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EquipmentOrientation
Anintroductiontotypicalhospitalequipment:

http://som.flinders.edu.au/FUSA/BME/FBEHomePage.htm

AstraightforwarddescriptionoftypicalhospitalequipmentthatBiomedswillcomeacrossastheygoabouttheirtasks.Goodfor "justbeenborn"Biomeds,itmayalsobeusefulforthosewhohaveEnglishasasecondlanguage. Thecontentsofthese pageswerederivedfromteachingmaterialcreatedandcompiledbyFBE

AnaesthesiaMachines BloodWarmers ColdLightSources Electrocardiograph Endoscope Humidifiers InfusionPumpsSyringe Laryngoscopes MedicalRegulator Ophthalmoscopes Phototherapy RippleMattress Ultrasound

Aspirators Capnographs Defibrillators Electroencephalographs ElectroSurgicalUnits IntraAorticBalloonPumps InfusionPumpsVolumetric Laser Microscopes Otoscopes PulseOximeters ShortWave Ventilators

BloodPressureMonitors Cardiotocographs DentalChairs Electromyographs Haemodialysis InfantIncubator Insufflator MedicalFlowmeter NonInvasiveBloodPressure PatientMonitor RadiantWarmers Treadmills XrayMachines

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

AnaesthesiaMachinesBasics
Whatdoes "Anaesthesia" mean? Whatdoesitdo? an=without aesthesia=sensation

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Theanaesthesiamachinemixesthecorrectconcentrationsofgasanddrugstobeinhaledandexhaled bythepatientsotheyloseconsciousness.Theyareheldunconsciousandhavenosensationwhilebeing operatedon,thenregainconsciousnessaftertheoperation. Anaestheticgasaffectsthenervoussystem,resultinginanumbingofthenervepathways.Thepatient becomesunconscious,unawareofwhatishappening,hasnopain,isimmobile(mayneedbreathing support)andfreefrommemorywhileundertheinfluenceoftheanaestheticagent. Air,Oxygen,andNitrousOxidearesuppliedfromwalloutletsorcylinders.Thepressuresarereducedby pressureregulatorsthenpassthroughanO2 failurealarm.Theflowofgasiscontrolledbyflowmeters. Thegasismixedandpassedoveravaporisercontainingtheanaestheticagent.AnAntihypoxicdevice ensuresthattheflowmetersdeliveraminimumof25%O 2 totheagentvaporiser. Thegasthengoes throughanoverpressurereliefvalveandbackflowvalve,thentothecommongasoutlet(CGO),readyto begiventothepatient. ThereisanemergencyO 2 flushvalveconnectedtogive100%O2 ifrequired.Thegasthenentersa patientcircuitandventilator.ExpiredgascanbestrippedofCO2 inasodalimefilterandrecirculated,or scavengedoutoftheroom. Flow:L/min,Pressure:kPaandcmH 2O Dependantonpatientsize,rateandstrengthofbreathing,circulationandsolubilityoftheanaesthetic.

Physiology

Howitworks

Unitsof measurement Typicalvalues Picturesof equipment

DatexOhmedaADU http://www.datexohmeda.com/products/anelifesupport.htm

Ulco http://www.ulco.com.au/AN_WORK.asp

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

AspiratorsBasics
Abbreviation/other Suctionunit names Whatdoesitdo?

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Removesunwantedbodyfluidsandirrigationfluidsfromanopenwound,surgicalsiteoranyotherarea whereexcessfluidhasgathered. Aspiratorsgenerallyconsistofanelectricmotordrivingapumpthatgeneratesanegativepressure.A suctionregulatorcontrolsthepressuretotherequiredlevel.Thefluidissuckedthroughatubeintoalarge jar(disposableinmanycases)forexaminationordisposal. Theamountofsuction(negativepressure)isnormallylowtoavoidtissueandorgandamage.Suction mayalsobeusedfromwalloutletsandportablemedicalgascylinders.However,aregulatormustbe usedtoreducepressure. NegativePressure:mmHgorkPa 0to760mmHgor0to100kPa

Howitworks

Unitsof measurement Typicalvalues Pictureof equipment

ClementsAspirator

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

BloodPressureMonitorsBasics
Whatdoesitdo? Physiology Itmeasuresthepressureintheveinsorarteries.

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Whentheheartbeats,itpumpsbloodtothebodythroughthearteries.Thebloodthenreturnstotheheart throughtheveins.Theamounttheheartcontracts,thevolumeofthebloodandthediameteroftheblood vesselsalldeterminethepressureinsidethevessels. Anarrowfluidfilledtubeisinsertedintoabloodvessel.Theendofthetubeisconnectedtoapressure sensor.Thepressureinthevesselpressurisesthefluidinthetubeandthepressuresensormeasures this.Thepressuresensorsendsanelectricalsignaltothemonitor,whichdisplaysthepressureona screen. Aninvasivebloodpressuremachineisalsousedtomeasureotherpressuresinsidethebodysuchas intracranialpressure(thefluidaroundthebrain),intrapleural(betweenthelungtissueandtheribs)and gastrointestinalpressures(insidethestomachorintestines)

Howitworks

Unitsof measurement Typicalvalues

mmHg Venous:mmHg Systolic:120mmHg Diastolic:80mmHg Meanarterial:100mmHg

Pictureof equipment

HP/PhilipsMerlinmonitorshowinginvasivebloodpressuredisplayandinputmodule

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

BloodWarmersBasics
Whatdoesitdo?

