Yarmouk University

Hijjawi Faculty for Engineering Technology

Biomedical System and Informatics department

Training Report

Name Saja Mohammed Al-Darabseh

Student Number 2013977102
Training Supervisor Eng. Sami Al-Mashaqbeh
Training Period 26∕6∕2019 to 26∕12∕2019
Company Prince Rashid Bin AL-Hassan Military
Hospital
Acknowledgment
I would like to express my thanks and gratitude to Allah, who give me the ability and the
willing to complete this work successfully. Special thanks go to my family who helped me
along the way, my supervisor ENG. Sami AL-Mashaqbeh for his support and
encouragement.

Also, I would like to thank the chair and all members of the Department of Biomedical
Engineering at the Yarmouk University for assisting me. In addition, special thanks are
extended to my friends who supported me to strive towards my goals.

i
ABSTRACT
University training is one of the best chances which helps us to enhance our ability to work
in team and under specific condition like those in the work at future.

It helps us to connect clearly between theoretical and practical parts in our field by
observing many medical devices and their components.

I had spent the whole training period (i.e. six months from 26/6/2019 to 26/12/2019) at
Prince Rashid bin Alhassan military hospital, maintenance workstation supervision by
engineers and technicians who were cooperative to provide us with required information
that we needed.

During this period, I have learned many new things about biomedical equipment, work
environment, and how to work within a team. I learned about electrical and mechanical
principles used in medical devices and about some components of all devices,
troubleshooting, safety rules and errors extraction, and in this report, I will introduce some
of technical information and practical skills I had learned.

ii
Table of Content

Acknowledgment ........................................................................................................................................... i
ABSTRACT...................................................................................................................................................... ii
Table of Content .......................................................................................................................................... iii
Table of Figures ............................................................................................................................................. v
List of abbreviations ..................................................................................................................................... vi
Chapter one: Introduction. ........................................................................................................................... 1
1.1. Prince Rashid Bin Alhassan military hospital ..................................................................................... 1
1.1.1 About hospital (general information). ......................................................................................... 1
1.1.3. Workshop Team. ......................................................................................................................... 3
1.1.3. Training schedule. ....................................................................................................................... 3
1.2. Medical device classification related to their function. ..................................................................... 4
Chapter two: Safety and maintenance. ........................................................................................................ 5
2.1. Safety ................................................................................................................................................. 5
2.1.1. Safety in hospital ......................................................................................................................... 5
2.2. Maintenance. ..................................................................................................................................... 6
2.2.2. Level of maintenance. ................................................................................................................. 6
2.3. Medical devices malfunctions............................................................................................................ 6
Chapter three: Operating department. ........................................................................................................ 7
3.1. Definition of operating department. ................................................................................................. 7
3.2. Position of operating department. .................................................................................................... 7
3.3. Department with direct contact to operating department. .............................................................. 7
3.4. Design of operating department. ...................................................................................................... 7
3.5. Component of operating department. .............................................................................................. 7
3.5.1. Operating room........................................................................................................................... 8
Chapter four: The Intensive Care Unit (ICU). .............................................................................................. 15
4.1. Definition of ICU............................................................................................................................... 15
4.2. Pre-installations ............................................................................................................................... 15
4.3. Main devices within the ICU unit ..................................................................................................... 15
4.3.1. Infusion pump. .......................................................................................................................... 16
4.3.2 Air mattress. ............................................................................................................................... 18

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 4.4.1 Troubleshooting. ........................................................................................................................ 18
Chapter five: Laboratory department. ........................................................................................................ 19
5.1. Definition of laboratory department. .............................................................................................. 19
5.2. Main device in this department. ...................................................................................................... 19
5.2.1. Centrifuge. ................................................................................................................................ 19
Chapter six: Conclusions. ............................................................................................................................ 22
5.1 Practical experience. ......................................................................................................................... 22
5.2. Learned lessons. ............................................................................................................................... 22
5.3 Recommendations. ........................................................................................................................... 22
5.4 My Note on Training. ........................................................................................................................ 22
References: ................................................................................................................................................. 23

