Oxygen Therapy, Respiratory and

Monitoring
Medical Device Training

For Biomedical Engineers and Technicians

Facilitator Manual

October, 2023
Addis Ababa, Ethiopia
Forward

Oxygen is an essential medicine that is used to treat a variety of health conditions, including
pneumonia, heart failure, and asthma. If left untreated, these conditions can lead to high
morbidity and mortality. Oxygen is also a critical component of health service provision for
maternal and newborn health, child health, prehospital and acute care, surgical care, inpatient
medical care, and the treatment of infectious respiratory diseases such as COVID-19.
The MOH in its five years Health Sector Transformation Plan (HSTP) and medical oxygen road
map II prioritized improving equitable access and management to quality health services to all
segments of the country. To realize this transformational agenda, and oxygen road map the
ministry devised multiple initiatives including strengthening of emergency medical services and
expansion of ICU services, which all of these require adequate availability of oxygen.
It is important to take good care of them and employ timely preventive maintenance to keep
them working last long and decrease downtime. The proper handling and maintenance of these
oxygen therapy, respiratory and monitoring devices can be achieved by deploying the well
trained and competent Biomedical Engineers/ Technicians to the respective health facilities. In
line with this, it is also important to provide continuous on job training to build their capacity and
introduce them to a new technology. Therefore, this training package is developed to provide
basic and ToT for biomedical education training provider institute instructors as well as
professional who are working at health facilities.
Finally, I would like to take this opportunity to thank all stakeholders who participated in the
development of this oxygen therapy, respiratory and monitoring devices training material.

Regasa Bayisa (B.Pharm, MSc)

Pharmaceutical and Medical Device Lead Executive officer
Ethiopian Federal Ministry of Health, Ethiopia
Approval Statement of the Ministry

The Federal Ministry of health of Ethiopia has been working towards standardization and
institutionalization of In-Service Trainings (IST) at national level. As part of this initiative the
ministry developed a national in-service training directive and implementation guide for the
health sector. The directive requires all in-service training materials fulfill the standards set in the
implementation Guide to ensure the quality of in-service training materials. Accordingly, the
ministry reviews and approves existing training materials based on the IST standardization
checklist annexed on the IST implementation guide.
As part of the national IST quality control process, this operating room medical devices IST
training package has been reviewed based on the standardization checklist and approved by the
ministry.

Assegid Samual Cheru

Human Resource for Health Development and Improvement Lead Executive Office
Ethiopian Federal Ministry of Health, Ethiopia

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Acknowledgment

The Federal Ministry of Health would also like to acknowledge the enthusiastic participation and
technical support of all the national Oxygen Therapy, Respiratory and Monitoring Medical
Device Training manual development workshop team members along with their organizations
who made the development of this training manual a reality.
The Ministry would like to thank and acknowledge CHAI and Jhpiego RISE project for the
financial and technical support in the preparation of this oxygen therapy, respiratory and
monitoring devices participant’s training manual.
Last but not least, we extend our heartfelt gratitude to the first document developer experts and
following reviewer listed health professionals for their valuable contributions and for their active
role in the preparation of this medical oxygen therapy and monitoring devises training manual.
S. No Team members Position Organization
1 Addisu Fayera Senior BME MOH PMD-LEO
2 Alemu Abibi Chief BME MOH PMD-LEO
3 Dinaol Desalign Chief BME CHAI
4 Dr. Meiraf Mulugeta Multi Sectorial Coordinator MOH PMD-LEO
5 Fraol Tamiru Senior BME St. Lukas Hospital
6 Hamza Shukri Senior BME MOH PMD-LEO
7 Mahdi Abdella Medical Device Desk Head MOH PMD-LEO
8 Megersa Kebede Chief BME CHAI
9 Samuel Tadesse Senior BME Jhpiego RISE
10 Tariku Mulugeta Chief BME TBH
11 Tolera Geremew Senior CPD Expert MOH HRD-LEO
12 Wondafrash Million Senior Expert BME CHAI
13 Zewdalem Melesse BME Team Leader AACAHB

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List of acronyms and abbreviation

CPAP Continuous Positive Airway Pressure

LCD Liquid Crystal Display
PPE Personal protective equipment
CPU Central Processing Unit
FHR Fetal Heart Rate
RF Radio Frequency
BP- Blood Pressure
CO2 - Carbon dioxide
ECG- Electrocardiography
EtCO2 - End-tidal carbon dioxide
FiO2 - Fraction of inspired oxygen
HR- Heart Rate
I: E - Inspiratory and expiratory ratio
IBP- Invasive Blood Pressure
MV- Minute volume
O2 - Oxygen
PH - potential of hydrogen
N2O - Nitrous oxide
NIBP- Non-Invasive Blood Pressure
PEEP- positive End-expiratory pressure
TV- Tidal volume
Cm H2O – centimeter of water
CMV- Control Mandatory Ventilation
ACMV- Assist Control Mandatory Ventilation
SIMV- Spontaneous Intermittent Mandatory Ventilation
CPAP - Continuous Positive Airway Pressure
Ppeak, Ppause, Pmean - Pressure peak, pressure pause, pressure mean
PEEPH- Positive End Expiratory Pressure High
PEEPL - Positive End Expiratory Pressure Low BPM - Breath Per Minute
RR - Respiration rate LPM - Litter Per minute

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PSI - Pound Per Square Inch
SPO2- Blood oxygen saturation level
ABG arterial blood gas
BME/T Biomedical Engineer/Technician
CO2 carbon dioxide
CPAP continuous positive airway pressure
COPD chronic obstructive pulmonary disease
ERV expiratory reserve volume
ESA Ethiopian Standards Agency
FRC functional residual capacity
GMS Gas management system
HEPA high-efficiency particulate arrestance
HTM Healthcare Technology Management
IC inspiratory capacity
ICU Intensive care unit
IR Infrared
IRV inspiratory reserve volume
kPA kilopascals
LMIC low and middle-income countries
MGMS medical gas management system
PSA pressure swing adsorption
psi pounds per square inch
RHB Regional Health Bureau
RV residual volume
TLC total lung capacity
TSA thermal swing adsorber
TV tidal volume
UPS uninterruptible power supply
VC vital capacity
WHO World Health Organization
LCD Liquid Crystal Display

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CPU Central Processing Unit
MCU Microcontroller Unit
ADC Analog-to-Digital Converter
IBF Interpolation Beam Forming
RF Resonant Frequency
HV High Voltage
HT High Tension
TFT Thin Film Transistor
CCD Charge-Coupled Device
MOS Metal Oxide Semiconductor
CCD Charge-coupled device
TFT Thin film transistors