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Bloodisstoredat2Candneedstobewarmedupduringbloodtransfusiontobetween37C and41C.Thispreventshypothermia(bodytemperaturetoolow) bloodlossthepatientcansufferfromanaemia(reducednumberofbloodcells)andlowblood pressure(fromthelossofbloodvolume)whichcanbelifethreatening. Bloodtransfusionsarealsooftenusedfortreatmentsofbloodrelateddiseaseslikeleukaemia. Thebloodiswarmeduptobodytemperaturebeforeinfusingitintothepatient.Thebloodmust notbeheatedabove43Corthebloodcellswilldie(haemolysis). Therearedifferenttypesofbloodwarmers.Somebloodwarmershaveawaterbathwherethe waterisheateduptoasettemperaturee.g.40C.Abloodbagisputintothisbathtowarmup. Theothertypes(e.g.thePrismaPrismatherm)hasacoiledbloodlinearounditsbody.Whilethe bloodisflowingthroughthecoiledbloodlineitheatsthebloodtothesettemperature.Allblood warmersmusthaveanoverheatcutoutthermostattopreventthebloodfromoverheatingabove 43C. Temperature=C Operationtemperature37C41C Overtemperaturealarm/cutout42C43C

Physiology

Howitworks

Unitsofmeasurement Typicalvalues

Pictureofequipment

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

CapnographsBasics
Abbreviation/other names Whatdoes "Capnograph"mean? Whatdoesitdo? Physiology EndTidalCO2(ETCO2),ExpiredCO2Monitor Capno=Carbondioxide Graph=Graphicdisplayreadoutorrecording. ACapnographmeasurestheamountofCO2intheexpiredairfromthelungsofapatient.

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Cellsofourbodyrequireoxygen,whichisgiventothemviatheblood.O2isgiventocells,and whenusedthewastegas,CO2,producedwithinthecellsisexhaustedintotheblood.TheBlood thentransportsittothecapillariesinthelungsandtheCO2isthentransferredintotheairinthe lung.AsthelungsexhaletheCO2isexhaustedtoatmosphere. TherearetwotypesofCapnographs,MainstreamorSidestream.Mainstream. Capnographs haveaCO2sensorthatattachestoadisposableairwayadaptorinsertedbetweenthe endotrachealtubeinthepatientandtheventilatorcircuit(afterthewyepiece).Thesensoris madeupofalightsourcethatsendsinfraredlightthroughtheadaptor,thesampleofgasanda filterchopperwheeltothephotodetector.InfraredisabsorbedbyCO2intheexhaledgas.The moreCO2gasthemoretheinfraredisabsorbedandlessreachesthephotodetector. ThissignalissenttotheCapnographandprocessedtogiveagraphicreadingonthescreen.The SidestreamCapnographtakesasampleofgasfromtheairway(fromthesameplaceasthe Mainstreamsensor)throughasmalltubeintotheCapnographandallofthemeasurementand signalprocessingtakesplaceinsidetheSidestreamCapnograph.(samemethodasMainstream Capnograph) %,mmHgpartialpressure.

Howitworks

Unitsofmeasurement Pictureofequipment

NovametricsTidalW ave

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

CardiotocographsBasics
Abbreviation/othernames CTG=Cardiotocograph,TocoorTocodynamometer FetalMonitors

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Whatdoes Cardio=heart "Cardiotocograph"mean? Toco=contractions(ofuterusduringlabour) Graph=machinetorecord Cardiotocograph=machinetorecordtheheartrate(fetalheart)andcontractionsofuterusduring labour Whatdoes Tocodynamometer mean? Toco=contractions(ofuterusduringlabour) Dyna=force Meter=devicetomeasure Tocodynamometer=devicetomeasuretheforceofcontractionsoftheuterus duringlabour CTG=Cardiotocograph,TocoorTocodynamometer Cardiotocographcanmonitorthefetusheartrate,themothersheartrate,themothers contractionsandthepressureinsidetheuterusduringlabour. Duringlabourthefetuscanbecomestressed.Theheartrateofthefetusismonitoredthroughout laboursostresscanbedetectedearly.Thecontractionsaremonitoredalsosothatthemidwife andmotherknowwhenthecontractionisoccurringandalsotocheckforfetaldistressduringthe contraction. TheCardiotocographhasadiscshapedultrasoundtransducer,whichisstrappedontothe mothersabdomenovertheareaoftheuterus.Thetransducerhasseveralcrystals(usually about7),whichemitultrasoundwavesintotheuterusandalsodetectthewavesthatare reflectedback.Theultrasoundwavesarereflectedfromdifferentsurfacesintheuterusand detectedbythetransducer. Thefetalheartmoveseverytimeitbeatsandthisbeatingmovementisdetectedbythechanging ultrasoundwavesbeingreflectedbacktothetransducer.Fromthisthecardiotocographcan calculatethefetalheartrate. Asecondultrasoundtransducercanalsobeusedatthesametimesothattwinscanbe monitored.Thesecondtransducerhasadifferentfrequencysothetwosignalscanbe separated. TheCardiotocographalsohasadifferenttypeoftransducertomonitortheuterinecontractions (thetocotransducer).Thistransducerisalsodiscshapedandisstrappedaroundtheuterus.The patientsabdominalmusclesdepressthetransducerscentralsectionduringacontraction.A straingaugebehindthemovingpartmeasuresthemovement.Thesizeofthecontractionis proportionaltotheamountofchangeinthestraingauge. TheCardiotocographcanalsomonitorfetalheartrateandcontractionsinvasively. FetalheartratecanbemeasuredbyusingaspecialECGelectrodeonthescalpofthebaby. ThemothersECGcanalsoberecordedbyamaternalECGleads.(SeeElectrocardiographfor explanation).ThepressureinsidetheuteruscanbemonitoredinvasivelybyaIntraUterine Pressure(IUP)transducer(seeinvasivebloodpressureforexplanation) Fetalheartrate(ultrasound/FECG):BPM(beatsperminute) Contractions:%(relativemeasureofmagnitudeofcontractions) IUP:mmHg