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Table of Figures
Figure 1.1 Prince Rashid Bin Alhassan military hospital [1] ......................................................... 1
Figure 1.1.2 Hospital Department and Divisions............................................................................ 2
Figure 1.1.3. Workshop Team ........................................................................................................ 3
Figure 3.5.1Operating table [7] ....................................................................................................... 9
Figure 4.3.1infusion pump [14] .................................................................................................... 16
Figure 4.3.2 infusion pump block diagram ................................................................................... 17
Figure 4.3.3 Troubleshooting [16] ................................................................................................ 17
Figure 5.2.1 Centrifuge ................................................................................................................. 19
Figure 5.2.2 block diagram Centrifuge ......................................................................................... 20

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List of abbreviations
PRE-OPP: Pre-Operation.
ESU: Electro Surgical Unit.
RF: Radio Frequency.
ICU: Intensive Care Unit.

UV: Ultra violet.

vi
Chapter one: Introduction.
1.1. Prince Rashid Bin Alhassan military hospital

1.1.1 About hospital (general information).

Figure 1.1 Prince Rashid Bin Alhassan military hospital [1]

Prince Rashid Ben Al Hassan Hospital (1966) is one of the military medical services hospitals in
Jordan. Located in Irbid, Aydoun. It provides health care to personal military and their families
with a capacity of 259 beds.
The hospital has many departments in patient health care with an occupancy rate of 85%, 22
thousand annual admissions and almost 6000 operations a year and a maintenance workstation
where maintenance of medical devices is performed, and our training is held. [2]

Hospital contact
Tel.: +962 2 7100890, 91.
Email: prmh@jrms.gov.jo
website:http://www.jrms.gov.jo/Default.aspx?tabid=92&language=en-US

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1.1.2 Department and Divisions

Figure 1.1.2 Hospital Department and Divisions

2
1.1.3. Workshop Team.

Figure 1.1.3. Workshop Team

1.1.3. Training schedule.

There was no specific schedule followed during our training period as it was in previous period.
Our spontaneous trainee depends on medical device malfunction which delivered to the medical
operator or if the technician tokes us to the departments when the maintenance required.

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1.2. Medical device classification related to their function.

Medical device can be classified in many different ways, I choose to write it is

classification related to their function.

Figure 1.2 Medical device classification

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Chapter two: Safety and maintenance.
2.1. Safety
It is the state of being "safe", the condition of being protected from harm or other non-desirable
outcomes. Safety can also refer to the control of recognized hazards in order to achieve an
acceptable level of risk.

2.1.1. Safety in hospital

When we talk about patient safety, we are really talking about how hospital and other health care
organizations protect their patient from errors, accidents, and infection.so, I will talk about some
type of patient and staff safety.
Personal safety:
 A patient or anyone who enter the magnetic resonance imaging (MRI) room must remove
all ring or anything which may conduct electricity.
 Anyone whose enters the operating room should wear special and sterilize clothes.

Environmental safety:
 Adequate light.
 Hospital must be connected to the reference ground.
 Wires must be shielded well and doesn't appear from the walls.

Electrical safety:
 Have periodic checks of ground wire continuity of all equipment.
 plugs must bs checked.
 Only devices tested for safety should be used.
Safety during maintenance:
 Disconnect the power source before repairing electrical equipment.
 Use only tool and equipment with non-conducting handles when working in electrical
devices.
 When it is necessary to handle equipment that is plugged in, be sure hands are dry and,
when possible, wear non-conductive gloves, protective clothes and shoes with insulated
soles.
 Always keep your left hand in your pocket where possible to avoid providing an electrical
path through your chest and heart.
 Do not work under poor lighting conditions.
 Discharge capacitors before working near them.
 Wash hands immediately after removing gloves.

