Report on Biomedical Training Done at

Dr. D. Y. Patil hospital and

Research Center, Kolhapur

Duration: 20 February 2023 to 24 April 2023

By:
Suleman Malgave

Under the Guidance of:

Mr. Nikhil Petkar
And
Mr. Shantanu Tilganji
Senior Manager Biomedical

Department, Dr. D. Y. Patil

Hospital and research centre,

Kolhapur.
 Acknowledgement

The internship opportunity I had with Dr.D.Y.Patil Hospital Kadamwadi, Kolhapur, was a great
chance for learning and professional development. Therefore, I consider myself as a very lucky
individual as I was provided with an opportunity to be a part of it. I am also grateful for having a
chance to meet so many wonderful people and professionals who led me through this internship
period.

Bearing in mind previous I am using this opportunity to express my deepest gratitude and special
thanks to the Mr. Nikhil Petkar, Senior Manager Biomedical Department, who in spite of being
extraordinarily busy with her duties, took time out to hear, guide and keep me on the correct path and
allowing me to carry out my project at their esteemed organization and extending during the training.

It is my radiant sentiment to place on record my best regards, deepest sense of gratitude to Mr.
Nikhil Petkar, sir, Mr. Shantunu Sir, Mr. Mandar patil Sir, for their careful and precious guidance
which were extremely valuable for my study both theoretically and practically.

I perceive this opportunity as a big milestone in my career development. I will strive to use gained
skills and knowledge in the best possible way, and I will continue to work on the improvement, in
order to attain desired career objectives. Hope to continue cooperation with all of you in future.
 Index

⮚ Chapter 1: Introduction of Hospital.

⮚ Chapter 2: Organization Structure.

⮚ Chapter 3: Introduction to Biomedical Engineering.

⮚ Chapter 4: Duties of a Biomedical Engineer.

⮚ Chapter 5: Departments in the Hospitals.

⮚ Chapter 6: Anecdotes

⮚ Chapter 7: Special/ Challenging Experiences

 Chapter 1: Introduction of Hospital

⮚ History

Dr. D Y Patil Medical College Hospital& Research Institute, Kadamwadi, Kolhapur is one of the most
renowned tertiary hospitals in the vicinity of Kolhapur District. The hospital was established in the year
2003 under the family of philanthropists and visionary leadership and guidance of Hon. Dr. Sanjay D
Patil. The base line of starting this grand health infrastructure with all ultra modern facilities, situated at
the heart of the city is to provide advance health care to the people of all races and creeds. The name Dr.
D Y Patil Hospital comes from the legendary founder of the D Y Patil Group& the revolutionary
educationalist, Hon. Padmashree Dr. D. Y. Patil (Dada), former Governor of Bihar and Tripura. The
hospital was inaugurated by the erstwhile Congress President Shrimati. Sonia Gandhi.

⮚ Types of service provide

Dr. D Y Patil Medical College Hospital& Research Institute an ISO 9001:2005 is a fully equipped multi
specialty hospital with 14 specialty services, 15 super specialty services, 4 critical care units& state of
the art diagnostic facilities. The Hospital is equipped with ICU-26, CCU-5, PICU-8, NICU-10 and
Casualty ICU-10. There are 13 ultra-modern operation theatres, blood bank with component separator,
pharmacy. All the departments are equipped with all advanced facilities and are manned with trained,
dedicated staff. The well equipped Radiology services include a 3 Tesla MRI, 64-slice CT scan, Doppler
Ultrasound, 2D Echocardiography, DSA, Digital X-rays and Portable X-Ray machines. The Central
laboratory services are of the highest standards. The hospital has four ambulances that are available
24×7 of which one is a designated Cardiac Ambulance and another one is fully equipped with ECG,
Oxygen cylinder, Ambu Bag, Emergency drugs trolley, Monitor with Ventilator and Defibrillator which
serves the needy patients at the most emergency situations. The in house nursing college which provides
5 nursing specialties adds up more technical sophistication for all medical procedures.

Dr. D Y Patil Medical College Hospital& Research Institute has intensive research activities in various
medical fields in collaboration with the Dr. D Y Patil Medical College, Kolhapur. Most important verity
is that the hospital has been a centre for tertiary care engaged in the treatment of complex and advance
health problems. The hospital not only servers local patients but has become a epicenter to provide
comprehensive, affordable, accessible and equitable health care services to the public at large. We strive
hard so the needy people of the society take benefits of free treatments and procedures under the
Mahatma Jotiba Phule Yojana& Pradhanmantri Jan Arogya Yojana. The Hospitals also provides free
treatments for Police personals& retired army personals under the Police Kalyan Yojana & ECHS
scheme respectively. The in house indigent patient fund provides free treatment for the most needed part
 of the society. The hospital also conducts various camps across several parts of the district in which the
focus is to reach the maximum parts of the society.

⮚ Specialty Provided

With advance medical expertise the hospital has following departments to serve the society at large:
Gen. Medicine, Pulmonary Medicine, Psychiatry, Skin& V.D, Pediatrics, Surgery (which includes
Neurosurgery, Pediatric Surgery, Urosurgery & Laparoscopic Surgery), Orthopedics,
Otorhinolaryngology (E.N.T.), Ophthalmology, Anesthesia, Dentistry, Obstetrics Gynecology,
Radiology, Pathology, Microbiology.