Whatdoesitdo? Physiology

Howitworks

Unitsofmeasurement

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CardiotocographsBasicsContinued
Pictureofequipment

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HPECG&Tocograph

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

ColdLightSourcesBasics
Abbreviation/other names Whatdoesitdo? Physiology Lightsource

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Highintensitylightusedinconjunctionwithendoscopes,rigidscopes,headlampsandoperating microscopesetc. Coldlightsourcesarenormallyusedtoilluminateaspecificworkareaduringsurgeryormedical examinations.Itisimportantthatthelightisasnearincolourtonaturallightsodoctorsareableto detectabnormalcolourationsoftheskinandtissue.Itisalsoimportantthatthelightdoesnotheat thetissue. Thehighintensitylightsourceconsistsofapowersupply,coolingfan,brightnesscontrols,lamplife indicatorandasparelamptoenableprocedurestobefinishediftheprimarylampfails. Filtersare alsoemployedtoreducethetransmissionofexcessiveheattotheoperatingsite.Thisiswhyitis calledColdLight.Thetwomaintypesoflampsusedarexenonarcandhalogen.Somexenon lampshaveauseablelifeofonly500hours. Thelightischannelledtotherequiredareaviaaflexiblefibreopticlightguide,madefromtightly bundledglassfibres.Thisconcentratesthelightandallowsthelighttobeeasilydirectedtowhereit isrequired.

Howitworks

Pictureofequipment

OlympusCLK3ColdLightSource

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

DefibrillatorsBasics
Whatdoes "Defibrillator"mean? De=toundo,orreverse Fibrillate=uncoordinatedcontractionsoftheheart Itstopsfibrillationoftheheart,andrestoresthenormalcoordinatedcontractions. Whatdoesitdo? Physiology

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Howitworks

Thecellsinsidetheheartmuscleconductelectricalcurrent.Somecellsintheheart(pacemaker cells)chargebythemselvesregularly,andtheycausetheothercellstocharge.Acurrentflowsthe heartmuscleinaparticularway.Everytimethishappenstheheartmusclecontractsandpumps theblood'heartbeat".Thiscoordinatedelectricalpatternisessentialtocausethehearttofilland emptywitheverybeatpushingbloodaroundthebody. Whenthiselectricalpatternbecomesuncoordinated(fibrillation),theheartmusclecontractionsare notcoordinatedandnobloodispumped.Thiswillleadtodecreasedbloodpressure,lackof oxygen,heartmuscledamage,anduntimleydeath.Thedefibrillatorisusedtoreversethis fibrillationandrestorethecoordinatedcontractions.Itcanalsobeusedifthehearthasstopped beatingtostartitagain.(e.g.afteranelectricshock) Thedefibrillatorusesthemainspoweroralargeinternalbatterytochargealargecapacitorto between5and400Joules.Twometal"paddles"(electrodes)areconnectedfromthedefibrillator, andplacedoneithersideofthepatient'schest.Theenergystoredinthecapacitoristhen dischargedfromonepaddletotheotherthroughthepatient'schest,whichshockstheheartinto beatingrythmicallyagainDefibrillatorsalsohavebuiltinECGmonitors,andECGrecordersto continuouslydisplayanddocumentECGwaveforms. Joules

Unitsofmeasurement Pictureofequipment

Philips(formerlyAgilent)

ZollDefib

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

DentalChairsBasics
Whatdoesitdo? Howitworks Dentalchairsprovideaplatformfromwhichadentistcansafelyandcomfortablyperformoral surgeryandexaminationwithallthenecessaryinstrumentsandfunctionscloseathand.

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Typicaldentalchairsarehydraulicallyoperatedsotheycanberaised,loweredandalsolaiddown toahorizontalposition.IncorporatedintothechairareHighandlowspeeddentaldrills,airand watersprays(syringes)towashdebrisfromtheareabeingworkedonandalsoasuctionsystemto removewateranddebris. Highspeeddentaldrillsareusuallyairdriventurbines,whereaslowspeeddrillsneedmoretorque andaregenerallyelectricmotordriven.Dentaldrillsalsohavewaterspraystocoolthearea,which isbeingcutaway. Waterthatisusedforirrigationisnormallydistilledoratleastfilteredtoavoidunnecessary contamination. Awaterandamalgamseparator Pressure:forexamplemmHg&kPa

Unitsofmeasurement Pictureofequipment

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

ElectrocardiographsBasics
Abbreviation/other names ECG Electrocardiogram(InAmericaitissometimescalledEKG) Electro=electricalactivity Cardio=heart Graph=machinetorecord Cardiotocographcanmonitorthefetusheartrate,themothersheartrate,themothers contractionsandthepressureinsidetheuterusduringlabour.