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2.2. Maintenance.
It is functional checks, servicing, repairing or replacing of necessary devices, equipment,
machinery.
2.2.1. Types of Maintenance.

There are two types of maintenance:

1. Corrective Maintenance (or Repair):
This is done to take corrective action in the event of a breakdown of the equipment.
The equipment is returned repaired and calibrated.
2. Planned (or Scheduled) Preventive Maintenance:
This work is done in a planned way before repair is required and the scheduled time
for the work. It involves cleaning, regular function, safety tests. [3]

2.2.2. Level of maintenance.

 Level 1: User (or first-line)

The user or technician will clean the filters, check fuses, and check power
supplies etc. Without opening the unit and without moving it away from the
point of use.
 Level 2: Technician
It is recommended to call the local technician when first-line maintenance
cannot rectify a fault or when a six-monthly check is due.

 Level 3: Specialized
Equipment such as CT Scanners, MRIs etc. will need specialized Engineers
and Technicians trained in this specific equipment. [3]

2.3. Medical devices malfunctions

There are many types of medical devices malfunctions that are:
1. Mechanical malfunctions.
2. Electrical malfunctions.
3. Software malfunctions.

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Chapter three: Operating department.
Operation department are one of the mostly used places of the hospitals due to their functions and
usability. These department must have specific specification and construction details that are
playing main role in their functionality.

3.1. Definition of operating department.

A specially equipped department, usually in a hospital, where surgical procedures are
performed.

3.2. Position of operating department.

In hospital ground near radiologist and sterile departments.

3.3. Department with direct contact to operating department.

 PRE OPP-Room (room used to prepare patient for operation)
 Sterilizations Department
 Surgery Department
 Resuscitation Department
 Emergency

3.4. Design of operating department.

It is divided to three main area:
1. Clean area
It is contained infrared scrap sink (with sterile material for hand wash).
2. Sterile area (one way)
It is contained sterile room for medical staff using steam or UV and it continued until
operating room door.
3. Dirty area (the first area in sterilizing department)
It is the final place where the medical staff going out when they finish their work and it is
the first stage of sterilizing for medical equipment.

3.5. Component of operating department.

 Operation rooms.
 Recovery room.
 Sterile room.
 Pre-opp room.
 Storage room. [4]

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3.5.1. Operating room.

1. Definition of operating room:

a specially equipped room, usually in a hospital, where surgical procedures are performed.
All operating room have essential Specifications, but everyone has special specification
related to it usage.[5]
2. Design of operating room:
It must allow one way of movement the operation table position is an important point so,
the patient foot must be to the interrace door direction.
3. Group inside operation room (medical staff):
 Doctors
- Specialist doctor
- Resident doctor
- Anesthesiologist
 Nurses
- Scrub nurse (they must not move)
- Runner nurse (they provide the other nurse with equipment using movable trolley)
- Anesthesia technicians

4.Main devices in operating room:

It contains many devices as follow:
 Operating table.
 Operating light.
 Anesthesia machine.
 Patient monitor.
 Defibrillator.
 Suction machine.
 Electro surgical unit.
 Also, sub-devices as follow:
 A pendant source.
 Blanket mattress (in long time operation). [6]

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3.5 4.1. Operating table
Operating tables provide an elevated surface that supports the patient’s body during
surgical procedures, stabilizing the patient’s position and providing optimal exposure of
the surgical field.

Figure 3.5.1Operating table [7]

1. Parts of operation table:

There are three parts of any operation table:
 Top
It made of metal, plastic, or a metal/plastic/carbon-fiber composite.
It can also be transferred to trolley to transport patient to and from the operating
room.
It contains side rare.
 Column
Contain back up control.
Join mechanism of movement (hydraulic or electrical).
 Base
Movable-base tables have swivel casters, which allow the table to be moved, and a
locking mechanism for the base, which stabilizes the table during surgical
procedures.

