electroconvulsive Therapy Unit

Electrohydraulic Lithotripter

Electrolyte Analyzer

Electromagnetic Blood Flow Detector

Electron Microscope

Electrophoresis System

Electrosurgical Unit

ELISA Analyzer

Emergency Cart

EMG & Evoked Potential Response Unit

Endoscope Cleaner

Endoscope Light Source

ENG Unit

Ergometer

Esophageal Motility Analyzer

Ethylene Oxide Sterilizer

External Automated Defibrillator

External Defibrillator

External Pacemaker

Extracorporeal Lithotripter

F

Feeding Pump

Fetal Monitor

Film Duplicator

Film Processor

Film Processor, Cine

Film Scanner

G

Gamma Camera

Gamma Camera, Mobile

Gamma Knife

Gas Liquid Chromatograph

Gas Monitor, Atmospheric

Gastroscope

Glucose Monitor

Glycohemoglobin Analyzer

H

Halogenated Anesthetics Analyzer

Harmonic Scalpel

Heart-Lung Machine

Hematocrit Centrifuge

Hematology Analyzer

Hemodialysis Machine

Hospital Bed

Hospital Information System

HPLC

Hyperbaric Chamber

Hypothermia Unit

I

Immunoassay Analyzer, Enzyme

Implantable Defibrillator

Infant Incubator

Infant Scale

Infant Warmer

Information System, Radiology

Infusion Pump

Instrument Cart

Insufflator

Insulin Pump

Intermittent Compression Unit

Intra-Aortic Balloon Pump

Intracorporeal Lithotripter

Intraoral Video Camera

Intravascular Ultrasound (IVUS)