⮚ Mission & Vision

✔ Vision-
To provide comprehensive, affordable, accessible and equitable health care services that maximizes safe,
patient-centered and efficient delivery of evidence based medicine relevant to the local community.

✔ Mission-

• Ensure safe, affordable, efficient and patient centered health care at the Dr. D.Y.Patil Medical College,
Hospital And Research Institute.

• Maximize equitable services to the people from all castes, religions and economic backgrounds, including
vulnerable population.

• Participate in preventive and curative health care practices to offer a balanced health care.

• Carry hospital services to the community with aim to contribute in health care of local population.

• To offer training opportunities to Doctors, Nurses and allied health care professionals.

• To provide basis for clinical research that helps in bringing medical advances from laboratory to patients.
 ⮚ QUALITY POLICY

DR. D.Y. Patil Medical College Hospital & Research Institute, Kadamwadi Kolhapur, (DYPH) is committed
to ensure Quality sustenance enhancement & innovation in patient health care with focus on providing
excellence in healthcare services with ethical business practices, honesty & dignity thus we pledge to practice
high standards of medical care through an effective quality improvement system & ensure that the patient is
treated with respect, compassion & affordable health care for the benefit of mankind.

DYPH is committed to undertake all such activities responsible for continual improvement in its Quality
management system & to satisfy applicable requirement.

⮚ DYPH is committed to

• Ensure safe, affordable, efficient and patient centered health care, at DR. D.Y. Patil Medical College
Hospital & Research Institute.

• Maximum equitable services to people from all backgrounds, casts, religions and economic backgrounds
including vulnerable population.

• Participation in preventive & curative health care practice to offer a balanced health care.

• Deliver hospital services to the community with the aim to contribute to the health of the local Population.
Chapter 2: Organization Structure.
 Fig 1.1 : Dr. D. Y. Patil hospital and Research Center, Kolhapur

Chapter 3: Introduction to Biomedical Engineering.

Biomedical engineering (BME) is the application of engineering principles and design concepts to medicine and
biology for healthcare purposes (e.g. diagnostic or therapeutic). This field seeks to close the gap between
engineering and medicine, combining the design and problem solving skills of engineering with medical
biological sciences to advance health care treatment, including diagnosis, monitoring, and therapy. Also
included under the scope of a biomedical engineer is the management of current medical equipment within
hospitals while adhering to relevant industry standards This involves equipment recommendations,
procurement, routine testing and preventative maintenance, through to decommissioning and disposal. This role
is also. Known as a Biomedical Equipment Technician (BMET) or clinical engineering

Biomedical engineering has only recently emerged as its own study, as compared to many other engineering
fields. Such an evolution is common as a new field transitions from being an interdisciplinary specialization
among already-established fields, to being considered a field in itself. Much of the work in biomedical
engineering consists of research and development, spanning a broad array of subfields. Prominent biomedical
engineering applications include the development of biocompatible prostheses, various diagnostic and
therapeutic medical devices ranging from clinical equipment to micro-implants, common imaging equipment
such as MRIS and EKG/ECGs, regenerative tissue growth, pharmaceutical drugs and therapeutic biological.
 Chapter 4: Duties of a Biomedical Engineer.

❖ Biomedical engineers typically do the following:

● Design systems and products, such as artificial internal organs, artificial devices that replace body
parts, and machines for diagnosing medical problems.

● Install, adjust, maintain, repair, or provide technical support for biomedical equipment.

● Evaluate the safety, efficiency, and effectiveness of biomedical equipment.

● Train clinicians and other personnel on the proper use of equipment.

● Work with life scientists, chemists, and medical scientists to research the engineering aspects of
biological systems of humans and animals.

Biomedical engineers may design instruments, devices, and software, bring together knowledge from many
technical sources to develop new procedures, or conduct research needed to solve clinical problems

They often serve a coordinating function, using their background in both engineering and medicine. For
example, in industry, they may create products for which an in-depth understanding of living systems and
technology is essential. Also, they frequently work in research and development or in quality assurance.

Biomedical engineers design electrical circuits, software to run medical equipment, or computer simulations to
test new drug therapies. They also design and build artificial body parts such as hip and knee joints. In some
cases, they develop the materials needed to make the replacement body parts. They also design rehabilitative
exercise equipment.

The work of these engineers spans many professional fields. For example, although their expertise is based in
engineering and biology, they often design computer software to run complicated instruments, such as three-
dimensional x-ray machine alternatively, many of these engineers use their knowledge of chemistry and
biology to develop new drug therapies. Others draw heavily on mathematics and statistics to build models to
understand the signals transmitted by the brain or heart.

Some specialty areas within biomedical engineering include bioinstrumentation; biomaterials; biomechanics,
cellular, tissue, and genetic engineering, clinical engineering, medical imaging, orthopedic surgery;
rehabilitation engineering, and systems physiology.

⮚ Chapter 5: Departments in the Hospitals.

Dr.D.Y.Patil hospital kollhapur is a 1000 bedded, NABH accredited multispecialty boutique hospital. It has
state of art facilities in Cardiology, Neurology, Diagnostic centre and Blood bank. The hospital also offers
treatments for Bone marrow transplant, Joint replacement, Liver transplantation, Cosmetic surgery, Spine
surgery.