Back

Whatdoes "Electrocardiograph" mean? Whatdoesitdo?

Physiology

Thecellsinsidetheheartmuscleconductelectricalcurrent.Somecellsintheheart(thepace makercells)chargebythemselvesregularlyandtheycausetheothercellstocharge.Acurrent flowsthroughtheheartmuscleinaparticularway.Everytimethishappenstheheartmuscle contractsandpumpsthebloodheartbeat. Thetissuesinthehumanbodyareelectricalconductorsandwhentheelectricalcurrentflowsin theheartwecanmeasureitinthesurfaceofthebody. ECGelectrodesaremadeofsilversilverchlorideandtheyarestucktotheskintogetherwithECG gel.Theelectricalsignalsfromtheheartarepickedupbytheseelectrodesandmeasuredand recordedbytheECGmachine. MeasurementofamplitudeinmV Adults:5090BPM Neonates:120180BPM TherepetitiveelectricalsignalproducedbytheHeartandmeasuredatthepatient electrodesisapprox.1mVinamplitude.

Howitworks

Unitsofmeasurement Typicalvalues

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HPECG&Tocograph

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

ElectroencephalographsBasics
Abbreviation/other names EEG Electro=electricalactivity Whatdoes Encephalo=brain "Electroencephalograph" Graph=recording mean? Whatdoesitdo? Physiology Howitworks Itrecordstheelectricalactivityinthebrain. Thecellsinthebraintransmitmessagestoeachotherbytinyelectricalcurrents.

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Theseelectricalpotentialsinthebraincanbemeasuredonthesurfaceoftheheadastinyvoltages. EEGelectrodesmadeofgold,silverorplatinumareplacedonthehead.Electrodegelisused betweentheelectrodeandtheskintotransmitthesignalfromtheskintotheelectrode. TheEEGwilldisplaythesignalonthescreenasaseriesofmanylinesrepresentingactivityin differentareasofthebrain.TheEEGmayalsofilterthesignalsintodifferenttypessuchasa,b,d etc. AmplitudeismeasuredinmV FrequencyismeasuredinHz ThesignalswillbeanalysedbyaNeurologist.Theylookforburstsofactivity, patterns,lackofsignals.Thereisnosimpletypicalvalue.

Unitsofmeasurement Typicalvalues Pictureofequipment

CompumedicsNeuroscan

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

ElectromyographsBasics
Abbreviation/othernames Whatdoes "Electromyograph"mean? Whatdoesitdo? Physiology E.M.G. Electro=electricalactivity Myo=muscle Graph=recording

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Recordstheelectricalactivityofamusclebymeansofelectrodesplacednear,or insertedintomusclefibres. Thetechniqueisusedfordiagnosingvariousnervedisordersandassessingthe progressinrecoveryfromsomeformofparalysis.Itisalsoabletoestimatethe densityofmusclefibresbelongingtoasinglemuscleactivity. Electromyographytestsnervesthesamewayanelectricianwouldtestawire. Sincenervesoperatebyconductingelectricalimpulses,theeasiestwaytoseeif theyaredamagedistosendacurrentthroughanervefromoneendtoseeifit reachestheother.Ifthecurrentreachestheotherpointatfullstrength,thereisno damagetothenerve.Iftheimpulseisreduced,ordoesnotcomethroughatall, theremaybedamagetothenerve. Microamperesmilliampere ManyvariablesdependingonthesiteoftheEMG.

Howitworks

Unitsofmeasurement Typicalvalues Pictureofequipment

CompumedicsNeuroscan

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FlindersBiomedicalEngineering
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EndoscopeBasics
Abbreviation/othernames Whatdoes "Endoscope"mean? Colonoscopes,Duodenoscopy,Gastroscope,Bronchoscope,Rhinoscope Endo=inside Scope=devicetolookorsee Endoscope=adevicetolookinside

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Whatdoesitdo?

Anendoscopeisusedtoexamineandtakebiopsiesinsidepassagesinthebody(eg.inside liningoftheupperandlowerdigestivesystem,bronchusetc).Theendoscopesarenamedand aredesignedtobeusedinspecificareas,forexamplethebronchoscopeisusedonlytogointo thebronchus,whilethegastroscopeisdesignedtoexamineandtakebiopsiesofthestomach. Endoscopycanbehelpfulintheevaluationordiagnosisofvariousmedicalproblemsincluding intestinal,stomach,abdomen,duodenumandbronchusbleeding,ulcers,andtumours.Biopsies canbetakenforexamination. Theendoscopeisalong,thin,flexibletubewithatinyvideocameraoreyepieceandlighton theend.Byadjustingthevariouscontrolsontheendoscope,theusercansafelyguidethe instrumenttocarefullyexaminetheinsideliningoftheupperorlowerdigestivesystem,nasal, bronchusetc.Theendoscopesaredesignedwithanairandwaterchannel,whilethelarger endoscopesalsohaveabiopsyandsuctionchannel.Theairandwaterisusedtokeepthe viewingareaclean.Afiberopticlightchannelilluminatestheviewingarea.Thedistalendofthe scopecanbeangledinalmostalldirectionsforexaminingthesurroundings