Oxygen Therapy and monitoring Devices Training Manual Page | vi

Introduction to the manual

Oxygen is an essential medicine that is used to treat a variety of health conditions, including
maternal and newborn health, child health, prehospital and acute care, surgical care, inpatient
medical care, and infectious respiratory diseases such as COVID-19. If left untreated, these
conditions can lead to high morbidity and mortality.
Ethiopia’s systems for oxygen therapy are insufficient. This has been further strained by the
surge in demand for oxygen during the COVID-19 pandemic, resulting in even less availability
of this critical resource. This emphasizes the need for robust systems to support oxygen access
and therapy. The administration of oxygen is an essential element of appropriate management for
a wide range of clinical conditions. It is included on the World Health Organization (WHO) list
of essential medicines and can be used for treatment of multiple acute and chronic cases related
to respiratory illness including COVID- 19 pandemic and other conditions which include trauma,
safe surgery, anesthesia, and obstetric care. While medical oxygen therapy device management is
expected to be maintained at all levels by trained Biomedical engineers and technicians.
However, due to different reasons medical oxygen management, maintenance, calibration and
capacity building is affected by multiple challenges.
Different survey indicated that there is very limited technical knowledge on how to maintain
oxygen therapy devices, lack of training for technical and user; lack of spare parts in the local
market and service providers, lack of planned calibration, preventive, and corrective maintenance
that resulted in non-functionality of oxygen therapy devices at service delivery points. MoH
conducted a rapid assessment of the current challenges in relation to oxygen therapy device
management which revealed that there are significant non-functional oxygen therapy devices.
Previous developed oxygen therapy training materials is not comprehensive and not included
range of oxygen therapy devices. This training document provides the knowledge and skills
necessary to handle, operate and maintain oxygen therapy devices safely and effectively. The
document is describing the purpose and clinical application, working principle, basic part and
their function, safety procedures, troubleshooting, and maintenance schedules of medical oxygen
therapy devices.
In response to these challenges which are identified in the areas of medical oxygen therapy
devices utilization and maintenance, PMD LEO in collaboration with CHAI and Jhpiego revised
this training manual to equip the required competencies for biomedical engineers and other

Oxygen Therapy and monitoring Devices Training Manual Page | vii

technical practitioners at health facilities to improve and strengthen management of medical
oxygen therapy devices and handling in order to deliver safe, effective, and efficient service
delivery.
The following are the core competency of this training manual:
 Describe working and operation principle of oxygen therapy, respiratory and monitoring
medical devices.
 Perform installation and commissioning of the oxygen therapy, respiratory and monitoring
medical devices.
 Apply troubleshooting techniques of the oxygen therapy, respiratory and monitoring
medical devices.
 Preform preventive and corrective maintenance of the oxygen therapy, respiratory and
monitoring medical devices.
 Perform proper handling and safe use of the oxygen therapy, respiratory and monitoring
medical devices.

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Course Syllabus

Course description: These 5 days course is designed to equip Biomedical engineers and
technicians with basic working principles, purposes, components and function, troubleshooting
techniques, preventive and corrective maintenance skill, and safety procedures for Oxygen
Therapy, Respiratory and Monitoring Medical device.
Course goal:
 To improve participants competency on proper utilization, installation and maintenance
Oxygen Therapy, Respiratory and Monitoring Medical device
Participant learning objectives:
At the end of this course, participants will be able to: -
 Describe purpose and clinical application of oxygen therapy, respiratory and monitoring
medical devices.
 Explain working principle and function of components of oxygen therapy, respiratory
and monitoring medical devices.
 Demonstrate installation and commissioning and safe handling of oxygen therapy,
respiratory and monitoring medical devices.
 Perform troubleshooting techniques and maintenance for oxygen therapy, respiratory
and monitoring medical devices.
Training Methods:
 Brainstorming
 Interactive lectures
 Group discussion
 Individual reflection
 Question and answer
 Practical demonstration and exercise
Training material and instrument
 Facilitator’s guide
 Participant manual
 Power point presentation

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  LCD projectors
 White board and marker
 Flip chart and marker
 Computer
 E-learning materials
 Video
 Inspection and performance checklist
Participant Selection Criteria
 Participant for this course should be Biomedical engineers/technician or professional with
relevant field working at public health facility and administrative offices working on
medical device management.
Facilitator/Trainer Selection
 The facilitator shall be selected from the training material developing technical team.
 Trainers of this material shall have training of trainer (TOT) level training with have
experience in adult learning techniques.
 Professionals who received basic training skill and training facilitation skill.
Methods of evaluation
Trainees/participant Evaluation
Formative
 Direct observation of participant daily activities
 Individual activities and presentations
 Pre-test
 Group exercises
Summative
For Basic Training
 Review of trainee’s work using assignments – 10%
 Practical Session with demonstration checklists - 50%
 Written Exam (Post Test- 40%)
For TOT training
 Teach back – 30%
 Practical assessment – 50%

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  Post Test - 20%

Certification Criteria
 Certificates will be provided to basic training trainees who have scored 70% and above
on summative assessment and attended 100% of the course.
 For TOT trainees, certificate shall be provided to those who have scored 80% and above
on summative assessment and attended 100% of the course.
Course Evaluation
 Daily Evaluation
 End of training evaluation
 Participant oral feedback
 Practice evaluation
Course duration:
 For basic training 5 days and for TOT training 7 days.
Suggested Class Size
 Suggested training class size shall not be more than 20 participants for basic and ToT 20
per training venue.
 Four trainers each staying for the whole duration of the training are needed for each
training session.
Training Venue
 Nationally accredited CPD centers having appropriate facilities, with functional medical
equipment maintenance workshop.
Continuing Educational Unit (CEUs)=15 CEUs

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 Course schedule:
Day Time Activities Responsibl Facilitato
e r
One 8:30-9:30am Registration and Introduction
9:30-10:45am Opening and Pre-test
10:45-11:00 Tea break
11:00-12:30 oxygen concentrators presentation
12:30-2:00 Lunch
2:00-3:45pm oxygen concentrators Practical
3:45-4:00 Tea break
4:00- 4:45 oxygen concentrators Practical
4:45-5:30 Medical oxygen cylinder

Two 8:30-10:45am Pulse oximeter Presentation and Practical

10:45-11:00 Tea break
11:00-12:30 Patient monitoring system presentation
12:30-2:00 Lunch
2:00-3:45pm Practical Patient monitoring system
3:45-4:00 Tea break
4:00-5:30 Practical Patient monitoring system

Thre 8:30-10:45am CPAP Presentation

e
10:45-11:00 Tea break
11:00-12:30 CPAP Presentation and Presentation
12:30-2:00 Lunch
2:00-3:45pm Mechanical Presentation
3:45-4:00 Tea break
4:00-5:30 Mechanical Presentation

Four 8:30-10:45am Mechanical Presentation

10:45-11:00 Tea break
11:00-12:30 Mechanical Presentation
12:30-2:00 Lunch
2:00-3:45pm Practical Mechanical
3:45-4:00 Tea break

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4:00-5:30 Practical Mechanical

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Chapter One: Oxygen Concentrator
Time: 4:00 hrs.
Chapter description:
This chapter describes the working principle, purpose, components, safe handling, and
troubleshooting of oxygen concentrators and its accessories to ensure a continuous supply of
quality medical oxygen.
Chapter Objective:
At the end of the chapter, participants will be able to handle, operate, and maintain oxygen
concentrators.
Enabling Objectives:
• Describe the purpose.
• Explain the working principles.
• Identify basic part and its functions.
• Demonstrate the safe use and handling of oxygen concentrators and,
• Apply troubleshooting techniques and conduct proper maintenance on oxygen
concentrator and flow splitter.
Materials:
 Participant manual
 LCD
 PPT presentation
 Service manuals
 Oxygen concentrator
 Tool kits
 Video for demo
 Inspection and performance checklist
 PPE
Preparation:
 Read Participant manual.
 Prepare PPT and other training aids.
 Materials needed (oxygen concentrator and Flow splitters)

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Activity Summary
Topic Methods Time (min) Resource
Introduction to oxygen concentrators Interactive Power point
presentation 15 Flip chart
Group discussion
The purpose of oxygen concentrators in Interactive Power point
health care settings presentation 15 Flip chart
Exercise
The basic components and working Interactive Power point
principles of oxygen concentrator. presentation Flip chart
40
Exercise Video demo
Group discussion Oxygen concentrator
Flow splitters Interactive Power point
presentation 20
Group discussion
Oxygen concentrator installation Interactive Power point
presentation 20 Flip chart
Skills lab Oxygen concentrator
Safe handling of oxygen concentrators Interactive Power point
15
presentation Flip chart
Preventive Maintenance Interactive Power point
presentation 45 Flip chart
practical Oxygen concentrator
Trouble shooting techniques Interactive Power point
presentation Flip chart
60
practical
Group discussion
Chapter summary Q and A 10 Last slide