Ruby Hall has 3 well equipped operation theaters, Cath lab, Dialysis, Endoscopy, Chemotherapy, NICU, ICU,
OPD, Radiology, Casuality, Laboratory, Blood storage and CSSD. DR .D.Y.patil also provides ambulance and
pharmacy.

5.1Departments in the hospital include:

● Casualty/Emergency Department: Also known as the casualty department, it is a medical treatment

facility specializing in emergency medicine, the acute care of patients who present without prior
appointment, either by their own means or by that of an ambulance.

Equipments:
o Patient monitor
o Ventilator
o ECG machine
 Fig 5.1: Casualty ward.

● Operation Theatre (OT): An operation theatre, also known as an operating room or, is a specialized

facility within a hospital where surgical procedures are performed.

Equipments:
o Anesthesia machine
o Suction machine
o Defibrillator
o OT light
o Sterilizer machine

Fig 5.2: Operation Theatre

● Intensive care unit: This is a specialized department in the hospital that provides intensive care
medicine.
 Equipments:
o Patient monitor
o Syringe pump
o HFNO machine
o Defibrillator

Fig 5.3: ICU

● OPD: An OPD (Outpatient Department) in a hospital typically includes various types of clinics where

patients can receive medical consultations, tests, and treatments without being admitted to the hospital.
Types of OPD:
o Cardiac OPD
o ENT OPD
o Dental OPD
o Gynecology OPD
 Fig 5.4: OPD

● Physiotherapy Department: Physiotherapy is treatment to restore, maintain, and make the most of
patient’s mobility, function, and well-being. Physiotherapy helps through physical rehabilitation, injury
prevention, and health and fitness.

Equipments:
o CPM
o SWD
o IFT
o Traction
o Ultrasound
o IR Lamp

Fig 5.6: Physiotherapy Department

● Pediatric Intensive care unit and Neonatal Intensive care unit (PICU & NICU): PICU stands for
Pediatric Intensive Care Unit. It is a specialized area of a hospital that provides care for critically ill
 children who require constant monitoring and medical attention. The PICU is staffed by a team of
healthcare professionals who are trained to care for children with a wide range of medical conditions,
including respiratory failure, heart failure, sepsis, and traumatic injuries.

Equipments in PICU:
o Patient monitor
o Ventilator
o Weighing scale
o Baby Warmer
o Pulse oximeter with NIBP

Fig 5.7: PICU

● Radiology: It is the department that uses medical imaging to diagnose and sometimes also treat
diseases within the body. A variety of imaging techniques such as X-ray radiography, ultrasound,
computed tomography (CT), nuclear medicine including positron emission tomography (PET), and
magnetic resonance imaging (MRI) are used to diagnose and/or treat diseases.
 Fig 5.8: MRI Room

5.2 Department of Casualty

❖ Patient Monitor

● Use of Bedside monitor: Patient monitors are used for continuous measurement of patient

parameters such as heart rate and rhythm, respiratory rate, blood pressure, blood-oxygen
saturation and many other parameters to take care of critically ill patients.
 Fig 5.9: Patient Monitor

● Technical Specifications :

Brand GE B105M

Cost Rs. 2,70,000

Dimensions 312 x 352 x 158 mm

Humidity Range 15 % to 95 % Relative

Humidity (RH) (non
condensing)
Weight 7 Kg

Display Size 12.1 inch

● Operating Procedure of Bedside monitor :

1. Ensure power cable is properly connected.

2. Ensure proper placement of batteries (in case of DC supply).
3. Turn ON the equipment by using ON button on unit.
4. Connect all the probes and electrodes to the patient as per requirement.
5. Ensure their firm connection at machine end.
6. Check whether all the required parameters are displayed on screen or not.
7. If not, go to the settings and make changes as per requirement. This may Include,
8. Display or Hide the particular parameter, display colour settings
9. Alarm settings: Its limits, its volume
10. Patient information Backup settings
11. Understand the nature of the fault, if any.
12. Approach the fault location.
13. Test all the predicted locations to find the fault.
14. Recover the fault.

● Maintenance of Bedside monitor:

1. Clean machine regularly

2. Check and clean the filter
3. Wipe the monitor
4. Check the water traps
5. Calibrate per manufacturer’s specifications
6. Check electrical safety of machine
7. Check all cables
8. Check the power supply
9. Check all knobs
10. Check electrodes

● Safety Precautions to be followed:

1. Handle equipment’s carefully to prevent permanent damage

2. Maintain bedside monitor carefully.
3. Use the appropriate maintenance steps and correct troubleshooting of the monitor.
4. Connect the probes properly to monitor and also to the patient.

● Maintenance Schedule: 6 to12 Months.

5.3 Department of Operation Theater(OT)

❖ Anesthesia machine

● Use of Anesthesia Machine:

An anesthesia machine is used in hospitals to deliver a controlled amount of anesthesia to patients

during surgical procedures. Anesthesia is a medical treatment that involves the use of drugs to block
pain and other sensations, allowing a patient to undergo a surgical procedure without feeling any
discomfort.
The anesthesia machine is also responsible for delivering oxygen and other gases to the patient’s
lungs while under anesthesia, as well as removing carbon dioxide and other waste gases. The
machine contains various components, including a ventilator to help the patient breathe, a vaporizer
to deliver the anesthetic agents, and monitoring devices to measure the patient’s vital signs and
ensure their safety during the procedure.