L

Laboratory Glucose Analyzer

Laboratory Hood

Laboratory Hood, Ductless

Laboratory Incubator

Laboratory Incubator, Thermocycling

Laboratory Information System

Laboratory Oven

Laboratory Safety Cabinet

Laboratory Scale

Laboratory Washer

Laboratory X-ray

Laparoscope

Laser - CO2

Laser - Diode

Laser - Excimer

Laser - Nd:YAG

Laser - YAG

Laser Blood Flow Detector

Laser Imager

Laser Lithotripter

Linear Accelerator

Lung Function Analyzer

M

Mammographic Phantom

Mammography Unit

Manual Wheelchair

Mass Spectrometer

Material Management Information System

Medical Gas Monitor

Medication Management System

Medicine Cart

Microbiological Culture Analyzer

Microcentrifuge

Microplate Washer

Microscope

Microscope, Operating

Microtome

Microtome Knife Sharpener

Mist Tent

Mobile X-ray

Motorized Wheelchair

Motorized X-ray View-box

MRI

MRI Phantom

Multi Image Camera

N

Nebulizer

Nephelometer

Nerve Locator

Nerve Stimulator

Neuromuscular Electrical Stimulator

Nuclear Computer

Nuclear Medicine Phantom

Nurse Call System

O

Obstetric Data Analyzer

Obstetrical Data Management System

Oculoplethysmograph

Operating Room Monitor

Operating Table

Ophthalmic Laser

Ophthalmic Retinal Laser

Optical Digitizer

Orthopedic Table

Osmometer

Oximeter

Oxygen Concentrator

Oxygen Monitor

Oxygenator

P

Pacemaker

PACS

Passive Motion Exerciser, Limbs

Pathology Information System

Patient Hoist

Patient Monitor

Patient Scale

Patient Warmer

Peritoneal Dialysis Unit

PET/CT

Phototherapy Unit

Physician Order Entry System

Plasma Sterilizer

Platelet Aggregation Analyzer

POC Coagulation Analyzer

Polysomnography

Portable ECG

Portal Imaging System

Powered Wheelchair

Practice Management System

Printer, Thermal

Prosthesis, Joint, Hip

Prosthesis, Joint, Knee

Pulmonary Stress Test

Pulse Oximeter

Pump IV

R

Rad Room, Analog

Rad Room, Digital

Rad/Fluoro Room, Flat Panel

Rad/Fluoro Room, Image Intensifier

Radiation Counter

Radiation Detector

Radioaerosol Delivery Kit

Radiographic Phantom

Radiographic Photospot Camera

Radioisotope Calibrator

Radiotherapy CT Simulator

Radiotherapy Phantom

Radiotherapy Planning System

Radiotherapy Simulator

Radiotherapy Verification System

Refractometer, Laboratory

S

Safety Eyewear

Scale, Chair

Sigmoidoscope

Silver Recovery Cartridge

Silver Recovery Unit

Single Channel ECG

Slide Stainers, Hematology

Slide Stainers, Histology

Slit Lamp

Spectrophotometer

Spirometer

Spot Film Device

Steam Sterilizer

Stereotactic Head Frame

Stereotactic Radiotherapy System

Sterilization Box

Stretcher

Suction Regulator

Supplies Boom

Surgical Helmet

Surgical Light

Surgical Power Tool

Surgical Smoke Evacuation System

Sweat Tester

Syringe Pump

T

Table Top Steam Sterilizer

Telemedicine System

Telemetry Monitor

Temperature Monitor

Thermometer

Thyroid Uptake System

Tissue Processor

Tomographic X-ray

Tourniquet

Training Manikin

Transport Ventilator

U

Ultracentrifuge

Ultrasonic Blood Flow Detector

Ultrasonic Cleaning System

Ultrasonic Fetal Monitor

Ultrasonic Lithotripter

Ultrasound and Electrical Stimulation Unit

Ultrasound Phantom

Ultrasound Therapy System

Ultrasound, Cardiac

Ultrasound, Diagnostic

Ultrasound, Portable

Ultraviolet Lamp

Urine Analyzer

Urine Analyzer, Automated

Urodynamic Measurement System

Urological X-ray

Uterine Aspirator

V

Ventilator, Intensive Care

Ventilator, Pediatric

Ventilator, Portable

Ventricular Assist Device

Video Conferencing Equipment

Video Endoscopy

Voice Recorder

W

Warming Cabinet

Washer / Disinfector

Water Purification System

Whirlpool / Bath

X

X-ray Generator

X-ray Subsystem

X-Ray Tube

Xenon System

Portable particulate air filter devices

Portable particulate air filters designed for convenient relocation within a medical institution. May also be used to protect from toxic elements (biological, industrial, or radioactive) in emergency shelters.

Tips for Buying an Air Cleaner

1. Basic personnel should be able to operate and maintain high-efficiency mobile air filter cleaners, and therefore all air cleaners should be easy to set up and require minimal training.

2. For ease-of-use, it is recommended that all air cleaner dials and gauges be easily readable and understandable, and that the portable air filtration systems be easily cleaned and moved.

3. A filter change indicator should be available on the air cleaner unit.

4. Some air cleaners have light emitting diode indicators, while others may rely on a pressure gauge.

5. Monitoring air cleaner system performance in general can benefit from pressure gauges. Measuring changes in pressure can help discover a dirty filter or leaks in the seal of the high-efficiency particulate portable air filtration system.

6. An ultraviolet germicidal irradiation lamp is usually offered, though it is not recommended by ECRI. It is an unneeded added expense, which may pose a potential health hazard due to harmful effects on exposed skin and eyes and the creation of ozone

7. Users must periodically change high-efficiency particulate air cleaners and pre-filters. High-efficiency particulate air filtration systems should be changed every 1-2 years, and pre-filters - every 60-90 days, depending on conditions. To check for adequate airflow and possible leaks around the filters or in the housing, routine inspections must be performed.

8. Frequently changing the mobile air filters increases the ongoing costs and raises the risk to personnel performing such maintenance. However, when filters are not changed often enough, capture and filtration efficiency decreases, and the risk of tuberculosis transmission is increased.

9. Air cleaner filter removal, replacement methods and other required maintenance should all be easily performed.

10. The instructions for air cleaner routine maintenance and service should be clear and simple. Ongoing air cleaner maintenance is required to ensure safe and effective operation.

Questions for the Seller

Before you purchase your Air Cleaner, we recommend you ask the seller the following questions:

Configurations

Does it include recirculating?

Does it include an exhaust?

Is it mobile?

Is the filter disposable?

Is the filter reusable?

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following inspections forms:

Mobile High-Efficiency-Filter Air Cleaners

Tips and Guidelines for Buying an Air-Purifying Respirator

Air-supplying and/or filtering respirators worn to protect from airborne particle/gas inhalation

Devices that filter environmental air for the protection of the wearer. Airborne particles and/or various gases are filtered to prevent wearer from contamination. Self-contained devices include air source, or devices that can be connected to an external source of compressed air.

Tips for Buying an Air-Purifying Respirator

1. Medical facilities should select a respirator that is comfortable and provides adequate protection for the duration of its use. The selected type must be compatible with any eye and face protection, corrective lenses, hearing protection, and protective head cover.

2. Medical facilities should consider the following factors when selecting respirators: the types of contaminants and their concentrations and relative toxicity, as well as compliance with applicable regulations; the physical circumstances of the user; the environmental conditions; the length of time protection is required, and the kinds of activity that need to be carried out while the device is being worn. Other important factors to be considered include: product availability, ease-of-use, reliability, and the service and technical assistance history of the manufacturer. When using the respirator, users should have a wide field of vision and the ability to communicate freely with others without having to remove the device.

3. Medical facilities are encouraged to select respirators that allow the use of cartridges, canisters, and filters from more than one manufacturer. These accessories have a significant replacement cost over the lifetime of a respirator.

4. Some face pieces can be used in both air purifying and air supplying devices. This is beneficial for facilities that require the use of both types of respirator.

5. Medical facilities should use the HR to determine the minimum APF needed. APF must be greater than or equal to the calculated HR.

6. A full-face elastomeric negative-pressure or chemical-resistant is recommended if a chemical can be absorbed through the skin and eyes.