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 Learning activities
# Time
Topic Activities
(min)
1 Introduction to Start the session by activity 1.1 Individual Reflection
oxygen Displaying the chapter objectives,
15
concentrators Explain the oxygen concentrator and summarize the
session using
2 The purpose of Provides an interactive presentation on the purpose of
oxygen oxygen concentrator in health care setting, ppt and flip
15
concentrators in chart
health care settings Summarize the session
3 The basic Start the session with activity 1.2: Think, pair and share,
components and use slide
working principles provides an interactive presentation on the working
40
of oxygen principle and components of oxygen concentrators,
concentrator. Summarize the session

4 Flow splitters Start the session with activity 1.3: Think, pair and share,
use slide
20
Provides an interactive presentation using on flow
splitters, operation and adjustment.
6 Oxygen Start the session by providing an interactive
concentrator 20 presentation on the installation,
Installation Summarize the session with safety concern of the device
7 Safe handling of Start the session by providing an interactive
oxygen 15 presentation on safe handling of oxygen concentrators
concentrators and flow splitters,
8 Preventive Start the session by providing an interactive presentation,
Maintenance 45 Provide the practical session on maintenance types.
Summarize the session through question and answer

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9 Trouble shooting Start the session by helping the participants to do the
techniques group discussion using activity 1.4. Group discussion,
provides an interactive
60
Provide practical session on troubleshooting techniques,
practical maintenance and repair.
Summarize the session using question and answer
10 Chapter summary 10 Summarize the main point using power point

Answer to Learning activities

Activity Activity
Answer
number description
1.1 What is oxygen An oxygen concentrator is a self-contained, electrically driven medical
concentrator, device that uses ambient air by separating the oxygen from nitrogen to
describe purpose produce up to 90–96% through a technique known as pressure swing
and clinical adsorption (PSA). It provides a safe, less expensive, relatively reliable,
application? and cost-efficient source of oxygen, which is more cost-effective than
oxygen cylinders, particularly in low-resource settings. It can provide a
continuous supply of oxygen for up to two patients at the same time when
used with flow splitters or flow meters.
1.2 Explain working
principle of the
oxygen
concentrator and
components?

1.3 Explain working The oxygen flow splitter is a device intended to distribute medical oxygen
the function of from a source to multiple independent outlets. It can be connected to any
flow splitter and low-pressure oxygen source, including concentrators, cylinders, and a
how to use? centralized system, and is suitable for tabletop or wall mounting.

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 When there are multiple patients requiring oxygen therapy but there are a
limited number of oxygen concentrators, while the available concentrators
have the performance to supply more oxygen, an oxygen flow splitter is
used. The flow splitter is connected to the oxygen concentrator and can
divide the supplied oxygen up to 5 with low flow.
1.4 Being in a group If the oxygen concentrator has an issue, it will have to be assessed for a
of five, discuss problem or a fault that requires repair or replacement of parts that
and reflect completely shut down the unit. In this case, the device will be
troubleshooting disassembled using appropriate tools based on the manufacturer's
techniques, basic guidelines. Applying the medical equipment troubleshooting techniques,
failures and share the faulty part(s) should be fixed to restore function. It is important that
your earlier troubleshooting be carried out in a slow, controlled, and methodical way.
experience to the
group.

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Chapter Two: Medical Oxygen Cylinder
Time: 4 hrs.

Chapter description:
This chapter describes the purpose, working principle, and maintenance of medical oxygen
cylinders
Chapter Objective:
By the end of this chapter, participants will be able to perform safe handling, troubleshooting and
maintenance of medical oxygen cylinder
Enabling Objectives:
After completing this chapter, the participant will be able to:
 Describe the purpose and clinical application of medical oxygen cylinders
 Explain the working principle, basic components and accessories of medical oxygen
cylinders and their functions
 Identify type and sizing of medical oxygen cylinder
 Demonstrate safe handling of medical oxygen cylinders
 Demonstrate troubleshooting techniques
 Perform maintenance on medical oxygen cylinders
Materials:
 Participant manual
 PPT presentation
 Medical gas cylinders
 Tool kits
 Video/simulation
 Inspection and performance checklist
 PPE
Preparation:

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  Read Participant manual
 Prepare PPT and other training aids.

Activity summary
Time Resource
Topic Methods
(min.)
Introduction to medical oxygen Individual Reflection Power point (3-5)
10
cylinders Interactive presentation Flip chart
Use of medical oxygen cylinders in Interactive presentation Power point (5)
5
health care settings Group exercise Flip chart
Types and sizes of medical oxygen Power point (6-14)
Interactive presentation
cylinders Flip chart
Group discussions and 15
Medical oxygen cylinder of
individual exercise
different size
Oxygen cylinder accessories and Power point (15-16)
functions Interactive presentation Flip chart
20
Question and answer Flow and pressure regulator
with cylinder
Oxygen cylinder operating instructions Interactive presentation Power point (17-19)
Demonstration 20 Flip chart
Question and answer Medical oxygen cylinder
Oxygen cylinder handling and safety Power point (20-22)
Interactive presentation
Flip chart
Demonstration 40
Video demonstration
Question and answer
Medical oxygen cylinder
Trouble shooting Power point (23)
Interactive presentation
Medical oxygen cylinder
Video Demonstration 30
toolkits
Individua Exercise
Video demonstration
Oxygen cylinder maintenance Interactive presentation 90 Power point (24-28)

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 Group and Individual Medical oxygen cylinder
Exercise Tool kits
Summary Q and A 10 Power point (29)

Learning Activities
# Time
Topic Activity
min.
1 Introduction to medical Start the session by displaying the chapter
oxygen cylinders description and objectives, use slide number 3.
Display activity 2.1 using slide number 4 and guide
10 to execute.
Provide the answer to the activity and through
defining medical gas cylinders using slide 5 and
summarize the session using slide number 5
2 Purpose and Clinical Explain the to the participants about purpose and
Application medical clinical application of medical oxygen use slide
5
oxygen cylinders in number 5 and flip chart
health care settings Summarize the session with slide number 5.

3 Types and sizes of Start the session by helping the participants to do the
medical oxygen group discussion using activity 2.2, use slide number
cylinders 6 provide 5 min to do the exercise and explain the
15
cylinder duration calculation formula and help them
to do exercise using activity 2.3 slide number 7-14.
Summarize the session with question and answer.
4 Oxygen cylinder Support the participants to distinguish Oxygen
accessories and cylinder accessories and functions by explain how
20
functions the accessories works using slide number 15-16.
Summarize the session through question and answer
5 Oxygen cylinder 20 Explain procedurally to the participants about
operating instructions Oxygen cylinder operating instructions use slide
number 17-19

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 Demonstrate the operating procedure on medical
oxygen cylinder
Summarize the session through question and answer
6 Oxygen cylinder Elaborate oxygen cylinder handling and safety to the
handling and safety participants use slide number 20-22
Demonstrate cylinder handling and safety to
40
participants on medical oxygen cylinder
Summarize the session using question and answer
use
7 Trouble shooting Start the session by describe to the participants
Trouble shooting techniques of oxygen cylinders use
slide number 23.
30
Demonstrate the trouble shooting exercise and Use
tool kits and cylinders to do practical exercise
Summarize the session using question and answer
8 Oxygen cylinder Display slide 24-28 and discuss oxygen cylinder
maintenance maintenance
90 Guide the participants to perform Oxygen cylinder
maintenance using tool kits
Summarize the session through question and answer
9 Summary Summarize the main point using power point slide
10
number 29.