Fig 5.10: Anesthesia machine.

● Technical Specification:

Company GE 9100c NXT

Cost Rs. 4,05,000

Weight/Height 140kg/145cm
TV 20 to 1500 ml

Breathing Frequency 4 to 99 bpm(non-spontaneous)

2 to 60 bpm(spontaneous)
Flow Trigger 0.2-10 L/min
 PEEP Off,4-25 cmH2o
I/E Ratio 2:1 to 1:8
Pressure Limiting (Pmax) 10-99 cm H2O
Inspiratory pressure(Pinsp) 5 to 50 cmH2O

● Operating Procedure of Anesthesia machine:

1. Plug the power cord into an electrical outlet.

2. Check that the breathing circuit is properly connected.
3. Turn the system Standby/On switch to On
4. Check gas supply & their pressure.
5. Check the vaporizers to ensure they are properly filled & calibrated.
6. Connect the tubing’s to the machine & then connect the tubing’s to the patient through the mask.
7. Set ventilator to the patient.
8. Connect the probes of 7 Para patient monitor to the patient.
9. Set the flow range of O2, N2O, & air also set sevoflurine.
10. Start anesthesia machine.
11. After completing operation slowly reduce the administration of anesthesia.
12. And then power OFF the machine.

● Maintenance of Anesthesia Machine:

1. Remove any dust/dirt with dry cloth.

2. Remove water and waste matter from inside.
3. If seal, plug, cable or socket is damaged, replace.
4. Apply lubricant to any moving parts that require it.
5. Check and calibrate the anesthesia machine’s settings and sensors.
6. This includes the flow meters, pressure gauges, and vaporizer settings.
 ● Maintenance Schedule: 6 to12 Months.

5.4 Department of Gynecological

❖ Cautery Machine.

● Use of Cautery

Electro surgery is the application of a high-frequency electric current to biological tissue as a means to stopping
bleeding, removing abnormal tissue, cut, coagulates, desiccate, or fulgurate tissue. Its benefits include the
ability to make precise cuts with limited blood loss in hospital operating rooms or in outpatient procedures.
Cautery, or electrocautery, is the application of heat to tissue to achieve coagulation.
 Fig 5.11: Cautery Machine.

● Technical Specifications :

Company Xcel Lance

Model name/number Shalya

Cost Rs. 1,20,000

Size/Dimension 380 x 140x 470 mm

Weight 7 kg
Automation Grade Automatic
No. of Program 09

Power fail memory Yes

Voltage 220 V

● Operating Procedure of Cautery Machine:

1. Check the accessories such as power cord, electrodes, patient plate & foot switch.
2. Connect the supply cord to 230V, 50Hz AC mains.
3. Connect the pencil cautery & neutral plate to the machine.
4. Keep the neutral plate below the area where surgical operation is needed.
5. Switch ON the machine.
6. Select the program for operation.
7. Select the mode for operation as cutting or coagulation as per the electrode.
8. Press the footswitch according to the mode selected, yellow for cutting & blue for coagulation mode at
the time of cutting or coagulation respectively.

● Maintenance of Cautery Machine:

1. Remove any dust and unplug, clean outside with damp cloth and then dry off.
2. Check all fittings and cables are properly connected.
3. Inspect filters, clean or replace if needed.
4. Check proper operation of all Controls, indicators and visual.

● Safety Precautions to be followed:

1. The cautery machine should be handled carefully to avoid accidental burns or injuries.
2. Machine should be kept away from flammable materials to prevent fires.
3. The machine should be properly grounded to prevent electrical shocks.
4. The machine should be stored in a clean and dry place when not in use.

● Maintenance Schedule: 6 to12 Months.

5.5 Department of Intensive Care Unit(ICU)

❖ Ventilator
 ● Use of Ventilator

A ventilator is a medical device that provides mechanical breathing support to patients who are unable to
breathe on their own or who require assistance to breathe. Ventilators are commonly used in hospitals,
particularly in intensive care units (ICUs), to help patients who are critically ill or undergoing certain medical
procedures.

Fig 5.12: Ventilator.

● Technical Specifications :

Model name Extend XT

 Brand Air Liquid

Cost Rs 12.05 lakh

Patient Age Group Paediatric, Adult

Machine Weight 27 kg

Ventilation Mode VCV, PCV, V-SIMV & P-

SIMV, PSV,CPAP, DUO-
LEVEL, APRV, PEEP,
CPAP, VCV-NIV, PCV-
NIV, SIMV-NIV, PSIMV
Inspiratory/Expiratory(I:E) 1:0.3-1:50.0
Ratio

● Operating Procedure of Ventilator :

1. Switch ON the unit.

2. Check the proper storage of gases.
3. Select the mode.
4. Set the amount and pressure of oxygen.
5. Connect the patient breathing system.
6. Start the ventilator.
7. Check for any alarm due to leakage or insufficient gas supply or any other emergency.
8. Switch OFF the machine at the end of the procedure.