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 2. Operating table positions:
I. Tilt left/right
II. Back ward/forward
III. Head up/down
IV. Back up/down
V. Emergency-Trend position (Trendelenburg): The most important position in the
table, which used in emergency situation where the patient has a bleeding in his/her
head so by one click and quickly it heads up and legs down and if the bleeding is
in his/her legs the body position will be upside down to reduce bleeding in the legs.

3. troubleshooting:

Figure 3.5.2 operating table troubleshooting [8]

3.5.4.2. Electro surgical unit (ESU).

An electrosurgical unit is a useful tool in all aspects of the surgical arena, it is a generator
capable of producing a cutting and/or coagulating clinical effect on tissue by the use of
alternating current at a high frequency (RF – radio frequency, also known as radio surgery).
Voltages and currents may vary depending on the desired clinical effect.

Figure 3.5.3 Electro surgical unit [9]

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1. Benefits of Electrosurgical unit:
It is uses to prevent incidence of infection transmission, to reduce bleeding during surgery,
to speed wound healing, and to prevent formation of scars after surgery.
2. The main components:
 Foot switch.
 Electro handle switch.
 Active electrode.
 Electrical power supply.
 Earth plate (double, single).
3. principle of operation:
 Monopolar electro surgery
Monopolar electro surgery can be used for several modalities including cut,
coagulation, and blend. Using a pencil instrument, the active electrode is placed in
the entry site and can be used to cut tissue and coagulate bleeding. The return
electrode pad is attached to the patient, so the electrical current flows from the
generator to the electrode through the target tissue, to the patient return pad and
back to the generator.
Monopolar electro surgery is the most commonly used because of its versatility and
effectiveness.
 Bipolar electro surgery:
Bipolar electro surgery uses lower voltages, so less energy is required. Because it
has limited ability to cut and coagulate large bleeding areas, it is more ideally used
for those procedures where tissues can be easily grabbed on both sides by the
forceps electrode. Electrosurgical current in the patient is restricted to just
the tissue between the arms of the forceps electrode. This gives better control over
the area being targeted and helps prevent damage to other sensitive tissues. With
bipolar electro surgery, the risk of patient burns is reduced significantly. In the most
common techniques, the surgeon uses forceps that are connected to the
electrosurgical generator. The current moves through the tissue that is held between
the forceps. Because the path of the electrical current is confined to the tissue
between the two electrodes.[10]

11
There are three modes of operation and can be produced on command, dependent upon the
waveform issued by the ESU.
1. Cut: A high-frequency alternating current yield smooth, rapid cuts that evoke little to no
homeostasis. The current stimulates cells to swell and explode.

Figure 3.5.4 cut wave: connected, continued and fixed [11]

2. Coagulation: the sparking of tissues leading to coagulation. There is no tissue-

electrode contact; rather, voltage is raised in order to incite a spark between
electrodes in order to coagulate the tissue in between.

Figure 3.5.5 coagulation wave: not connected, continued and decade [11]

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 3. Blend: It is a combination effect of cutting and coagulating; dampened waveform that
produces some homeostasis during cutting.

Figure 3.5.6 cut wave: connected, continued and decade [11]

4.Block diagram
ESU circuit design is made to provide the correct electrical waveforms to be delivered to the site
of surgery to coagulate blood vessels thus cutting tissues in a safe and smooth manner. A
Surgeon may use the electrosurgery unit instead of, or in addition to a conventional scalpel.

When used properly, the electrosurgical unit has a less damaging effect on tissues than
that of a scalpel and allows for a safe way to stop bleeding.
These electrosurgical equipment uses an electric current of an oscillating frequency of
nearly 500 kHz to cut and coagulate tissues. When the electrical current is passed through
the tissue, it gets heated up resulting water evaporation which ultimately destroys
cells. Thus, the process of cutting, clotting, dehydrating blood cells and tissues is
achieved with minimal blood loss.
An alternating current enters into the patient’s that is part of the closed circuit consisting
of a generator, an active electrode, patient, and the patient's return electrode.
A transformer allows generating a high voltage to let the passage of high electric current
that corresponds to the power required for surgical purposes.
The voltage on the electrode is between 1000 to 10000 Volts peak to peak. There are
mainly three modes of functioning for the electronic surgical unit: cutting, coagulation,
and blended mode.[11]