Answer to Learning activities

Activity Activity description Answer
number
2.1 What do you know Medical oxygen cylinders are part of oxygen therapy and are used
about the function of to store supplemental oxygen1. They are used when a person has
a medical cylinder? a lung condition or difficulty breathing1. The oxygen in these
cylinders may be in gas or liquid form.
2.2 In group of five Based on facility type, infrastructure, service mode and other

Oxygen Therapy and monitoring Devices Training Manual Page | 9

 discuss and reflect factors and referring to different international and national
how do you materials.
determine the N
Cylinder Code AZ C D E J AF F G
o
appropriate cylinder
1 Nominal contents (L) 170 170 340 680 6800 1360 1360 3400
size for your facility? 2 Nominal pressure 137 137 137 137 137 137 137 137
cylinder (bar)

6 Water capacity (L) 1.2 1.2 2.3 4.7 47.2 9.4 9.4 23.6

7 Nominal weight full (Kg) 2.5 2.5 3.9 6.5 78 12 17 39

2.3 Calculate duration in Based on the above formula we are given with:
minute of a 50 L a. Cylinder volume in liter= 50L
Oxygen cylinder b. Cylinder pressure in bar= 200bar in psi =2900 psi
which is filled at 200 c. Flow rate= 5 LPM
bar and administered d. Residual constant to be left in the cylinder- 200 psi
at a flow rate of e. Pressure after subtracting residual and converted to bar=
5LPM. 186bar
Duration= ((186*50))/5= 1860 minute~31 hrs.

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Chapter Three: Pulse Oximetry
Duration: 3 hrs.
Chapter description:
This chapter describes the purpose, working principle, maintenance, safe handling and of pulse
oximeter
Chapter Objective:
By the end of this chapter, the participants will be able to handle, operate and maintain pulse
oximeter.
Enabling Objectives:
After completing this chapter, the participant will be able to:
 Describe the purpose & clinical application
 Explain the working principle
 Identify basic parts and functions
 Demonstrate safe handling
 Demonstrate troubleshooting
 Perform maintenance
Materials:
 Participant manual
 PPT presentation
 LCD/LED display
 Laptop,

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  Marker Flip chart,
 Pulse oximeter
 Service manuals
 Tool kits
 Video/simulation
 Inspection and performance checklist
 PPE

Preparation:
 Read Participant manual
 Prepare PPT and other training aids.

Activity summary
Topic Methods Resources
Time (min)
Think in pair Power point (4-5)
Introduction to Pulse
Interactive 10 Flit chart
Oximeter
presentation
Purpose and clinical Power point (6-8)
Interactive
application of pulse 15 Flit chart
presentation
oximeters
Group discussion Power point (9-10)
Interactive Flit chart
Working principles of
presentation 30 Video simulation
pulse oximeters
Group exercise

Group discussion Power point (11-16)

Basic parts and function of Interactive Flit chart
pulse oximeters 25
presentation Video simulation
Group exercise Pulse oximetry
Group discussion 25 Power point (17-18)
Safe handling of pulse

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 Interactive Flit chart
presentation Video presentation
oximeter
Group exercise Pulse oximetry
Interactive Power point (19-20)
Pulse oximeter presentation Flit chart
40
troubleshooting group and individual Pulse oximetry
Exercise
Interactive Power point (21-25)
Preventive & corrective
presentation Flit chart
maintenance of pulse 30
group and individual Pulse oximetry
oximetry
Exercise
Power point (26)
Summary Q and A 5
Flit chart

Learning Activities
# Time
Topic Activity
(min.)
1 Introduction to medical Displaying the chapter objectives, use slide number 3
oxygen cylinders Start the session by activity 3.1 pair reflection using
10 slide 4
Introduce the participants what pulse oximery is
using slide number 5
2 Purpose and clinical Explain the participants about purpose and clinical
application of pulse application of pulse oximetry, use slide number 6-9
15
oximeters and flip chart Summarize the session with question
and answer
3 Working principles of 30 Start the session by helping the participants to do the
pulse oximeters group discussion using activity 3.2, use slide number
9, provide 10 min to do the exercise and explain
pulse oximeter working principle. Conduct an
interactive lecture regarding the working principle

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 using slide number 10
summarize the session with question and answer
4 Basic parts and their Start the session by helping the participants to do the
function of Pulse group of four and discussion using activity 3.3, use
oximeters slide number 11, provide 10 min to do the exercise
and identify basic parts of pulse oximeter
Conduct an interactive lecture regarding the working
25 principle using slide number 12-16
Explain different types of pulse oximeter using slide
number 12
Explain different types of pulse oximeter probe
connectors using slide number 15 & 16
Summarize the session with question and answer
5 Safe handling of pulse The facilitator explains procedurally to the
oximeters participants pulse oximeter safe handling using slide
number 17 & 18
25
Demonstrate safe handling of pulse oximeter using
the device Summarize the session with question and
answer
6 Troubleshooting of Start the session by helping the participants to do a
pulse oximetry group of four and discussion using activity 3.4, use
slide number 19, provide 25 min to do the
40 troubleshooting of pulse oximeter
The facilitator explains some troubleshoot methods
by using slide number 20
Summarize the session with question and answer
7 Preventive & corrective 30 Start the session by guiding the participants
maintenance of pulse preventive maintenance procedures of pulse oximeter
oximetry using slide number 21-25 & toolkits
Guide the participants to perform Oxygen cylinder
maintenance using tool kits

Oxygen Therapy and monitoring Devices Training Manual Page | 14

 Summarize the session with question and answer
9 Summary Summarize the main point using power point slide
5
number 26

Answer to Learning activities

Activity Activity Answer
number description
3.1 Be in pair and A pulse oximeter is a medical device used to measure the
discus what you oxygen saturation level of a person's blood. It also measures the
know about pulse rate. It typically consists of a small clip-like device that
pulse oximeter attaches to a person's finger, earlobe, or toe. The pulse oximeter
uses light sensors to detect how much oxygen is being carried
by the red blood cells and provides a digital reading of the
oxygen saturation level, which is displayed as a percentage. It is
commonly used in hospitals, clinics, and homes to monitor
oxygen levels and pulse rates in people with respiratory
conditions, such as chronic obstructive pulmonary disease
(COPD) or heart conditions.
3.2 Being in a Group A pulse oximeter operates based on the principle of
of four and spectrophotometry. It consists of a probe that is typically
explain the clipped onto a patient's fingertip or earlobe, and it emits two
working different wavelengths of light, usually red and infrared light,
principle of pulse into the body tissue. The probe then measures the amount of
oximetry light absorbed by the oxygenated and deoxygenated hemoglobin
in the blood. Since oxygenated hemoglobin absorbs light
differently than deoxygenated hemoglobin, the pulse oximeter
can determine the oxygen saturation level by comparing the

Oxygen Therapy and monitoring Devices Training Manual Page | 15

 ratio of absorbed light at different wavelengths. Additionally,
the pulse oximeter also measures the pulsatile changes in blood
flow caused by the heartbeat, providing heart rate information.
Overall, by analyzing the differences in light absorption and
blood flow, the pulse oximeter can accurately assess a person's
oxygen saturation level and pulse rate.
3.3 Being in a Group Sensor: The sensor is the part of the oximeter that usually
of five and attaches to a person's finger, toe, or earlobe. It contains two
discuss the basic light-emitting diodes (LEDs) and a photo detector. The LEDs
parts and their emit red and infrared light into the skin, while the photo
function of pulse detector measures the amount of light that passes through the
oximeter tissue.
Display: The display is where the readings are shown. It can be
a digital screen or a set of LED indicators. The display typically
shows the oxygen saturation level as a percentage (%SpO2), the
pulse rate in beats per minute (BPM), and sometimes a
waveform or a plethysmogram.
Power Source: Pulse oximeters can be battery-operated or
rechargeable. Some models also offer USB or wall socket
charging options.
Control Buttons: The oximeter may have control buttons that
allow the user to switch it on/off, adjust settings, or view
previous readings. The buttons can include power, menu, and
navigation keys.
Alarm System: Many pulse oximeters come with an alarm
system that alerts the user when oxygen saturation levels fall
below or rise above a certain threshold. This feature is
particularly useful for monitoring patients with respiratory
conditions.
3.4 Group in to four
1. Inaccurate readings: The device may display incorrect oxygen
and list common
saturation (SpO2) levels or heart rate measurements.