● Maintenance of Ventilator:

1. Regular Inspection of Ventilators.

2. Never Neglect the Signs of Damage.
3. Examine the Batteries of Venilators
4. Regular Disinfections
5. Clean and Change the Filters.

● Maintenance Schedule: 6 to12Months.

 ❖ ECG Machine

● Use of ECG Machine

An ECG is used to see how the heart is functioning. It mainly records how often the heart beats (heart
rate) and how regularly it beats (heart rhythm). It can give us important information, for instance about
possible narrowing of the coronary arteries, a heart attack or an irregular heartbeat like atrial fibrillation.

Fig 5.13: ECG Machine.

● Technical Specification:

Brand BPL

Cost Rs. 97,000

Model Number/Name 9108

Display Digital

Battery Built-In rechargeable

14.8V,Li-ion
Battery,2500mAh
Dimensions 420mmx330mmx105mm

Machine Type Portable

Keyboard QWERTY Alphanumeric

● Maintenance of ECG Machine:

1. Regularly clean the cables and lead wires.

2. Make sure the ECG leads are separated from each other.
3. If your ECG machine has a built in printer make sure the paper is inserted as per the
manufacturer’s instructions.
4. Make sure any printer rollers are clean- you can use an alcohol wipe to remove
debris/dust.

● Maintenance Schedule: 6 to12 Months.

 5.6 Department of PICU

❖ Baby Warmer

● Use of baby warmer:

Warmth is provided by an overhead heat lamp and a heated mattress in infant warmers. The purpose of these
devices is to deliver warmth from beneath the infant. Infant warmers allow for easy access to neonates who
require immediate medical assistance while maintaining a comfortable temperature.

Fig 5.14: Baby Warmer.

● Technical Specification:

Company Phoenix

Cost Rs. 50,000

Power Supply 220-240V AC

Heater Output 650 Watts

Fuse 5 Amp

Dimensions 1800mm×800mm×900mm

Weight 70kg approx.

Wattage 400W

Display Type 2x16 LED

● Operating procedure of baby warmer:

1. Connect the power cable to the plug and then turn on the machine.
2. Then, set the machine to manual mode. Set the power to the highest level for the quick heating of the
baby tray, bed sheets, and other kinds of clothes used in it.
3. Then set the machine to the servo mode. Set the temperature to 36.5°C
4. Place the baby on the baby tray.
5. Connect the temperature sensor to the skin of the abdomen of the baby with tape.
6. No need to turn on the observation lamp while the baby is not under observation. An observation lamp is
only necessary during the treatment or observation of the baby.
7. Regularly record the temperature of the baby.
8. Turn off the heating rod if there is no need to operate the machine.
9. Set the time if there is an option in the machine.
● Maintenance of baby warmer:

1. Check for signs of physical damage or abuse.

2. Check for evidence of fluid spills.
3. Check for secure mounting.
4. Check casters/brakes/mounting.
5. Check AC plug/cord/receptacle.
6. Check strain relief at both ends of cord.
7. Check controls/switches.
8. Check caution/operation labels present & legible.
9. Check filters, Clean/replace as needed
10. Check power-on sequence.
11. Test all audible & visual alarms and indicators.
12. Clean interior/exterior as required.
13. Check all the nuts and bolts are tight.
14. Run a demo test before using it on baby.

● Things to be considered while using the skin probes

1. Do not touch the tip of the probe with your nail.

2. Do not apply probe on the wet skin surface.
3. Do not apply probe on the bruised skin.
4. Do not apply the probe to the plastic dressing.
5. Attach the tip of the sensor, on the baby, with the help of the tape of 2-3 inch length. Make sure
that the tip of the sensor is not exposed to the environment.
6. Check the position of the probe regularly. If the probe comes out of the skin of the baby, the
sensor will detect the lower temperature of the atmosphere. Hence, the warmer will deliver a
higher amount of heat in servo mode. So, the baby may have to face the condition of
hyperthermia.

● Maintenance Schedule: 6 to12 Months.

 ❖ Defibrillator:

● Use of Defibrillator:

Defibrillators are devices that send an electric pulse or shock to the heart to restore a normal heartbeat. They are
used to prevent or correct an arrhythmia, an uneven heartbeat that is too slow or too fast. If the heart suddenly
stops, defibrillators can also help it beat again.

Fig 5.15: Defibrillator.

● Technical Specifications:

Company BPL

Cost 1.32 lakh

Screen Type LCD
Power Supply 100 to 230 V AC

On off Control Yes

Screen Size 5.7 inch

Weight 10.5 kg

Capacity of energy level 230 joule

● Operating Procedure of Defibrillator:

1. Switch ON the defibrillator.

2. Select the manual mode or synchronous mode using mode selector switch.
3. Select the energy by using energy selector switch.
4. Wait for some time till the beep is heard.
5. Observe indicator and confirm the capacitor is charged.
6. Discharge energy by pressing buttons on paddles at apex and other at sternum.

● Safety Precautions to be followed:

1. Handle equipment’s carefully to prevent permanent damage.

2. Do not touch the victim while defibrillating.
3. Do not use alcohol to wipe the victim’s chest dry.
4. Maintain Defibrillator machine carefully.
5. Use the appropriate maintenance steps and correct troubleshooting of the machine.
6. Connect the electrode properly and select the appropriate charge.