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 Figure 3.5.7 ESU block diagram [11]

5. Troubleshooting:
 Power supply failure.
 Reusable earth failure.
 Control panel failure.
 Hand switch failure.

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Chapter four: The Intensive Care Unit (ICU).
4.1. Definition of ICU
It is a unit in the hospital where seriously ill patients are cared for by specially
trained staff.

4.2. Pre-installations
 The ICU should be easily accessible to the emergency department and surgical units.
Increasingly, it is desirable to site the ICU close to the imaging department. Careful siting
of departments can help to minimize the distances patients are moved.
 The size of ICUs varies from 8 to 13 beds in PRH.
 A supply of compressed air, filtered and free of particles including bacteria, carbon, oil and
water droplets, should be available at a pressure of 4 bar.
 A supply of 100% medical oxygen should be available at a pressure of 4 bar.
 A central medical vacuum supply should be available.
 The ICU should be fully air-conditioned.
 The door system should be sized to permit rapid movement of patients, equipment, and
personnel into or out of the room.

4.3. Main devices within the ICU unit

The main devices within ICU unit can be classified into treating, diagnosing and life
support equipment.
1. Electric bed (Treating device).
2. Air mattress (Treating device).
3. Ventilator (Life supporting machine).
4. Feeding pump (Treating device).
5. Syringe pump (Treating device).
6. Infusion pump (Treating device).
7. Patient monitor (Diagnosing).
8. Defibrillator (Life supporting machine).[12]

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4.3.1. Infusion pump.

An infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is
generally used intravenously, although subcutaneous, arterial and epidural infusions are
occasionally used. And used to give large amounts of medication or fluids during the short period
of time or long according to the needs of the patient by selecting the quantity you want to give it
the patient on the device during certain period of time.[13]

Figure 4.3.1infusion pump [14]

1. Device Parts:
1. LCD screen: user interface Show flow rate, the time, the health of the pumping system,
the amount of battery life remaining and alarm conditions.
2. Air bubble sensor: a typical detector uses an ultrasonic transmitter and receiver to detect
when air is being pumped. Because it is very dangerous to have air inside the blood
vessels. When an air bubble is detected, the device stops and gives an alarm.
3. Drip sensor: it consists of LED and photo detector, used to count the number of drops
passing through the drip chamber to provide flow Feedback and to detect any occlusions.
4. Pressure sensor: detects when the patient's vein is blocked, or the line to the patient is
twisted and if the bag is empty (UP sensor).
5. Door sensor.
6. Pump.
7. Main board.
8. Batteries, so the pump can operate if the power fails or is unplugged.
9. Power supply board.

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2. block diagram

Figure 4.3.2 infusion pump block diagram [15]

An infusion pump for administering fluid from a fluid source to a patient comprises a base member
having an electric motor for driving a fluid pump housed within a cassette detachably mountable
on the base and connectable to the motor. The cassette houses a reciprocative piston and cylinder
assembly which both pumps fluid to the patient while simultaneously drawing fluid from the fluid
source so as to maintain a continuous flow rate of fluid to the patient.
The cassette also houses deformably closable pairs of tubes connecting each of the pump's two
fluid chambers to the cassette inlet and outlet respectively to provide the necessary valving to
produce continuous flow in cooperation with the reciprocative piston and cylinder assembly. The
fluid flow rate is adjustable controlled by a microcomputer which regulates the motor by
repeatedly initiating electric motor driving pulses at a predetermined time rate, and terminating
them in response to the advancement of the motor beyond one of a plurality of predetermined
positions so as to maximize accuracy and reliability of flow rate while compatibly maximizing the
power efficiency of the motor for portable applications requiring a battery power source.[16]

4. Troubleshooting:

Figure 4.3.3 Troubleshooting [71]

17
4.3.2 Air mattress.