Oxygen Therapy and monitoring Devices Training Manual Page | 16

failures in pulse
Recommendations to fix the failures:
oximetry device
- Ensure proper placement: Verify that the oximeter sensor is
and then
positioned correctly on the patient's finger, earlobe, or other
recommend
appropriate location as per the device's instructions. Re-adjust if
actions to be
necessary.
taken to fix the
- Quality sensor: Check the condition of the sensor and replace
failures.
it if it is damaged or worn out.
- Cleanse the area: Clean the patient's finger or site of sensor
placement to remove any dirt, oil, or sweat that may interfere
with accurate readings.
- Patient movement: Advise the patient to remain still during
measurements, as excessive movement can affect accuracy.
- Device calibration: Some devices require periodic calibration
by the manufacturer or authorized service centers. If available,
consider calibrating the device as recommended.
2. Weak signal strength: The oximeter may struggle to detect
the pulse signal, leading to unreliable or intermittent readings.
Recommendations to fix the failures:
- Check battery levels: Ensure the batteries are fully charged or
replace them if necessary. Low battery levels can affect the
device's signal strength.
- Positioning: Re-position the sensor carefully to obtain a
stronger pulse signal. Try different locations if the initial
placement doesn't yield a good signal.
- Sensor contact: Confirm the sensor is making proper contact
with the patient's skin and that it is not loose or slipping. Adjust
or replace the sensor if needed.
- Sensor cleanliness: Clean the sensor to remove any debris or
buildup that might affect signal transmission.
- Patient condition: Some patients with weak pulses or poor
circulation may present challenges in obtaining a strong pulse

Oxygen Therapy and monitoring Devices Training Manual Page | 17

 signal. In such cases, utilizing alternative sensor placement
locations (e.g., earlobe, toe) might be helpful.
3. Device malfunction: The pulse oximeter may exhibit overall
failure, including issues with power, display, or connectivity.
Recommendations to fix the failures:
- Power supply: Check the batteries or power source, ensuring
they are functional and properly connected. Replace batteries or
switch power sources if needed.
- Restarting the device: Sometimes, a simple restart can resolve
issues. Turn off the pulse oximeter, wait a few seconds, and
then turn it back on.

Oxygen Therapy and monitoring Devices Training Manual Page | 18

Chapter Four: Patient Monitoring System
Time: 6hrs.
Chapter description:
This chapter discuss the working principle, purpose, main components and their functions,
troubleshooting techniques, maintenance and safety procedures for Patient Monitoring System.
Chapter Objective:
By the end of this session, the participants will be able to know how to handle, operate and
maintain patient monitoring system
Enabling Objectives:
After completing this chapter, the participant will be able to:
 Describe the purpose and clinical application of patient monitoring system
 Explain the working principle of patient monitoring system
 Differentiate basic parts and function of patient monitoring system
 Apply safe handling and proper operating procedure of patient monitoring system
 Demonstrate troubleshooting technique
 Perform preventive and corrective maintenance of patient monitoring system
Materials:
 Participant manual
 Facilitator Manual
 PPT presentation
 Patient monitoring system
 Tool kits
 Video/simulation
 Inspection and performance checklist

Oxygen Therapy and monitoring Devices Training Manual Page | 19

 Preparation:
 Read participant manual
 Read facilitator manual
 Read existing PPT, other training aids and Prepare your PPT
 Refer additional sources on patient monitoring system maintenance
Activity Method of delivery Time Resource
(min)
Introduction  Individual reflection 20 Slide number (3)
 Interactive presentation
Purpose and clinical application of  Group discussion 20 Slide number (4-5)
patient monitoring system  Interactive presentation

Working Principle of Patient monitoring  Individual 40 Slide number (6-9)

system  Interactive presentation
Basic Parts and Function of Patient  Group exercise 40 Slide number (10-14)
monitoring system  Interactive presentation
Safe handling Procedure for Patient  Group discussion 30
monitoring system  Interactive presentation Slide number (15-16)

Troubleshooting techniques and Repair  Group discussion 40 Slide number (17-20)

of Patient monitoring system  Interactive presentation
 Practical demonstration

Maintenance Procedure for Patient  Group discussions 160 Slide number (20-24)
monitoring system  Interactive presentation
 Video demonstration
 Practical maintenance

Oxygen Therapy and monitoring Devices Training Manual Page | 20

Summary  Interactive presentation 10 Slide number (25)

Activity summary

Learning Activities
Topic Time Activity
(min)
Introduction 20  Help participants to form group of five
 Guide them to discuss on patient monitoring system
 Introduce patient monitoring system to the trainer

Purpose and clinical 20  Guide participant to form group and discuss on patient monitoring system
application of patient  Assist participant to reflect on patient monitoring system
monitoring system  Provide interactive lecture and explain the purpose and clinical
application of patient monitoring system
Working Principle of 40  Ask participants to explain the working principle of patient monitoring
patient monitoring system
system  Ask participants to list and discuss the Bio-signal types and processing
 Explain the working principle of the patient monitoring system using
diagram
 Provide interactive lecture on Bio-signals and processing
Basic Components 40  Split participants in to groups of five to discuss patient monitoring system
and Function of basic pats and their function
patient monitoring  Guide to discuss and provide clarification on basic components ad
system functions
 Explain the patient monitoring system basic parts and its function using
appropriate material: video and pictures
Safe handling 30  Guide how to putting the patient monitoring system into operation.
Procedure for Patient  Explain how to connecting cables and accessories to patient monitor
monitoring system  Introduce trainer the appropriate safe handling procedures for each of

Oxygen Therapy and monitoring Devices Training Manual Page | 21

 patient monitoring system components
 Discuss correct working order and operating condition of patient
monitor

Troubleshooting 40  Direct participants to form a group and discuss and explain steps of
techniques of patient troubleshooting
monitoring system  Define troubleshooting steps, and discuss specific scenarios related with
patient monitoring system
 State and discuss common component patient monitoring system failures
 Guide participants to perform practical troubleshooting on patient
monitoring system
Maintenance 160  Assist participants to form group of five and discuss practical scenarios of
Procedure for Patient preventive and corrective maintenance of P.M.S,
monitoring system  Explain preventive and corrective maintenance activities related with
patient monitoring system
 Guide Participants to share their experience encountered on working area.
 Arrange the participants in a group and conduct practical maintenance
Summary 10  Ask participant to summarize the whole session