● Maintenance Schedule: 6 to12Months.

 5.7 Department of Dialysis

❖ Dialysis Machine

● Use of Dialysis Machine:

With hemodialysis, a machine removes blood from your body, filters it through a dialyzer (artificial kidney) and
returns the cleaned blood to your body. This 3- to 5-hour process may take place in a hospital or a dialysis
center three times a week. You can also do hemodialysis at home.
 Fig 5.16: Dialysis.

● Technical Specification:

Company AVS Healthcare

Brand oCm
Cost 6 Lakh
Resolution 20mmHg
Dimension 1370x480x480nm
Model Name/Number 4008s
Operation Mode Automatic

● Operating Procedure of Dialysis machine:

1. The dialysis machine should properly clean and disinfected and all necessary supplies are
available.
2. The patient data is taken and access site for dialysis is cleaned and prepared.
3. The access site is connected to tubing, then draws blood from the patient and pumps it through
dialyzer a filter that removes waste and excess fluid.
4. Dilacerate is prepared that helps filter the blood which is prepared according to patients needs
and is heated to appropriate temperature.
5. The blood is taken from artery and passes to dialyzer.
6. And filtered blood is return through vein to the body.
7. Excess waste is removed back side of machine in the can.

● Maintenance of dialysis machine:

 1. Produce fresh dilacerate.
2. Provide correctly prepared dilacerate to the dialyzer.
3. Remove fluid from the patient by ultra filtration.
4. Handle & monitor spent dilacerate.
5. Operate & control the extracorporeal circuit.

● Maintenance Schedule: 6 to12 Months.

5.8 Department of Radiology

❖ CT Machine

● Use of CT scan machine:

A computerized tomography (CT) scan combines a series of X-ray images taken from different angles around
your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels
and soft tissues inside your body. CT scan images provide more-detailed information than plain X-rays do.
 Fig 5.17: Computerized tomography (CT)

● Technical Specifications:

Company Optima
Cost 1,45,00,000
Number Of Slices 128- Slice
Brand GE Healthcare
Machine Condition New
Gantry Rotation 0.058 msec
Model Name/Number 660
Operation Mode Automatic
Rotation Speed 0.35 sec
No of Channel Detector 64
 ● Operating Procedure of CT scan machine:

1. On the main power supply of CT machine

2. Press the Gantry Enable switch to start the machine.
3. The patient should lie down on table, if necessary contrast dye may injected into vein to
enhance the image through injector.
4. Move to the console and start the computer system.
5. Select the option “tube burn” if the system is started after long time.
6. Press the “move to scan” button.
7. Press the “start scan” button.
8. Press the “stop scan” button.
9. Press the “home” button to take the patient table to its original place after the scan.

● Maintenance of CT machine:

1. Clean the exterior and interior of the CT machine using dry cloths and appropriate cleaning
agent.
2. CT machine should be calibrated regularly.
3. Check the movement of CT table.
4. Check the angle between CT table and gantry.
5. Check the gantry movement.
6. CT machine software should be updated regularly.
7. Regular radiation safety checks should be conducted.
8. Check interfacing between CT machine and control room.

● Maintenance Schedule: 6 to12 Months.

 ❖ MRI Machine:

● Uses of MRI machine:

Magnetic resonance imaging (MRI) uses a large magnet and radio waves to look at organs and
structures inside your body. Health care professionals use MRI scans to diagnose a variety of
conditions, from torn ligaments to tumors. MRIs are very useful for examining the brain and
spinal cord.
During the scan, you lie on a table that slides inside a tunnel-shaped machine. Doing the scan can
take a long time, and you must stay still. The scan is painless. The MRI machine makes a lot of
noise. The technician may offer you earplugs.

Fig 5.18: MRI Machine.

● Technical Specifications:

Magnetic Strength 3 Tesla (T)

Cost 1,45,00,000
Magnet Type Supercon
Brand Philips
Machine Condition New
 Bore Size 70 cm
Model Name/Number Ingenia 3.0T
Max. Amplituid 45 mT/m/s
Max. Slew Rate 220 T/m/s
Magnet weight 4600 kg

● Operating Procedure of MRI machine:

1. Remove all metallic and magnetic field susceptible objects

2. Switch on the MR gradients hardware, the gas scavenger, and the animal heat ventilation
unit in the MR electronic room
3. Unlock and enter MRI magnet room turn on lights and perform a quick visual inspection
of the 3T MRI scanner, its accessories, and the general state of the room. Clean if
necessary.
4. Turn on the heating unit.
5. Select and install the appropriate animal scan bed.
6. Check that the RF coil is appropriate for the scan subject, study, and scan bed. The coil
should be appropriately tuned, matched, and connected prior to scanning.
7. Assemble all the necessary scanner preparation materials ensuring that all the necessary
components are readily available. Replenish items as necessary.
8. Prepare any additional components necessary for the scan as per the particular
experimental protocol (AUP)
9. At the MRI console in Room, open desktop PC and configure the settings for the
 respiration, temperature, and any additionally monitored vital signs as outlined in the
particular experimental protocol.