7. Facilities should select a lightweight respirator with little or no breathing resistance, such as a PAPR, for conditions including strenuous work, long periods of use, or high heat and humidity. When a PAPR is required, it is recommended to test the flow rate of the unit using the protocol supplied by the manufacturer. A tight-fitting unit should provide a flow rate of 4 cfm, while a loose-fitting face piece, helmet, or hood should have airflow of at least 6 cfm.

8. In oxygen-deficient and/or IDLH atmospheres, or when the contaminant and/or concentration are unknown, it is recommended to use an atmosphere-supplying respirator. Facilities purchasing such a respirator should verify an airflow rate of 4-15 cfm for a tight fitting facepiece, while a loose-fitting facepiece, helmet, or hood should maintain an airflow rate of6-15 cfm. During use of an atmosphere-supplying respirator, users should ensure that the length and position of the air-line do not affect mobility or pose a tripping hazard.

9. Buying a replacement part - such as a gas cylinder, a battery, a facepiece, or a visor - may be significantly cheaper than replacing the entire respirator. Facilities should look for manufacturers who provide fit testing or any other support with the purchase of a respirator.

Questions for the Seller

Before you purchase your Air-Purifying Respirator, we recommend you ask the seller the following questions:

Air-Purifying APF

Half-face?

Full-face?

Atmosphere Supplying

Air line?

Pressure demand?

Does it include an air source?

Escape bottle?

Does it include a compressor?

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following inspections forms:

Mobile High-Efficiency-Filter Air Cleaners

Pulmonary Resuscitators, Gas-Powered

Tips and Guidelines for Buying an Alternating Pressure Bed

Bed with electrically controlled inflatable air cushions

Electrically controlled beds with inflatable fabric cushions using automated air compressor. Inflation and deflation intervals are controlled. Used for patients with problems that specifically concern skin such as burns, and for patients suffering circulatory problems to prevent ulcers and skin breakdown.

Tips for Buying an Alternating Pressure Bed

1. Alternating pressure beds should support a maximum weight of 159 kg, which should accommodate most patients. However, for bariatric patients, they should support 272 kg or more, depending on the individual patient.

2. Alternating pressure beds should have casters of at least 12 cm in diameter. To ensure that the air bed remains stationary when necessary, brakes are required.

3. For safety purposes, the air-fluidized beds should include CPR controls that, when triggered, provide a hard surface on which CPR can be performed.

4. Noise levels of operating these alternating pressure beds should not exceed 35 dBA, which is the typical sound level in a quiet hospital.

5. When the air bed or air-pressure mattress is not functioning within specified ranges, the system should alarm.

6. To allow constant functioning of the alternating pressure bed during transport and power outages, a battery backup or other feature should be available.

7. Specialty care beds are expensive and have limited application. Buyers should compare the cost of buying vs. leasing them when needed. Facilities should ask suppliers for training programs for clinical personnel who will be using these alternating pressure beds.

8. Specialty air-fluidized bed frames should have side rails that can be locked in the upright position. To prevent slippage, mattress overlays should have straps.

9. There is no compelling evidence that one support surface performed better than others, under all circumstances.

10. The alternating pressure bed's surface should match the patient, so when selecting a support surface for the alternating pressure bed, caregivers should consider the clinical condition of the patient, characteristics of the care setting, and characteristics of the support surface.

11. Low-air-loss and air-pressure mattress replacements and overlays are often cheaper than low-air-loss beds because they use a standard bed as the platform. However, facilities should know that mattress overlays and replacements may have a shorter life span than low-air-loss beds.

12. Mattresses and overlays eliminate the need to store two large bed frames because an existing bed frame is used. However, mattress overlays and mattress replacements may not be compatible with all hospital beds.

13. Buyers need to determine whether air-fluidized bed or low-air-loss therapies are necessary in the hospital. Home use of these therapies may be a better option.

14. Facilities should keep in mind that surfaces that can be laundered require cleaning and disinfecting, especially in the case of overlays and air-pressure mattress replacements. Specially treated surfaces may require chemical disinfection or other special handling.

Questions for the Seller

Before you purchase your Alternating Pressure Bed, we recommend you ask the seller the following questions:

Accessories

Does it include a compressor?

Does it include an input air filter?

Does it include a pressure gauge?

General Information

Are there any signs of rust?

Does the mattress of the bed keep the pressure?

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following inspections forms:

Beds - Air-Fluidized and Low Pressure

Tips and Guidelines for Buying an Alternating Pressure Mattress

Inflatable mattresses designed for pressure relief

Controlled air loss inflatable mattresses designed for pressure relief, and to avoid skin maceration. Inflation and deflation are alternated in a controlled manner in order to both support patient and relieve pressure. May be used for both patients at risk, and for those who have already developed skin conditions which need management.

Tips for Buying an Alternating Pressure Mattress

1. These beds should support a maximum weight of 159 kg, which should accommodate most patients. However, for bariatric patients, they should support 272 kg or more, depending on the individual patient.