Physiology

Howitworks

Pictureofequipment

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

ElectrosurgicalunitsBasics
Abbreviation/othernames ESU Diathermy Whatdoes "Diathermy"mean? Whatdoesitdo? Dia=through Thermo=temperatureheat TheESUcutstissueand/orstopsthebleedingbycoagulatingtheblood (haemostasis)

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Physiology

Duringsurgerythetissueandbloodvesselsarecutwhichcausesbleeding.Topreventtoo muchbloodlossandtokeeptheoperatingfieldfreeofexcessblood,electrosurgicalunitsare used.Differentmodesofoperationcanbeset.Cutisforcuttingtissue,Blendisamixtureof cuttingandcoagulation.Thismodeisusedtocutandthesametimereducesbleeding (haemostatic).CoagulationisusedformaximumHaemostasis,Desiccationisusedfor destroyingtissue.Themonopolarmode(singleelectrode)isusedforcuttingandcoagulation, thebipolarmode(forcepslikeelectrode)isusedmainlyfordesiccation(destroyingtissue) Anelectriccurrentwithafrequencyofabout500kHzisusedtocutandcoagulatetissue.This processinvolvesapplyinganRF(RadioFrequency)sparkbetweenaprobeandthetissue.The electriccurrentthroughthetissueheatsupthetissueandevaporatesthewaterinthecell destroyingit.Thisachievesspecialsurgicaleffectsnamelycutting,coagulationanddesiccation. Thevoltageontheelectrodeisbetween100010,000Vpp. Watts BipolarCut:50WattsCoag:8Watts MonopolarCut:150300WattsCoag:4080Watts

Howitworks

Unitsofmeasurement Typicalvalues Pictureofequipment

ValleylabForce2

http://www.valleylabeducation.org/pages/vliceesself.html

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

HaeomodialysisunitsBasics
Abbreviation/othernames RenalMachine,DialysisMachines Whatdoes "Haemodialysis"mean? Haemo=blood Dialysis=removalofwasteproductsfromtheblood Dialyser=anartificialkidney Decontaminatetheblood Maintainliquidbalance Maintainelectrolytebalance Replacingthefunctionofthefailedkidneys

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Whatdoesitdo?

Physiology Howitworks

Solutionsaremixedwithreverseosmosis(RO)watertocreatedialysate(cleansingfluid).The dialysateisheatedto37C,deaeratedandpassedthroughthedialyser(artificialkidney),where thebloodiscleanedbyosmosis,diffusion,andultrafiltration.Anticlottingagentsareusedto preventdialyserblockages.Wastefluidispumpedtodrain. Temperature:C,Conductivity:millimohs,Pressure:mm/Hg,Flow:ml/min Temperature37C,Conductivity14Ms,VenousPressure100200mm/Hg, Dialysateflow500ml/min,Bloodflow200300ml/min

Unitsofmeasurement Typicalvalues Pictureofequipment

Fresenius

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FlindersBiomedicalEngineering
AjointdepartmentofFlindersMedicalCentre andFlindersUniversityofSouthAustralia,FacultyofHealthSciences

HumidifiersBasics
Whatdoes"Humidifier" mean? Whatdoesitdo? Humid=moist Humidifier=adevicetomakeairmoist Decontaminatetheblood Maintainliquidbalance Maintainelectrolytebalance

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Physiology

Thegasfromabottleorhospitalgassupplyisverydryandcool.Ifapatientonaventilatorinhales thiscooldryair,thetissueintheairwaypassagesandlungtissuescandryoutandbedamaged. Whentheairwaytissuebecomesdrythemucousbecomesthickanddifficulttoremovebysuction. Thehumidifierhumidifiestheairtopreventalloftheabove.Theairisalsowarmedtoprevent temperaturelossinthepatient.Theidealgastoenterapatientisatatemperatureof37C,and moisturelevelsinthegasof44mg/L(100%humidityat37C) Ahumidifierisacontrolledheaterblockwithachamberofwaterontop.Theheaterplateheatsthe waterinthechamberandcausessomewatertoevaporate.Thegasintheventilatorpatientcircuit passesoverthewaterchamberandiswarmedtothedesiredtemperatureandhumidified.A heaterwireisalsoinsertedalongthetubinggoingtothepatienttopreventthegasfromcooling alongthelengthofthetube.Thecontrolleralsoincludesvariousalarmsofhighorlowtemperature intheairwayorwaterchamber. DegreesCelsius.C,watercontentmg/L,%RelativeHumidity 37degC,44mg/L,100%RelativeHumidity http://www.fphcare.com/humidification/default.asp

Howitworks

Unitsofmeasurement Typicalvalues Pictureofequipment

F&PMR850andoxygenblenderreadytogo

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FlindersBiomedicalEngineering
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IntraAorticBalloonPumpsBasics
Whatdoes "IntraAortic"mean? Intra=Between,Inside Aorta=Themajorarteryfromthehearttothebody. Intraaortic=insidetheAortanexttotheheart Helpstheheartrecoverbyreducingtheamountofworkithastodo.