● MRI Safety and Conduct:

1. Be sure to remove all metallic objects and magnetic sensitive materials (e.g. data cards and
cards with magnetic strips) before entering the MRI magnet room.
2. Persons with defibrillators, pacemakers, insulin pumps, dosage devices for medication,
metallic prostheses or implants, are restricted from gaining access to the MRI magnet room.
3. In order to gain access, all personnel and/or collaborators who will need to enter the MRI
magnet room must first complete a MR safety orientation at the SAIL.

Chapter 6: Anecdotes
6.1 Breakdown maintenance of Sphygmomanometer:

Problem: Tube of sphygmomanometer was broken and Mercury Level was less.

Cause: The Sphygmomanometer was dropped by someone.

Action Taken: We replaced the tube and refilled the mercury in it.
 Fig 6.1: Sphygmomanometer.

6.2 Breakdown maintenance of Pulse Ox meter:

Company: BPL

Problem: Display was not getting on.

Cause: Strip connected to display was departure.

Action Taken: We opened the machine and visually inspect the machine then we realized connection
was not proper so we connected the strip to display.
 Fig 6.2: Pulse Ox meter.

6.3 Breakdown maintenance of Nebulizer:

Company: BPL.

Problem: The nebulizer was not generating pressure.

Cause: Shaft of motor was departure.

Action Taken: We visually inspect the machine then we realized shaft was fallen so
we reattached it.

Fig 6.3: Nebulizer.

6.4 Breakdown maintenance of Patient Monitor:

 Company: GE.

Problem: The display was not getting on.

Cause: Keypad of monitor was damaged.

Action Taken: We visually inspect the machine then we realized that the power button of keypad was
damaged.

Fig 6.4: Patient Monitor.

6.5 Breakdown maintenance of Ventilator:

Company: Air Liquid Healthcare.

Problem: Display was showing Flow meter was not connected.

 Cause: Dust particles was stuck in Flow Meter.

Action Taken: We removed flowmeter from ventilator then we disassembled it and cleaned it using
Ultrasonic cleaner then, let it dry for 4 hours then we assembled it and connected to ventilator and taken
performance test.

Fig 6.5: Disassembled Flow Meter.

Fig 6.6: Assembled Flow Meter.

Chapter 7: Special/ Challenging Experiences

7.1Sonography Machine
Manufacturer: Philips

Model: IU-22

Fig 7.1: Sonography Machine.

Ultrasonography is a form of body imaging using sound waves to facilitate making a medical diagnosis.

A transducer, or probe, is used to project and receive the sound waves and their echoes. A gel is wiped onto the
patient's skin so that the sound waves are not distorted as they cross through the skin. This may take a fair
amount of time and require the probe to be repositioned and pointed in different directions. As well, the
technician may need to vary the amount of pressure used to push the probe into the skin.
 ❖ The quality of the picture depends on many factors:

● Sound waves cannot penetrate deeply, and an obese patient may be imaged poorly.

● Ultrasound does poorly when gas is present between the probe and the target organ. Should the
intestine be distended with bowel gas, organs behind it may not be easily seen. Similarly, ultrasound
works poorly in the chest, where the lungs are filled with air. Ultrasound does not penetrate bone
easily.
● The accuracy of the test is very much operator dependent this means that the key to a good test is the
ultrasound technician.
● Ultrasound can be enhanced by using Doppler technology which can measure whether an object is
moving towards or away from the probe. This can allow the technician to measure blood flow in organs
such as the heart or liver, or within specific blood vessels.

7.2Syringe Pump:

Manufacturer: Smiths Medical

Model: Graseby 2100

Fig 7.2: Syringe Pump.

A syringe pump is a small infusion pump (some include infuse and withdraw capability), used to gradually
administers small amounts of fluid (with or without medication) to a patient or for use in chemical and
biomedical research.
Syringe pumps are small pumps operated by driving a syringe via a very precise motor.
Changing the syringe allows a wide range of flow rates on the same pump.
They are used for infusion, infusion & withdrawal and continuous flow applications.
 In a syringe pump, fluid is held in the reservoir of a syringe, and a moveable piston controls fluid delivery.
Syringe pumps are also useful for delivering IV medications over several minutes.
While using the syringe pump the safety measures must be kept in check.
Common error that occurs in syringe pump is occlusion error which can be fixed by flushing out the drug a
little bit and connecting to the patient again.

7.3 X-ray Machine:

Manufacturer: DRX Evaluation

Model: Carestream

Fig 7.3: X-ray Machine.

An X-ray generator is a device that produces X-rays Together with an X-ray detector; it is commonly used in a
variety of applications including medicine, fluorescence, electronic assembly inspection, and measurement of
material thickness in manufacturing operations. In medical applications, X-ray generators are used by
radiographers to acquire x-ray images of the internal structures (eg. bones) of living organisms, and also in
sterilization.

X-ray machines are used in health care for visualizing bone structures, during surgeries (especially orthopedic)
to assist surgeons in reattaching broken bones with screws or structural plates, assisting cardiologists in locating
blocked arteries and guiding stent placements or performing angioplasties and for other dense tissues such as
tumors. Non-medicinal applications include security and material analysis.
The main fields in which x-ray machines are used in medicine are radiography, radiotherapy, and fluoroscopic
type procedures.