2. Beds should have casters of at least 12 cm in diameter. To ensure that the bed remains stationary when necessary, brakes are required.

3. For safety purposes, the beds should include CPR controls that, when triggered, provide a hard surface on which CPR can be performed.

4. Noise levels of operating these beds should not exceed 35 dBA, which is the typical sound level in a quiet hospital.

5. When the bed or mattress is not functioning within specified ranges, the system should alarm.

6. To allow constant functioning of the bed during transport and power outages, a battery backup or other feature should be available.

7. Specialty care beds are expensive and have limited application. Buyers should compare the cost of buying vs. leasing them when needed. Facilities should ask suppliers for training programs for clinical personnel who will be using these beds.

8. Specialty bed frames should have side rails that can be locked in the upright position. To prevent slippage, mattress overlays should have straps.

9. There is no compelling evidence that one support surface performed better than others, under all circumstances.

10. The surface should match the patient, so when selecting a support surface, caregivers should consider the clinical condition of the patient, characteristics of the care setting, and characteristics of the support surface.

11. Low-air-loss and alternating-pressure mattress replacements and overlays are often cheaper than low-air-loss beds because they use a standard bed as the platform. However, facilities should know that mattress overlays and replacements may have a shorter life span than low-air-loss beds.

12. Mattresses and overlays eliminate the need to store two large bed frames, because an existing bed frame is used. However, mattress overlays and mattress replacements may not be compatible with all hospital beds.

13. Buyers need to determine whether air-fluidized or low-air-loss therapies are necessary in the hospital. Home use of these therapies may be a better option.

14. Facilities should keep in mind that surfaces that can be laundered require cleaning and disinfecting, especially in the case of overlays and mattress replacements. Specially treated surfaces may require chemical disinfection or other special handling.

Questions for the Seller

Before you purchase your Alternating Pressure Mattress, we recommend you ask the seller the following questions:

Accessories

Does it include a compressor?

Does it include an input air filter?

Does it include a pressure gauge?

General Information

Is there any loss of pressure?

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following inspections forms:

Beds - Air-Fluidized and Low Pressure

Tips and Guidelines for Buying an Ambulatory Infusion Pump

Liquids infusion pumps for ambulatory use

Infusion pumps with disposable syringe or bag reservoir, small enough to be worn by ambulatory patients. These pumps are used to deliver therapeutic drugs. They can deliver liquids intravenously, epidurally, or subcutaneously. The pumps have a battery powered mechanism (which includes peristaltic, syringe-driven, elastomeric, and osmotic mechanisms) for propelling the infusate, with a flow control mechanism, and a display for user prompts and alarm.

Tips for Buying an Ambulatory Infusion Pump

1. Ambulatory Infusion Pumps are used to deliver parenteral agents from syringes or collapsible bags. Their size should be small enough so that patients can comfortably wear or carry them. During sleep they should not disturb the patient, and during daily use they should not be conspicuous.

2. Medical facilities should carefully select patients to ensure successful insulin infusion therapy. The patients should be motivated and mature with a history of good compliance with insulin therapy.

3. All pumps should be able to run for at least 72 hours without draining the reservoir or depleting the batteries. Pumps should have a flow range of <=0.5 to >=100 mL/hr and maintain a flow accuracy of 5%. Ambulatory infusion pumps should be capable of operating in a continuous infusion mode, though it is desirable for pumps to offer additional modes. In a Peristaltic pump, a set of rollers pinches down on a length of flexible tubing, pushing fluid forward.

4. Luer-lock fittings or integral tubing, distal air filters, and air-in-line detectors may be used as protection methods against air embolism in ambulatory infusion, ambulatory insulin pumps and peristaltic infusion pumps that can deliver from an external reservoir.

5. Volumetric Infusion Pumps should detect an upstream occlusion and suspend infusion when downstream pressure is >=10 psi. The bolus volume released after an occlusion is cleared should be 0.5 mL.

6. Volumetric Infusion Pumps can be utilized for continuous or intermittent delivery through clinically acceptable routes of administration such as: intravenous (IV), intra-arterial (IA), subcutaneous, epidural, or irrigation of fluid spaces applications

7. Free flow protection should be part of any ambulatory and ambulatory infusion pump. Audible alarms should sound for all conditions that might interrupt infusion, including: high pressure/occlusion, low or depleted battery, reservoir-side obstruction, pump malfunction, air-in-line, and empty or near empty reservoir.

8. Ambulatory Infusion Pump alarm volumes should be adjustable with settings loud enough for critical alarms and soft enough for social situations. The pumps should have data logs that can store up to 200 events including: volume delivered, program settings, error codes, alarms, and rate.

9. Display screens in ambulatory insulin infusion pumps, volumetric infusion pumps and peristaltic infusion pumps should be clear and easy-to-read and should indicate: time, basal rate, bolus dose, and accumulated dose.