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Whatdoesitdo? Physiology

Ifthebloodsupplytotheheartmusclebecomesreducedbyabloodclot,theheart'sabilitytodoits normalworkisreducedbecausethereislessoxygenbeingcarriedtothemuscle.Theheartmuscle intheareaaffectedbytheblockedsupplyworkson,depletingoxygen.Theregionbeginstodie.If thenormalbodyloadtheheart"sees"isreducedbyaBalloonPump,theworkandoxygendemand isreduced,whiletheheartmusclebloodsupplyisimproved.Themusclecannowsurviveandheal. Acatheteror"balloon"isinsertedintothefemoralartery,andusinganultrasonicdetectingdevice, isslidintopositionbelowtheaorticarch.ItisthenconnectedtotheBalloonPump. TheBalloonpumpusesheliumgastodrivethecatheterratherthanairbecauseitletstheballoon inflateanddeflatemuchmorerapidly.Theinflationanddeflationcyclesaretimedelectronicallyfrom anarterialpressurewaveoranECGsignal. Astheleftventriclebeginstocontractandpushesthebloodoutthroughthesemilunaraorticvalve, theflowisobstructedbythebodyresistance,requiringappropriateworkfromtheheartmuscle.If theBalloonfillingtheaorticarchissuddenlydeflatedatthistime,it"sucks"outthecontentsofthe ventricle,andtheheartchambercanemptywithlittleeffort. Whentheleftventricleisempty,thebody'snaturalbackpressureclosestheAorticsemilunarvalve. SuddenlyinflatingtheBalloonnowpushesthebloodaroundthebodyandthecoronaryarteries. Theballoonremainsinflateduntiltheventricleisreadytocontractagain. Astheheartheals,theassistancetheIABPgivescanbegraduallydecreasedbyreducingthe volumeofinflation,andassistingonlyeverysecondorthirdheartbeat.IABPassistanceistypically requiredfor5days. Pressure Volts 70mmHg Datascope98XT http://www.datascope.com/

Howitworks

Unitsofmeasurement Typicalvalues Pictureofequipment

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InfantIncubatorsBasics
Abbreviation/othernames Humidicrib(notacorrectname) Whatdoes"Incubator" mean Whatdoesitdo? Physiology Incubate=tokeepwarm Incubator=adevicetokeepwarm

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Howitworks

Unitsofmeasurement

Typicalvalues

Aninfantincubatorisusedmainlytokeepababyscoretemperaturestableat37degrees Celsius.Mostincubatorsalsohumidifytheairandcanaddextraoxygen. Thecoretemperatureofthehumanbodyneedstobekeptataconstanttemperatureof37 degreesCelsius.Ifthetemperaturegoestoohighortoolow,thentheorganscanbedamaged andillnessordeathcanresult.Prematurebabies(babiesbornbeforetheyareduetobeborn) haveundevelopednervoussystemsandalsolacktheenergytoregulatetheirowntemperature, sotheirtemperatureneedstobemaintainedbyanincubator.Wecanonlygivesmallbabiesa smallamountoffoodforgrowing.Wewantthemtousealloftheirenergyforgrowthratherthan wastingitonkeepingwarm,sosometimesweusetheincubatortohelpthemgrowfaster. Themattresswherethebabyliesiscompletelyenclosedbyaclearplasticcanopy.The temperatureintheincubatorisincreasedbyaheaterelementbelowthemattress.Amotordriven fanneartheheaterdrawsinfreshairthroughafilterandblowsitpasttheheater,warmingthe air.Theairisdirectedupthroughslotsintotheareaabovethemattressandcirculatedaround. Theairtemperatureismonitoredbytemperaturesensorsandisadjustedbycontrollingthe currenttotheheater.Theincubatorcanalsomonitorthebabysskintemperaturebyusingaskin temperatureprobe,whichisstuckontotheskin.Theusercaneithersettheincubatortocontrol thetemperatureoftheairortocontrolthetemperatureofthebabysskin(servocontrolmode). Supplementaryoxygencanbetakeninbyanoxygeninletconnectionwhereitismixedwiththe freshairthroughthefilter.Thehumiditycanbeincreasedbytheuseofwaterbaths(passive humidification)orbydrippingwateronaheatedelement(activehumidification).Thebabyis caredforthroughspecialaccessdoorsorarmports. Temperature:degreesCelsius Totalgasintake:L/min RelativeHumidity% Oxygenconcentration:% AirTemperature:32to38C Babyskintemperature:34to36C Totalgasintake:35L/min Relativehumidity:50100%

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DragerCaelo

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InfusionPumpsSyringeBasics
Abbreviation/othernames SyringePump Whatdoesitdo? Howitworks Itisusedtopumpfluids(drugs,liquidfood,glucose,saline)intothebody.

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Aplasticsyringecontainingfluidisplacedintothesyringeholder.Atube(orgivingset)is connectedtothepatientsveinbyaneedle,cannulaorintothepatientsstomachviaatube. Whentheflowrateisset,thepumppushesthesyringeplungersothatthefluidflows.Thespeed thattheplungerispusheddependsonboththediameterofthesyringeandtheflowrateset. WhenSyringeInfusionPumpsareinuse,FlowRate,VolumeandPressureofFluiddeliveryare constantlymeasuredandtheoperatoralertedbyalarmsifanerrorexistsintheseandother parameters.OverorUnderInfusionofcertaindrugscanbeveryhazardoustothepatient.Plastic Syringesmadebydifferentmanufacturersarenotexactlythesame.SyringePumpsarelabelled orprogrammedtospecifywhichbrandofSyringetouse.Significanterrorsinflowrateand volumedeliveredwillbeintroducedifthewrongSyringeisused.SyringeInfusionPumpsdonot allowthepressureoftheliquidinfusedtogotoohighasdamagetotheveinwillresult.High pressureswillresultinanOcclusionAlarm.