Answer to Learning activities

Activities Solution
Activity 4.1 Patient Monitoring devices are used to monitor patient ‘s physiological parameters such as
Electrocardiogram (ECG), respiration rate (RESP), blood oxygen saturation level and
carbon dioxide (SPO2 and CO2), noninvasive and invasive blood pressure (NIBP and
IBP), and temperature (TEMP) continuously in a dynamic and longtime range. It is used in
various hospital rooms such as Operation Room, Coronary Care Unit, Intensive Care Unit,
and Neonatal Intensive Care Unit, Emergency room and on Triage to provide vital
diagnostic information to medical and nursing staff about the physiological condition of
the patients.
Activity 4.2 A patient monitoring system is a medical device that is used to monitor and record various

Oxygen Therapy and monitoring Devices Training Manual Page | 22

 physiological parameters of a patient. The purpose of a patient monitoring system is to
provide continuous and accurate data on a patient's vital signs, such as heart rate, blood
pressure, respiratory rate, oxygen saturation, and temperature.
In addition to critical care settings, patient monitoring systems can also be used in non-
critical care settings such as ambulatory care, home care, and long-term care facilities. In
these settings, patient monitoring systems can help healthcare providers to monitor patients
remotely and provide personalized care. Patient monitoring system is a system for the
acquisition of patient parameters, which are processed and presented in an instantly
recognizable form on a variety of displays, these parameters include the continuous
noninvasive monitoring of the electrocardiogram, respirations, arterial oxygen saturation
level (SPO2), arterial CO2 level, blood pressure (NIBP) and temperature. Insertion of
specialized catheters enables continuous invasive monitoring of arterial blood pressure
(IBP), central venous pressure, pulmonary arterial pressure, right and left atrial pressure,
intracranial pressure and intermittent calculations of stroke volume, systemic and
pulmonary vascular resistance, and cardiac output. Arrhythmia detection algorithms are
the first advances to take advantage of improved computer power and use real time R
wave and ventricular arrhythmia detection algorithms to identify and detect cardiac
ventricular arrhythmias with a sufficient sensitivity and specificity.
Patient monitoring systems are widely used in hospitals, clinics, and other healthcare
settings to monitor patients who are critically ill, undergoing surgery, or recovering from
an illness or injury.
Activity 4.3 The working principle of a patient monitoring system involves the use of sensors that are
attached to the patient's body to measure various physiological parameters. These sensors

are connected to a monitor or a computer system that displays the data in real-time. The
sensors used in patient monitoring systems can vary depending on the parameter being
measured. For example, a pulse oximeter sensor is used to measure oxygen saturation,
while an electrocardiogram (ECG) sensor is used to measure heart rate and rhythm.
The data collected by the sensors is transmitted to the monitor or computer system through
wired or wireless connections. The monitor or computer system then processes the data
and displays it in a visual format for healthcare professionals to interpret

Oxygen Therapy and monitoring Devices Training Manual Page | 23

 Patient monitoring systems can also include alarms and alerts that are triggered when
certain parameters fall outside of normal ranges.

Activity 4.4 1. Handle

 Hidden Handle
2. Physiological Alarm Indicator Lamp
 Red with a high flicker frequency: a high-level alarm.
 Yellow with a low flicker frequency: a middle-level alarm.
 Constantly yellow without flicker: a low-level alarm.
 Blind: no physiological alarm.
3. Display Screen
 Where the result is displayed
4. Power Switch
 Turn on: press this button to start the monitor after A.C. power connection.
 Shut down: press this button to shut down the working monitor (the shut-
down time lag depends upon the manufacturer's preset).
5. Battery Power Indicator Lamp
 On: power is supplied by the battery.
 Off: battery is not in use.
6. Battery Charging Indicator Lamp
 Battery is charged: Lights flickers;
 The charge is finished: Lights steadily;

Oxygen Therapy and monitoring Devices Training Manual Page | 24

  Power is supplied by the battery: Light is off.
 Battery is absent: Light is off.
7. Alarm Silencing Button
 Press this button to silence an alarm will be displayed in the information
region. Other sounds (such as button pressing and ORS tones) will not be
affected.
8. Alarm Pausing Button
 Press this button to pause an alarm will be displayed in the information
region. Press it again to restore the alarm.
9. Freezing Button
 Press this button to freeze the waveform on the screen under a failure-free
operation mode. Press it again to release the frozen waveform.
10. Recording Button
 If the monitor is equipped with a recorder, press this button to record the
real-time waveforms. Press it again to stop the recording.
11. NIBP Button
 Press this button to start or stop NIBP measurement.
12. Main Menu Button
 If the main menu has not been displayed on the screen, press this button to
show the main menu; if the main menu has already been displayed on the
screen, you can return to the home screen by pressing this button.
13. Shuttle
 Rotating: the cursor can be moved by rotating the shuttle clockwise or
counter-clockwise.
 Pressing: some menus can be entered or some functions can be chosen by
pressing the pushbutton.

Oxygen Therapy and monitoring Devices Training Manual Page | 25

Chapter Five: Continuous positive Airway Pressure machine
Duration: 6hrs

Chapter description:
This chapter describes the purpose, working principle, and maintenance, of CPAP machines.
Chapter objective:
By the end of this session, the participants will be able to: to know how to handle, operate and
maintain CPAP machine.
Enabling Objectives

 By the end of this chapter the participants will be able to:

 Describe the purpose and clinical application of CPAP machine.
 Explain the working principle.
 Identify basic components
 Apply safe handling and proper operating procedure.
 Demonstrate troubleshooting techniques.
 Perform preventive and corrective maintenance.
Materials:
 Participant manual
 Facilitator manual
 PPT presentation
 Video/simulation
Preparation:
 Read participant manual.
 Refer additional sources on CPAP machine maintenance.

Oxygen Therapy and monitoring Devices Training Manual Page | 26

Topic Methods Time min Resource
Individual reflection Power point (3-4)
Introduction to CPAP
Interactive lecture 10 Flip chart
Purpose and clinical Group discussion Power point (5-7)
application of CPAP Interactive lecture 30 Flip chart

Group discussion Power point (8-9)

Working Principle of CPAP
Interactive lecture 40 Flip chart
Basic components and Individual reflection Power point (10-12)
function Interactive lecture 40 Flip chart

Group discussion
Safe handling and proper Power point (13-15)
Interactive lecture
operating Flip chart
Practical demonstration 80

Group discussion Power point (16-19)

Troubleshooting techniques Interactive lecture Flip chart
and maintenance Video demonstration LCD
Practical maintenance Video
Interactive lecture 150 Maintenance tools

Power point (20)

Summary
Interactive lecture 10 Flip chart

Activity summary

Oxygen Therapy and monitoring Devices Training Manual Page | 27

 Learning Activities
Topic Time(min)
Introduction
Purpose and clinical
application of CPAP
Working Principle of CPAP
Basic Parts/Components
and Function of CPAP
Preventive maintenance
Troubleshooting techniques
and Repair of CPAP
Oxygen Therapy and monitoring Devices Training Manual
Activity
 Help participants to think individually and reflect on the
CPAP machine.
10
 Then after 5 minutes display the PPT. slide number…
 Introduce CPAP machine to the trainer display the PPT.
 Guide participant to form group and discuss on CPAP.
Assist participant to reflect on CPAP machine.
30
 Provide interactive lecture and explain the purpose and
clinical application of CPAP machine
 Ask participants to explain the working principle of
CPAP machine.
 Ask participants to list and discuss the gas source,
40 blending and controlling techniques.
 Explain the working principle of the CPAP machine using
diagram.
 Provide interactive lecture on physical working principle
 Split participants into groups of five to discuss CPAP
basic pats and their function.
 Guide to discuss and provide clarification on basic
40
components and functions.
 Explain the CPAP basic parts and its function using
appropriate material: video and pictures
80  Direct participants to form a group and discuss and
explain steps of troubleshooting.
 Define troubleshooting steps, and discuss specific
scenarios related with CPAP.
 State and discuss common component CPAP failures.
Page | 28
  Guide participants to perform practical troubleshooting on
CPAP machine
 Assist participants to form group of five and discuss
practical scenarios of preventive and corrective maintenance
of CPAP.
Maintenance Procedure for  Explain preventive and corrective maintenance activities
CPAP machine 150 related with CPAP.
 Guide Participants to share their experience encountered
on working area.
 Arrange the participants in a group and conduct practical
Maintenance
 Ask participant to summarize the whole session.
10
Summary  Summarize the whole session using the PPT