10. All ambulatory insulin infusion pumps offered should be able to deliver basal flows of 5 to 100 U/day with a resolution of 2 U/day. The recommended ones are those with a bolus dose range of <=0.5 to >=25 U/bolus with a resolution of <=0.5 units.

Questions for the Seller

Before you purchase your Ambulatory Infusion Pump, we recommend you ask the seller the following questions:

Controls

Is it programmable?

Alarms

Reservoir unlocked?

Temp alarm silence?

Air-in-line?

Infusion near end?

Reservoir empty?

System malfunction?

Low battery?

Transtelephonic

Status check?

Programming?

Data Log

Display?

Printout?

Time/date stamp?

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following inspections forms:

Infusion Devices

Tips and Guidelines for Buying an Amino Acid Analyzer

Analyzer of primary and secondary amino acid levels in physiologic fluids

Primary and secondary amino acids in physiologic fluids are detected and measured by this automated analyzer, utilizing ion-exchange or reversed-phase high pressure liquid chromatography techniques. In clinical use it is also possible to monitor treatment of genetically produced disorders in protein metabolism.

Tips for Buying an Amino Acid Analyzer

1. Automated features should be a factor for facilities considering the purchase of amino acid analyzers. Some automatic features can best facilitate sample analysis, and automatic sample injection is preferred to manual injection.

2. It is best if the clinical laboratory HPLC amino acid analyzers can interface with a laboratory information system for easier collection and reporting diagnostic test results. Displaying results and other data should be available both on a monitor and as a printout.

3. Rustproof material should make up the sample amino acid analyzer's column, to ensure greater life expectancy. The column should generally be 10-150 cm long and 2-5 mm wide.

4. When using an amino acid analyzer, to ensure sufficient separation of the sample, the particle size should be as uniform as possible. The following pumps are generally acceptable: dual piston, single-piston, and syringe eluent pumps. Pumps should have a pressure limit of at least 2,000 psi.

5. Facilities need to assess the HPLC amino acid analyzers in their own clinical environment for a few weeks before making a purchase. On-site evaluation allows laboratories to test the qualities of the amino acid analyzer instrument, as reported by the manufacturer with the workload and sample types they normally handle.

6. Facilities should prefer amino acid analyzer devices that diminish the risk of infection involved with handling any body-fluid specimen, by minimizing operator contact with specimens.

7. Procedures may become more complex and sophisticated in certain situations when purchasing or upgrading an amino acid analyzer device. Implications may include additional staff training and certification, as well as changes in quality control, proficiency testing, quality assurance programs, and other laboratory procedures.

8. Computer interface capability is another significant factor to keep in mind. The effectiveness of the HPLC amino acid analyzer interface with the existing laboratory information system or the facility's central computer system, is extremely important for inputting test data and verifying testing accuracy.

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following inspections forms:

Medical laboratory device

Tips and Guidelines for Buying an Anaerobic Chamber

Airtight chambers providing anaerobic environment for laboratory testing needs

An anaerobic laboratory environment, for growth of specimen cultures, testing, and/or incubation in a strictly oxygen-free environment. These large airtight containers are of rigid stainless steel, flexible acrylic, or vinyl. Chamber is accessible using gloves sealed into the wall, in order to sustain anaerobic conditions. Isolation and culturing of anaerobes is facilitated by use of specialized equipment, which includes integral or modular antechamber airlock entry port with fittings for vacuum pump and gas connection, catalyst box, and oxygen monitor.

Tips for Buying an Anaerobic Chamber

1. In the system specification chart, users can find recommendations for minimum requirements for safe and effective anaerobic chambers or anaerobic glove boxes.

2. These devices are designed to provide a stable, oxygen-free environment for the growth and study of anaerobic microorganisms.

3. It is recommended that these anaerobic chamber devices contain an oxygen monitor, as well as a method for circulating anoxic gases through the chamber.

4. A preferred feature, though not a required one, is an integral vacuum pump.

5. For a safe and reliable anaerobic chamber system, vacuum gauges and pressure regulators are required features. Humidity removal is also necessary to prevent the growth of contaminants.

6. Facilities needing rapid culturing and identification of large volumes of microbial agents should consider purchasing anaerobic chambers or glove boxes.

7. The chamber and the antechamber must be large enough to allow for a reasonable-sized working space.

8. Some anaerobic box suppliers offer add-on work chambers, trays, and plate racks.

9. Automated antechambers are frequently used with manual antechambers to assist with the initial evacuation of the chamber. The automated antechambers lessen the time of entry into the chamber.

10. Anaerobic box models containing internal incubators or heating blocks diminish contamination, because they eliminate the need to move the specimens to external anaerobic environments.

Tips and Guidelines for Buying an Analytical Scale

Highly accurate analytical balances and scales, designed for laboratory and other accurate weighing use

High precision analytic mechanical balances and scales, electronic or mechanical, with an accurate weighing range of up to 200g, and a readability of 0.01-1 mg. Used for clinical, pharmaceutical and toxicological laboratories. This balances produce data with superior reproducibility and stability.