When the patient lays on his back for long period, he/she could suffer from an ulcer so,
an air mattress is placed between the patient and the bed to reduce the probability of its
occurrence.
An air mattress contains two groups of air cells (odd and even) which they are inflated
and deflated alternatively by mean of pump placed near the bed. [18]

Figure 4.3.2 air mattress [19]

4.4.1 Troubleshooting.

Air leakage: turn air pump on then find the leakage and fix it using suitable gluey.
Air pump fail: it is rarely happened.

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Chapter five: Laboratory department.
5.1. Definition of laboratory department.
Medical laboratory or clinical laboratory is a laboratory where clinical pathology tests are
carried out on clinical specimens to obtain information about the health of a patient to aid
in diagnosis, treatment, and prevention of disease. [27]

5.2. Main device in this department.

 Blood chemistry.
 Blood gas analyzer.
 Centrifuge.

5.2.1. Centrifuge.

A centrifuge is a motor-driven equipment which is used in hospital laboratories. A

centrifuge prepares body liquid from a patient for further examination.
For diagnosing diseases, the examination of the components of body liquids like blood and
urine are important. Each component has a specific use in the body and therefore a different
test is required. But before particles of body fluids can be examined, they first have to be
extracted from the supporting fluid. This is what the centrifuge does. The liquid samples
are spun around at high speed, which causes large centrifugation forces and consequently
the substances separate due to their different densities. The separated components can then
be examined.

Figure 5.2.1 Centrifuge

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1.Principle of operation.
After some time, the particles from a suspension settle at the bottom of the liquid. This
process is called sedimentation. The driving force of sedimentation is gravity. The
sedimentation process can be accelerated by centrifugation.
The rotation motion of a centrifuge generates a centrifugal force which forces the
substances of the suspension against the walls of the container. Particles with different
density settle at different speeds and get separated as a result.
The centrifugal force is higher, the bigger the radius and the higher the speed of rotation.
The density of the particles in the liquid determines the rate of sedimentation. Dense
particles settle first, lighter particles later.
2. Main components:
 Sample holder: include a blood or urine sample
 Motor: for rotation sample holder.
 Timer: to determine a time of rotation.
 Speed control: by potentiometer to determine a rotation\hours.
 Control board and power board.
 Latch consists of safety switch: is not allowed open door in rotation.[22]

3.Block diagram

Figure 5.2.2 block diagram Centrifuge

The control unit is the heart of the centrifuge, which receives the settings from the control knobs
for the speed and the centrifugation timer. Also, the sensors for the actual speed, an open lid or
an imbalanced load are connected here. The control board processes all this information and then
controls the motor, the brake and the lid lock.

20
4.Troubleshooting:

Figure 5.2.3 troubleshooting [21]

21
Chapter six: Conclusions.
5.1 Practical experience.
From my personal interesting experience for six months I learned how to use my previous
knowledge in practical work, learned some device error and how to fix, learned how to
use some equipment, grow up my knowledge about some electronics components,
learned How to make repair report and how to make tender report.

5.2. Learned lessons.

1. I learned to respect time.
2. I learned how to think for problem and the steps of solving problem.
3. I learned how to be Patient.
4. I learned how to work within a team.
5. I learned Some safety issues.
6. I improve my communication skills.

5.3 Recommendations.
1. For university:
I suggest divide the trainee period for two months in summer semester start from third year or I
suggest make Mandatory two months trainee in summer semester start from third year excepted
those applied.
2. For students:
 Always have your note book.
 Don not be shy of asking any question (it is your chance to learn more).
 Always be patient and take enough time for thinking to achieve good understand.

5.4 My Note on Training.

 Uncomfortable maintenance workstation.
 there was undefined training schedule.
 Some time there was unprofessional way of solving problem.
 Some time there was lack of commitment in safety issues.

22
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