Answers to Activities

Activities Solution
Activity 5.1 Continuous positive airway pressure (CPAP) therapy is a common treatment for
obstructive sleep apnea. A CPAP machine uses a hose connected to a mask or nosepiece
to deliver constant and steady air pressure to help you breathe while you sleep.
Activity 5.2  Obstructive sleep apnea (OSA) or sleep apnea/hypopnea syndrome (SAHS).
 CPAP units are also used as a preventive and support device for patients with other
diseases, such as
o acute asthma,
o congestive heart failure,
o cardiogenic pulmonary edema,
o Cystic fibrosis, and chronic lung disease (CLD)

Oxygen Therapy and monitoring Devices Training Manual Page | 29

Activity 5.3

Activity 5.4 CPAP machine consists of three major components/Parts:

Gas sourcePressure generatorPatient interface
Activity 5.5 Refer 5.5 of the participant manual.
Activity 4.6 Prepare
o PPE (personal protective equipment) o cleaning material
o Melt meter to check electrical parameters.
o Mechanical and electrical tool kits to trouble shoot.
o Service manual
o Checklists to check qualitative and quantitative data.
Physical inspection
o Physically observe (Smell for burning cables and components, hear for abnormal
noise, Look physical breakage, if any)
o Check if there is power from the power outlet, power supply cable and trace all
power flowing path.
o Check the entire circuit from wall to baby to outlet to ensure that it is functioning
o Check for leaks and/or broken connections.
Check the status of
o Air temperature control
o Integral humidification
o Alarm system
o Check the status of temperature sensor, oxygen sensor, humidifier sensor displays
unit and the connection with patient probe.
o check for Blended air/oxygen gas supply.
o check whether the Flow is between 5-10 liters/min.

Oxygen Therapy and monitoring Devices Training Manual Page | 30

 o Check whether the Humidifier temperature is correct (36.8-37.3 °C)
o Check whether the Humidifier water level is correct.
o Check whether the Oxygen analyzer correctly set.
o Corrugated tubing correctly placed.
o Once the system is applied, check that the prongs are positioned appropriately, and
that the CPAP system is bubbling at 5 cm H20.

Chapter Six: Mechanical Ventilator

Time: 6 hrs.
Chapter description:
This chapter describes the purpose, working principles main components and their functions,
operations, maintenance and safety procedures of mechanical ventilator
Chapter Objective:
At the end of this chapter the participants will be able to describe how to use, handle, and
maintains’ of Mechanical Ventilators.
Enabling Objectives:
By the end of this module, the participants will able:
 Describe purpose and clinical application
 Describe Common terminologies in Mechanical Ventilator
 Describe the working principle
 Identify basic parts and their functions
 Perform troubleshooting techniques
 Perform preventive and corrective maintenance
 Conduct performance test
Materials:
 Participant manual
 PPT presentation
 Mechanical Ventilator

 Tool kits/analyzers

Oxygen Therapy and monitoring Devices Training Manual Page | 31

  Video/simulation/optional
 Inspection and performance checklist
 PPE
Preparation:
 Read Participant manual
 Prepare PPT and other training aids.

Activity summary

# Activity Method of delivery Time(min) Resource

Introduction  Brainstorming Power point (1-2)
1 15
 Interactive presentation Flip chart
Clinical applications of  Individual exercise Power point (3-4)
2 30
Mechanical Ventilator  Interactive presentation Flip chart
Working principles of  Group discussion Power point (5-6)
3 40
mechanical ventilator  Interactive presentation Flip chart
Basic terminologies in  Interactive presentation Power point (7-8)
4 25
Mechanical Ventilator Flip chart
Basic parts of Mechanical  Group discussion Power point (9-11)
Ventilator and their functions  Interactive presentation Flip chart
5 40
Mechanical ventilator
basic parts
Basic modes of Mechanical  Group discussion Power point (12-16)
6 60
Ventilator Interactive presentation Flip chart
Basic Troubleshooting  Group discussion Power point (17-20)
7 procedures for Mechanical Interactive presentation 40 Flip chart
Ventilator
Preventive Maintenance  Group discussion Power point (21-24)
8 30
Interactive presentation Flip chart
9 Safety and Handling of  Individual exercise 40 Power point (25-26)
Mechanical Ventilator

Oxygen Therapy and monitoring Devices Training Manual Page | 32

 Interactive presentation Flip chart
User maintenance  Group discussion Power point (27-30)
10 30
Interactive presentation Flip chart
11 Summary  Q&A 10 Power point (31)

Learning activity
# Topic Time Activity
1. Introduction to mechanical Start the session by activity 6.1 Individual Reflection
ventilator Displaying the chapter objectives,
20 min
Define mechanical ventilator using the and summarize the
session
3 Purpose and clinical Explain the to the participants about purpose and clinical
application of mechanical application of mechanical ventilator
20 min
ventilator Summarize the session
Help participants to exercise on purposes of medical ventilator
4 Basic working principle of Facilitate participants to share their experience on how
mechanical ventilator mechanical ventilator
15 min
Provide interactive lecture on working principle of mechanical
ventilator
5 Classification criteria of Provide interactive lecture on criteria’s mechanical ventilator is
20 min
mechanical ventilator classified
6 Modes of mechanical Ask participants to brainstorm on modes of mechanical
ventilator ventilator
20 min
Provide interaction lecture on mode of mechanical ventilator
and their parameter setting
7 Basic components and their Ask participants to identify the pneumatic and electronic parts
functions of mechanical ventilator
10 min
Provide interaction lecture on basic components and their
functions

Oxygen Therapy and monitoring Devices Training Manual Page | 33

8 General safety of mechanical
ventilator
9 Mechanical ventilator
maintenance
1 Planned preventive
0 maintenance
1 Calibration and performance
1 check
On mechanical ventilator
1 Corrective maintenance of
2 mechanical ventilator
1 Troubleshooting processes of
3 mechanical ventilators
1 Summary
4
Oxygen Therapy and monitoring Devices Training Manual
Provide interaction lecture on safe handling of mechanical
20 min
ventilator
Ask participants to brainstorm on mechanical ventilator
10 min Provide interaction lecture on mechanical ventilator
maintenance
Help participants to form small group and ask them to discuss
on how to prepare schedule preventive maintenance Provide
10 min
interaction lecture on daily, weekly and annual preventive
maintenance activities of mechanical ventilator
Help participants to form small group and ask them to discuss
on calibration procedure of parts and performance test of to
40min prepare ventilators
Provide interaction lecture on Calibration and performance
check of mechanical ventilators
Help participants to form small group and ask them to list
common problem of ventilators
60min
Provide interaction lecture on common failure of mechanical
ventilators
Prepare the case study and form large group of participants and
help them to discuss on the case study
Provide interaction lecture on troubleshooting processes of
mechanical ventilators
Help participant, to involve in practical activities of mechanical
360min
ventilator fault finding and fault correction approaches
Individual reflection and activities on failed mechanical
ventilator in workshop/hospital
Provide interactive practical training on maintenance word
records
 Ask one or two participants to summarize the session
Q&A
Page | 34
 Answer to Learning activities
Activity
Activity description Answers
number
6.1 What do you know A mechanical ventilator is a machine that assists a patient breath or
about mechanical ventilate when they are having surgery or cannot breathe on their own
ventilator? due to critical illness.