Tips for Buying an Analytical Scale

1. Before making an analytical scale purchase, buyers need to consider the minimum load, the maximum weight needed for the scale to weigh, and the scale's reproducibility and linearity. A full list of applications and features contained in an analytical scale can be found in the model's user manual.

2. Typically, analytical electronic balance scales using AC power adapters are more accurate than battery-operated models.

3. Facilities should inquire whether the analytical scale weighs only in grams or whether it has multiple weighing units, such as the option for % weighing, piece counting, target weighing (weighing of packed products for fill weight), or supports density (underhook) weighing . Moisture balances can be used to determine loss on drying of samples.

4. Certain analytical scale models can transfer data to a computer or printer. Facilities should look into whether interface cables for PCs or printers, or communications software are included with the microanalytical balance.

5. The method of calibration that the microanalytical balance has is an important factor to consider. Internal calibration balances use an internal weight to automatically calibrate the instrument at a preset time, or due to changes in temperature, or upon request; while external analytical electronic calibration balances are manually calibrated by placing a calibration test weight on the balance pan.

Tips and Guidelines for Buying an Anesthesia Cart

Carts for use during anesthesia procedures with appropriate storage space

Anesthetist carts equipped with all storage features necessary for organizing equipment, including instruments and drugs for use during anesthesia procedures. An easily cleaned work surface provides space to prepare all items that may be needed during anesthesia procedures.

Tips for Buying an Anesthesia Cart

1. Before making the purchase, buyers should examine the cart's stability, durability, maintenance requirements, and maneuverability.

2. If drugs are to be stored in the cart, then security features are an important factor for buyers.

3. These units should include several drawers and shelves for storage of drugs, disposables, and other instruments.

4. To help separate contents in a logical fashion, dividers should be available as an option.

5. To help control access to the cart, locks or seals should be standard.

6. To provide stability during transport, casters should be large enough and include at least 2 locks to prevent unwanted movement.

7. To help users tailor the carts to meet specific needs, manufacturers should offer a wide range of accessories.

8. Manufactures offer a wide range of features, including varying numbers and sizes of drawers, shelves, and compartments.

9. Facilities are encouraged to seek a group purchase discount because acquisition usually involves several carts.

10. Customized carts can be made according to the specific needs of an individual facility.

Questions for the Seller

Before you purchase your Anesthesia Cart, we recommend you ask the seller the following questions:

Drawers

Does it include Dividers?

Does it include Lock or seal?

Casters

Does it include Conductive casters?

Does it have brakes?

Accessories

Does it include an equipment hanger?

Does it include a tape dispenser?

Does it include an IV pole?

Does it include a waste container?

Does it include a sharps disposal?

Does it include a lockbox?

Does it include a drawer tray?

Does it include a record holder?

Does it include a supply basket?

Does it include a portable light?

Does it include an electrical outlet strip?

Does it include a long catheter container?

Does it have divided organizers?

Does it include a bag/bottle holder?

Does it include a drug transfer tray?

Does it include a spare gas tank carrier?

General Information

Does it include a top guardrail?

Does it include push handles?

Does it include shelves?

Does it include accessory clips/rail?

Is it all Stainless steel?

Are there any Plastic/composed materials parts?

Tips and Guidelines for Buying an Anesthesia Machine

Ventilator device transferring specified gas mixtures to patient during anesthesia

An anesthesia unit including integral or optional ventilator. The ventilator uses positive pressure to transfer specified gas mixtures to the lungs. The gas mixture is produced by the anesthesia unit according to anesthetist's requirements.

Tips for Buying an Anesthesia Machine

1. Buyers can purchase customized modular systems assembled from standard components or they can put together their own modular systems.

2. Standardization of anesthesia equipment should be seriously considered. Facilities should choose systems that are compatible with the equipment already in their possession, reduce parts inventory, minimize the number of suppliers and service personnel, and diminish confusion.

3. A preferred unit is one that accepts compressed-air input, to allow delivery of air and N2O.

4. It shouldn't be possible to deliver air and N2O simultaneously. Anesthetic vapor concentration delivered to the common gas outlet should be accurate within 0.2% vapor concentration of agent, or 10% of the set value at any gas flow.

5. It is preferable that ventilation rate and PEEP values will be monitored.

6. The anesthesia unit should include a gas supply and control circuit, breathing and ventilation circuit, and a scavenging system.

7. The units must be able to measure O2 concentration, airway pressure, and either the volume of expired gas or the concentration of expired CO2.

8. Medium performance units can be upgraded to high performance units by adding stand-alone physiologic and/or gas monitors.

9. Pre-configured monitoring offers advantages such as convenience, electronically integrated displays and prioritized alarms.

10. If the facility already owns the monitors, it can use modular systems, which can be cheaper than preconfigured systems.

11. Pulse oximeters provide a spectrophotometer assessment of hemoglobin oxygenation by measuring light transmitted through a capillary bed, synchronized with the pulse.