X-ray machines are used to take pictures of dense tissues such as bones and teeth. This is because bones absorb
the radiation more than the less dense soft tissue. X-rays from a source pass through the body and onto a
photographic cassette. Areas where radiation is absorbed show up as lighter shades of grey (closer to white).
This can be used to diagnose broken or fractured bones. In fluoroscopy, imaging of the digestive tract is done
with the help of a radio contrast agent such as barium sulfate, which is opaque to X-rays.

7.4Microscope:

Manufacturer: Olympus

Model: BX

Fig 7.4: Microscope.

A microscope is a laboratory instrument used to examine objects that are too small to be seen by the naked eye.
Microscopy is the science of investigating small objects and structures using a microscope. Microscopic means
being invisible to the eye unless aided by a microscope.

There are many types of microscopes, and they may be grouped in different ways. One way is to describe the
method an instrument uses to interact with a sample and produce images, either by sending a beam of light or
electrons through a sample in its optical path, by detecting photon emissions from a sample, or by scanning
across and a short distance from the surface of a sample using a probe. The most common microscope (and the
first to be invented) is the optical microscope, which uses lenses to refract visible light that passed through a
thinly sectioned sample to produce an observable image. Other major types of microscopes are the fluorescence
microscope, electron microscope (both the transmission electron microscope and the scanning electron
microscope) and various types of scanning probe microscopes.

7.5 HOT AIR OVEN:

Manufacturer: REMI

Model: ROHO 50

Fig 7.5: HOT AIR OVEN.

Hot air ovens are electrical devices which use dry heat to sterilize. They were originally developed by Louis
Pasteur. Generally, they use a thermostat to control the temperature. Their double walled insulation keeps the
heat in and conserves energy, the inner layer being a poor conductor and outer layer being metallic. There is
also an air filled space in between to aid insulation. An air circulating fan helps in uniform distribution of the
heat. These are fitted with the adjustable wire mesh plated trays or aluminum trays and may have an on/off
rocker switch, as well as indicators and controls for temperature and holding time. The capacities of these ovens
vary. Power supply needs vary from country to country, depending on the voltage and frequency (hertz) used.
Temperature sensitive tapes or biological indicators using bacterial spores can be used as controls, to test for the
efficacy of the device during use.

7.6Ultrasound Doppler

Manufacturer: Dipel

Model: DFM-051
 Fig 7.6: Ultrasound Doppler.

o Technical Specifications –

● Frequency: 2 MHz

● Intensity: <10 mW/sq.cm

● Heart Rate: 60–220 BPM

● Input: 230V, 50 Hz

● Mains & Battery operated: (6 Dry Cells Eveready 1050 type)

An ultrasound doppler machine is used to evaluate blood flow in the body. It uses high-frequency sound waves
to create images of blood vessels and measure the speed and direction of blood flow. The machine is commonly
used in the following medical fields:

1. Obstetrics: The machine is used to monitor fetal heart rate and blood flow during pregnancy.

2. Cardiology: The machine is used to evaluate blood flow in the heart and detect abnormalities such as
blockages or narrowing of arteries.
 3. Vascular surgery: The machine is used to assess blood flow in arteries and veins before and after
surgery.

4. Neurology: The machine is used to evaluate blood flow in the brain and diagnose conditions such as
stroke or aneurysm.

5. Oncology: The machine is used to detect blood flow in tumors and evaluate the effectiveness of cancer
treatments.

Overall, the ultrasound doppler machine has become an essential tool in medical diagnosis and treatment,
providing non-invasive and accurate assessments of blood flow in the body.

7.7Electroencephalograph (EEG)
 Fig 7.7: Electroencephelograph

EEG (electroencephalography) 24 leads is a method of measuring and recording the electrical activity of the
brain using a set of 24 electrodes attached to the scalp. The electrodes are arranged according to the
international 10-20 system, which is a standardized method of electrode placement that ensures consistency
across different EEG recordings.

The 24 electrodes are arranged in a specific pattern, with some electrodes located on the midline of the scalp
and others located on the left and right sides. The electrode placement is based on the location of specific areas
of the brain that are associated with different functions such as language, movement, and vision.

During an EEG recording, the electrodes pick up electrical signals generated by the brain's neurons, which are
then amplified and recorded by the EEG machine. The signals are then displayed on a computer screen or
printed on paper in the form of a graph, with each electrode representing a specific area of the brain.

The EEG 24 leads system allows for a more detailed and comprehensive recording of brain activity than a
standard 10-20 EEG, which typically uses 19 electrodes. With 24 electrodes, the EEG can provide more
accurate information about the location and timing of brain activity, making it useful for diagnosing and
monitoring a wide range of neurological conditions such as epilepsy, sleep disorders, and brain injuries.

In addition to diagnostic applications, EEG 24 leads can also be used in research to study brain function and to
develop new treatments for neurological disorders. The detailed information provided by the EEG 24 leads
system can help researchers understand how different parts of the brain work together and how they are affected
by various stimuli such as light, sound, and touch.

Overall, EEG 24 leads is a valuable tool in the diagnosis, monitoring, and research of neurological conditions
and brain function. The information provided by the system can help healthcare providers make more accurate
diagnoses and develop more effective treatments, ultimately improving outcomes for patients