6.2 Being in group of 3-5 Purposes of mechanical ventilator

discuss and explain The patient does not have to work as hard to breathe – their respiratory
purpose and clinical muscles rest. Helps the patient get adequate oxygen and clears carbon
applications of dioxide
mechanical ventilator Clinical applications of mechanical ventilator
Routine, short-term use during general anesthesia for surgical
procedures. Respiratory failure from pneumonia, chronic obstructive
pulmonary disease (COPD, chronic bronchitis, emphysema), acute
asthma attack, acute respiratory distress syndrome, or severe viral
infections (such as West Nile virus or influenza)
Severe heart disease.

Oxygen Therapy and monitoring Devices Training Manual Page | 35

6.4 Being in a group of 2-
3 and describe the
working principle of
mechanical ventilator

6.5 Describe the criteria’s Ventilator classification describes how the ventilator works. The
used to classify components of a ventilator classification Criteria’s are the control
mechanical variables, breathe sequence, and targeting scheme.
ventilators.

Checklist of practical session

Note: The entitled marks will be awarded up on completing all activities of all medical
devices in each chapter of this training manual. The total mark is collected and converted
to 50% and to be used as summative criteria of the course with posttest.
1. Did he/she describe all basic components and explain the working principle of the
device? (15%)
Yes
No
Remark: ___________________________________________
2. Did he/she demonstrate proper device operation? (15%)
Yes
No
Remark: ___________________________________________
3. Did the he/she demonstrated the troubleshooting techniques? (20%)
Conducted observation and gathered information
Identified the problem and prepared a plan
Implemented the plan and conducted repair
Tested the device after repair
4. Did he/she repair the fault given? (20%)

Oxygen Therapy and monitoring Devices Training Manual Page | 36

 Check the full functionality of the device
Yes
No
Remark: ___________________________________________
5. During maintenance did he/she used appropriate tools and PPE? (15%)
Yes
No
Remark: ___________________________________________
6. Did the he/she implemented Sop and procedures, and documented all the preventive and
corrective maintenance activity? (15%)
Yes
No
Remark: ___________________________________________

Pre / post Questions and Answers

1. What are some of the common maintenance tasks that need to be performed on medical
oxygen cylinders?
A. Inspect the cylinder for signs of damage or wear
B. Lubricate the cylinder valve and other moving parts with flammable lubricants
C. Do not Test the cylinder pressure
D. Clean and disinfect the cylinder with alcohol
2. How often should medical oxygen cylinders be inspected and tested?
A. Medical oxygen cylinders should be inspected and tested at every month
B. The inspection should be performed by a qualified technician who cannot identify
any defects or potential hazards.
C. The cylinder should be tested to ensure that it can withstand the required pressure
with qualified technician.

Oxygen Therapy and monitoring Devices Training Manual Page | 37

 D. Tested every week with any health professionals
3. What are some safety precautions to take when using medical oxygen cylinders?
A. Always use a regulator and flowmeter to control the flow of oxygen
B. open the cylinder valve quickly or too forcefully.
C. Do not close the cylinder valve immediately after use.
D. Smoke or use open flames near oxygen cylinders.
4. What are some of the things to keep in mind when storing medical oxygen cylinders?
A. Store cylinders in a well-ventilated, clean, and dry area.
B. Do not store cylinders near heat sources or combustible materials.
C. Keep cylinders upright and secured to prevent them from falling over.
D. Protect cylinders from damage, such as dents, scratches, and corrosion.
E. Inspect cylinders regularly for signs of damage or wear.
5. Which of the following component is required to functionalize cylinder?
A. Compressor
B. Nebulizer
C. Oxygen sensor
D. Flow and pressure regulator with humidifier
6. How does a pulse oximeter work?
A. Measures carbon dioxide levels in the blood
B. Determines blood pressure by detecting blood flow
C. Senses the level of oxygen in the blood
D. Calculates respiratory rate by monitoring chest movements
7. Which of the following components is responsible for emitting light in a pulse oximeter?
A. Photo detector
B. Display screen
C. Light-emitting diode (LED)
D. Finger clip
8. What part of a pulse oximeter measures the amount of light absorbed by the blood?
A. Finger clip
B. Photo detector
C. Display screen

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 D. Processor unit
9. How should the pulse oximeter be cleaned?
A. Use alcohol-based wipes or disinfectant solution
B. Rinse it with water and soap
C. Scrub it vigorously with a brush
D. No cleaning is necessary
10. Which component of a pulse oximeter may need to be replaced if the readings are
consistently inaccurate?
A. Sensor probe
B. Button batteries
C. LED display
D. Motherboard
11. Among of the following which one is the basic components of patient monitoring
system?
A. Power Switch
B. Display screen
C. Main menu button
D. All
12. Which of the following is the safe handling of power unit of patient monitoring system.
A. Based on the service manual check whether the device has an appropriate
earthling
connection or not.
B. The AC cord provided along with the instrument must be used for connection
with
DC power and other electrical wires shall be used.
C. To assure a fully charged battery which is ready for use, it is recommended that
the
system be plugged into DC power whenever it is not in use.
D. No need of Ensuring the battery is always fully charged when the device is placed
in storage for an extended period of time.

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13. Which one is included in preparatory steps of troubleshooting technique in patient
monitoring system
A. PREPARATION
B. Physical inspection
C. Check Component failures of patient monitoring
D. Cleaning
14. A part or component of mechanical ventilator that mixes oxygen and atmospheric air is:
A. gas accumulator C. gas accumulator
B. Humidifier D. gas blender
15. Volume of air moved in and outside the lungs in each respiratory cycle.
A. Peak flow C. Lung compliance
B. Tidal volume D. Positive end expiratory pressure
16. Describe how the ventilator manages pressure, volume, and flow during the inspiratory
phase.
A. Breath types C. Control Variables
B. Targeting Scheme D. Spontaneous breath
17. Is a ventilation mode that adjusts the patient’s ventilation parameters based on minimum
work of breathing (WOB).
A. Volume assist-control ventilation (ACV)
B. Pressure-assist/control ventilation mode (P-A/C)
C. Continuous positive airway pressure ventilation mode (CPAP)
D. Adaptive minute ventilation mode (AMV)
18. Is the factor that initiates inspiration based on pressure, flow and time?
A. Cycle C. Trigger
B. Respiration rate D. Sensitivity
19. Which of the following devices is used for delivering CPAP therapy?
a. Nasopharyngeal catheter
b. Nasal prongs
c. Tight fitting face mask
d. All
20. Which one is an absolute contraindication for CPAP use?

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 A. Respiratory distress syndrome in neonates
B. A patient unable to breath spontaneously
C. To facilitate oxygenation in patients congestive heart failure
D. Obstructive sleep apnea
21. Which one of the following is safe care Of CPAP Machine?
A. Do not operate the device if any of the components appear to be damaged or
broken.
B. Damaged or broken components should be discarded and replaced.
C. Do not position the device in a location that reduces its ventilation.
D. Do not block any of the air vents on the sides or bottom of the device.
E. All

Solution to the pre-post question

1. A
2. C
3. A
4. A
5. D

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6. C
7. C
8. B
9. A
10.A
11.D
12.A
13.D
14.D
15.B
16.C
17.D
18.C
19.D
20.B
21.E

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