12. Line-powered units should be equipped with a power loss alarm, while battery-powered units should have an automatic low-battery alarm. If line power is interrupted, the anesthesia unit should automatically switch to the internal battery.

Questions for the Seller

Before you purchase your Anesthesia Machine, we recommend you ask the seller the following questions:

General

What is the date of the last periodic maintenance?

Software installed? (Name + Version)

System Features

Is an airway pressure monitor included?

Is a high-pressure alarm included?

Is an expiratory vol/flow monitor included?

Is an O2 failsafe device included?

Is a hypoxic mixture failsafe device included?

Is an O2 concentration monitor included?

Is a disconnection/leak/obstruction alarm included?

Is an automatic ventilator included?

Does it have pediatric capability?

Does it have neonatal capability?

Is a suction system included?

General Information

Is a scavenging system included?

Is it FDA certified?

Is it CE certified?

Is a back-up battery included?

Is it a trolley mount unit?

Is it a wall mount unit?

Is it a rail mount unit?

Is it a ceiling suspended pendant mount unit?

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following:

Anesthesia Unit Ventilators

Anesthesia Units

Tips and Guidelines for Buying an Apheresis Machine

Automated units for blood component collection, separation, and reinfusion

Aphereses units separate blood components using centrifugation and/or filtration, depending on the specific blood product to be separated. These automated devices, complete with centrifugation chamber, filters, and safety detectors, can be used in blood donations and for therapeutic purposes. These units can be used to collect blood products (donors), separate substances for removal or exchange, or a combination of these procedures.

Tips for Buying an Apheresis Machine

1. These units must allow users to manually set the anticoagulant ratio and the replacement fluid balance.

2. Some of the preferred features include: auto calculation of the anticoagulant, replacement volume, and extra corporeal volume. These units should have monitors or alarms, and a battery backup.

3. Standardization of equipment is important for reducing costs for training, inspection and preventive maintenance.

4. Providing users with training for these units is extremely important.

Questions for the Seller

Before you purchase your Apheresis Machine, we recommend you ask the seller the following questions:

General Software installed? (Name + Version)

Tips and Guidelines for Buying an Apnea Alarm

Airway pressure alarms signaling ventilation failure

Alarms used in critical and non-critical ventilators, breathing circuit connections, and anesthesia circuits. They warn of high or low pressure changes in airway circuits of mechanically ventilated patients, indicating ventilation failure.

Tips for Buying an Apnea Alarm

1. A remote alarm feature should be available.

2. The airway pressure alarm should have a continuous elevated pressure alarm. If operated on line power, it should also have a power failure alarm.

3. Battery-operated apnea alarm systems should have a low-battery indicator.

4. Both visual and audible alarms should be part of the breathing circuit monitor unit: there should be an apnea alarm delay of 5 to 100 seconds, a low-pressure alarm of 2 to 30 cm H2O, and a high-pressure alarm of 5 to 100 cm H2O.

5. Audible and visual airway pressure alarms should be clear and noticeable.

6. Apnea alarm systems offering volume adjustments should not allow users to turn the volume down, so it is not likely to be heard. When silencing an alarm, there must be a clear visual display. Turning off visual alarms should be impossible. Alarms should remain until the condition is corrected.

7. Users should protect the breathing circuit monitors in the appropriate way against loss of power.

Questions for the Seller

Before you purchase your Apnea Alarm, we recommend you ask the seller the following questions:

Pressure Alarm Parameters

Does it include PEEP, cm H2O?

Does it include I/E ratio?

Does it include CPAP, cm H2O?

Does it include continued elevated pressure, sec?

Does it include subatmosphere pressure?

Does it include respiratory rate?

Does it include MAP, cm H2O?

Pressure Alarm

Low Battery?

Low-Battery Test Function?

Line-Power Failure?

System Alarm Parameters

Low battery?

Low-battery test function?

Line-power failure?

Other (free text)

Alarm Types

Does it include an audible alarm?

Does it include a visual alarm?

Tips and Guidelines for Buying an Apnea Monitor

Devices which detect breathing stops (apnea)

Apnea monitors measure respiration parameters in order to detect instances where breathing stops. Audio- visual alarms note changes in respiratory rate or air volume. Alarm activation parameters can be set by user. Respiration can be sensed mechanically or directly, using thermistors and carbon dioxide sensors.

Tips for Buying an Apnea Monitor

1. These devices are designed to detect the cessation of breathing in infants and adults who are at risk of respiratory failure and alert the parent or attendant in such a condition.

2. The apnea monitors should interpret clinical waveforms, accurately detect respiration, avoid misinterpreting inappropriate signals as breaths, and incorporate an adjustable bradycardia alarm setting.

3. Breath rates up to 90 bpm should be detected; the minimum bradycardia alarm limit should be 30 bpm. If a respiration rate meter is included, it should be accurate to within 10%.

4. Each detected breath should activate a light to indicate respiration. The visual indicator should be bright enough to be seen from across the room, in a well-lit room at varying angles.