Unitsofmeasurement Typicalvalues Pictureofequipment

mL/h 0250mL/h

GrasbeyPCA(PatientControlledAnalgesia)

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InfusionPumpsVolumetricBasics
Abbreviation/other names Whatdoesitdo? Howitworks PeristalticPump Itisusedtopumpfluids(drugs,liquidfood,glucose,saline)intothebody.

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Abagoffluidishungonapoleorhookabovethepumpandisconnectedtoatube.Thetubeisfilled withfluidandisplacedinthepumpagainstaseriesoflittlefingersorrollers.Asthefingersmoveor astherollersturnthefluidispushedalongtowardthepatient. Theusersetstherequiredflowrateandvolumeonthepump,thentherollersorfingersmoveatthe speedrequiredfortheflowrateset.Oncetherequiredvolumehasbeendeliveredanalarmis activated. Thetubepassesthroughanairinlinedetectorandwillalarmandstoptheflowoffluidifitdetectsan airbubble. VolumetricInfusionPumpsmonitorpressureanddonotallowthepressureoftheliquidinfusedinto thepatienttogotoohighasdamagetotheveinwillresult.HighpressureswillresultinanOcclusion Alarm mL/h 0250mL/h

Unitsofmeasurement Typicalvalues Pictureofequipment

IMEDGemini

Lifecare

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InsufflatorsBasics
Whatdoes"Insufflator" Inflate=tofillwithair mean? Whatdoesitdo? Aninsufflatorinflatestheabdominalcavities(likeaballoon),removesgasand smokeduringlaparoscopic(keyhole)surgery.

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Physiology

Laparoscopicorkeyholesurgeryisusedincreasinglyforexploratorysurgery,removingthe gallbladder,herniarepairandobesityreductionsurgery.Threeholesarepuncturedaboutafew centimetresapartinacirclewithatrocar.Theholesareusedforthelaparoscope,theforceps,light, insufflatorinletandsuction.Thistypeofsurgeryhasmany advantages.Itismuchlessinvasivethan normalsurgerythereforereducingbloodloss,daysinhospital,permanentscaring,recoverytimeand thepatientonlyneedsalocalanaesthetic. CO 2 gasisusedtopressuriseabdominalcavitiesinaverycontrolledway.CO 2 highpressuregasis regulateddownfrombottlepressuretoamaximumof25mmHg.Theusersetstheoutletpressure andflowofgas.Duringsurgerygaswillleakoutthroughthekeyholes.Theinsufflatormustkeepthe pressureinsidethecavityconstant.Theunithasmanysafetyfeaturestopreventtheabdominal pressurerisingmorethan5mmHgabovethesetvalue.Thefailsafeoverpressurevalveprevents theabdominalpressurerisingabove35mmHg.Someunitsareequippedwithasuctionoutlet.

Howitworks

Unitsofmeasurement Pressure:mmHg Flow:L/min Typicalvalues Safetyvalvepressure:35mmHg Operatingpressure:3mmHg25mmHg Flowrate:.535L/min Excessive:5mmHgabovesetpressure Suction:Max40L/min http://www.wisap.de/Produkte.html

Pictureofequipment

Picturesuppliedby W ISAP:7083HiFlowInsufflatorwithgaspreheatingandmaxflowupto45L/min

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LaryngoscopesBasics
Whatdoes "Laryngoscope" mean? Whatdoesitdo? Physiology Laryngo=larynx Scope=toview Itisusedtoviewthelarynx.

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Thelarynxistheareainyourairwaybetweenthemouthandthetrachea.Itisotherwiseknownasthe vocalcords.Whenapatientrequiresartificialventilation,atube(endotrachealtube)isinsertedinto thetracheaviathemouthornose.Whenthetubeisbeinginsertedthedoctorusesalaryngoscopeto gentlyliftthetonguetoseewherethetubeisgoingtoensurethetubegoesinthetrachea(pathtothe lungs)andnottheoesophagus(pathtothestomach) Thelaryngoscopeconsistsofahandleandablade.Therearebatteriesinthehandle,whichare sometimesrechargeable.Thereisasmalllightbulbeitherinthehandleortheblade.The laryngoscopeswiththebulbinthehandlehaveafiberopticpathfromthebulbtotheendoftheblade. Whenthebladeispushedintopositionthelightcomeson.Thebladeisinsertedintothemouthandis shapedsothattheusercanseepastthebladeintothelarynx.Therearedifferentsizedbladesfor Adults,ChildrenandNeoNates.Oftenthesedifferentbladescomeasasetwithone handle.

Howitworks

Pictureofequipment

Laryngoscope

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LasersBasics
Whatdoes "LASER"mean? Whatdoesitdo? LASERisanacronymLightAmplificationbyStimulatedEmissionofRadiation Lasersareusedinhospitalsforsurgicalproceduressuchas,cuttingtissue,controllingbleeding (gastriculcers),ophthalmology(repairingdetachedretinas)andoncology(destroyingtumours).