5. Clear visible and/or audible alarms should be available. Users will not be able to turn the volume down on an audible alarm so it could not be heard. An audible alarm silence is acceptable, but the alarm must recur automatically if the condition is present, and a visual display should clearly indicate which alarm is silenced.

6. For safe and effective monitoring, several features are crucial. These include a built-in heart rate detector, a remote alarm, a power-loss alarm, and a battery-charge or AC-power indicator.

7. Other important features include: documentation capabilities, output jacks for additional devices, such as recorders and pulse oximeters. The maximum respiratory sensitivity should be 0.2 to 0.3 ohms. The sensitivity control should be automatic to prevent user error. When a manual control is provided, it should be graduated to facilitate adjusting and troubleshooting.

8. Home monitors include some important features to ensure that alarms are always seen and heard. Among these are visual alarms that can be seen from a variety of angles, loud and distinct audible alarms, and remote alarms.

9. To prevent tampering, some of these home units feature hidden alarm controls.

10. Manufacturers and facilities often offer home care services for setting up and maintaining the monitor. These should include educational support, 24-hour telephone hotlines, and replacement equipment in the event of a failure.

11. Suppliers must provide parents or caregivers with training in the use of a home monitor. To ensure that the monitor performs effectively, safety practices should be followed.

Questions for the Seller

Before you purchase your Apnea Monitor, we recommend you ask the seller the following questions:

Breath Detector

Does it include a visual alarm memory?

Does it include a ratemeter?

Does it have a disable indicator?

Does it have a malfunction alarm?

ECG Functions

Does it include a ratemeter?

Does it have a heart rate alarm?

Does it have memory?

Does it have a lead-fault alarm?

Does it have a malfunction alarm?

Memory

Is a computer required?

Is a computer included?

Is a battery backup included?

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following inspections forms:

Apnea Monitors

Tips and Guidelines for Buying an Argon Coagulator

Electrosurgical units capable of delivering argon gas for coagulation purposes

Argon gas delivery systems on mobile carts. These units can be connected to electrosurgical units that perform both monopolar and bipolar (without use of argon) functions. Gas and electric current can be delivered simultaneously. Argon enhanced electrosurgical units are used for coagulation of large surfaces, in a rapid and uniform manner.

Tips for Buying an Argon Coagulator

1. These units should come with a solid-state generator, with a typical frequency range of 0.3 to 1 MHz. They should have an isolated monopolar output, a hand switch, a footswitch, and bipolar output.

2. The output power for monopolar cutting should not exceed 300 W, and the open circuit voltage should not exceed 2,000 peak-to-peak volts. These values apply for general-purpose use.

3. For coagulation, the output and open circuit voltage should not exceed 120 W and 6,000 peak-to-peak volts, respectively. Bipolar mode should use no more than 50 W and 300 peak-to-peak volts.

4. Units should include the following: a return electrode contact quality monitor, independent output, visual and audible activation indicators, alarm capable of volumes higher than 45 dB at one meter, power-setting display, and convection or fan cooling system.

5. Argon-enhanced units should have a flow range of 0 to 10 L/min, a tank capacity of more than 1,200 L (42 ft3), and a low-pressure alarm. The device should include an alarm capable of volumes higher than 45 dB at one meter.

6. There are numerous designs of electrosurgical units, and facilities should base their comparisons among devices according to characteristics, usefulness of features, safety, and reliability - all of these affect clinical performance.

7. Users who are considering which argon-enhanced coagulation system to purchase, should determine whether they wish to expand their current electrosurgical system with a compatible argon module or get a new one with an integral argon unit.

Inspections Forms

When you order an inspection prior to purchase, we highly recommend that you use the following inspections forms:

Argon-Enhanced Coagulation Units

Tips and Guidelines for Buying an Arthroscope

Internal visual evaluation of joints, especially during surgery

Arthroscopes have a rigid external casing, a working channel for catheters and other working devices, and a lighting system. They are inserted into a joint to allow visual evaluation, as well as biopsy and treatment of lesions if necessary. A television camera electronically transmits images for display and video recording.

Tips for Buying an Arthroscope

1. Standard arthroscope and articular cavity endsoscope units should permit connection to all common models of camera heads.

2. Video arthroscopes should be compatible not only with the facility's current video processors, but also with more recent processor models offered by the same manufacturer.

3. To ensure compatibility, facilities are encouraged to buy arthroscopes and accessories from the same manufacturer. Anthroscope accessories may include video monitors, specially designed leg or arm holders, scissors, and knives.

4. To permit connection to all common light source designs, manufacturers should offer a wide variety of light guides.

5. Facilities need to consider the reprocessing methods approved by the rigid endoscope manufacture. The more options, the better the facility may effectively manage its inventory.

6. Facilities should prefer scopes that are also compatible with autoclaving and other fast sterilization methods.

7. Facilities are strongly encouraged to use the arthroscopes that they wish to purchase on a trial basis; this will allow surgeons to directly compare