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Physiology

Lasersareabletoproducearangeofresponsesinlivingtissue,suchasvariousopticalinteractions, thermal,photoablative(separationofmolecularbonds),electromechanical(thunderlikeshockwave), photochemical(likeskintanninginthesunlight)andbiostimulation(e.g.improvingcirculationby cellularstimulation).Thelaserinteractionwithtissuecanbereflected,scattered(changeinlights direction),absorbed(thelightenergyistransferredintothetissue)andtransmitted(nolossofenergy whilegoingthroughtissue).Thisinteractiondependsonthewavelength,powerdensityandpulse durationofthelaserlight. Fourmaincomponentsofalaserare: 1.Theactualsubstanceoractivemediuminwhichthelaseractiontakesplace, thiscanbeasolid,liquid,orgas,whichdeterminesthetypeoflaser(eg.HeliumNeon,Carbon Dioxide,Nd:YAG,Ruby) 2.Theopticalcavitycontainsthesubstanceoractivemediumandhasmirrorsateachendtoamplify thelight.Oneofthemirrorsisonlyapartialmirroranditisthroughthisthatthelaserbeamemerges. 3.Externalenergysourceintheformofintenselightorvoltageisdeliveredtotheactivemediumto excitetheatomsthatgiveofflightwhenstimulated,triggeringthelaserprocess. 4.Laserdeliverysystemincludesaformofcontrol(e.g.power,exposuretime),deliverypath(e.g.fibre optics,mirrorsandtube,beamspotsize)andmethodofaimingthebeam(withanotherlowpower, visiblesafelaser)tothedesiredsurgicalsite. Thesurgicallaserwillemitaconcentrated,singlewavelengthbeam,inphaseandinthesame directionaimedattissuetoprovidethedesiredeffect.

Howitworks

Unitsofmeasurement Power:Watts Typicalvalues Wavelengths:Argon490510nm,Heliumneon,630nm,NdYAG1064nm,CO210600nm

Pictureofequipment AlconLaser

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MedicalFlowmetersBasics
Whatdoesitdo? Physiology Flowmetersmeasureandcontroltheflowofmedicalgasessuchasoxygen,airandnitrousoxide.

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Medicalgasessuchasoxygen,breathingairandnitrousoxideareusedinanaestheticmachines, ventilators,ordirectlytothepatientbymeansofabreathingmask.Oxygenisusedforpatientswith breathingproblemstoincreasethelevelofoxygenintotheirblood.Amixtureofnitrousoxidewith oxygen(entonox)isusedforpainrelieforrelaxingmuscles.Medicalairandoxygenareusedon ventilators.Oxygen,nitrousoxideandmedicalairareusedonanaestheticmachines.Flowmetersare usedinalloftheseapplications Flowmetersconsistofataperedglasstubecontainingaballwhichfloatsonthe streamofmovinggas.Asthegasflowrateincreases,theballiscarriedfurther upthetube,indicatingtheflowrate.Flowmetersarespecificallyconstructedfor eachgas,sincetheflowratedependsonboththeviscosityanddensityofthe gas.OnlythecorrecttubeandballcanbeusedtorepairflowmetersSomeFlow Metershaveadialtypegaugetomeasureflow.Againonlythecorrectgauge canbeusedtorepairtheflowmeter.

Howitworks

Flowmetervalves Theneedlevalveisthemostcommonmeansofcontrollinggasflowrate.Asthevalveisopened,the orificearoundtheneedlebecomeslargerandflowincreases.Whenclosing,thevalvemustnotbe overtightenedthiswilldrillouttheorificeandcauseittoleak

Unitsofmeasurement Flow:l/min Typicalvalues Pictureofequipment 015l/min

Oxygen(White)andAir(Black&White)Flowmeters,AdditionalSafetyAIRGuardhasbeenfittedtotheAirflowmeter

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MedicalRegulatorsBasics
Whatdoes "Regulate"mean? Whatdoesitdo? Regulate=Controlandmaintain

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Aregulatorreduceshighpressuregasdowntoaloweruseablepressure(normallyabout400kPa)and keepsthepressureconstant. Medicalgasessuchasoxygen,breathingairandnitrousoxideareusedinanaestheticmachines, ventilators,ordirectlytothepatientbymeansofabreathingmask.Oxygenisusedforpatientswith breathingproblemstoincreasethelevelofoxygenintotheirblood.Amixtureofnitrousoxidewith oxygen(entonox)isusedforpainrelieforrelaxingmuscles.Medicalairandoxygenareusedon ventilators.Oxygen,nitrousoxideandmedicalairareusedonanaestheticmachines.Regulatorsare usedinalloftheseapplications.. Asgasflowsoutofthelowpressurechamber,thedropinpressure reducestheforcegeneratedbythediaphragmagainstthespring, allowingthevalvetoopenandadmitgasfromthehighpressure chamber.Theoutputpressuremaybeadjustedbyascrewthatalters theforceappliedbythespring.Mostmedicalregulatorsproducea higheroutputasthesupplypressuredrops. Regulatorscanbebuiltto haveadoublestagepressurereductiontoimproveregulation. Warning:Neverlubricateoxygenregulatorswithoilorgrease. Alwaysuseoxygencompatiblelubricant,pressuregaugesand oxygencompatiblethreadtape.Oil/greasewhenmixedtogetherwithhighpressureoxygenis veryexplosive.

Physiology

Howitworks

Unitsof measurement Typicalvalues Pictureofequipment

Pressure:kPa Hospitaluse415kPaor60PSI

NitrousOxideRegulator

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MicroscopesBasics

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Whatdoes Micro=small "Microscope"mean? Scope=opticalinstrument Operating=surgicalprocedure Microscope=anopticalinstrumentformagnifyingimagesofsmallobjects Whatdoesitdo? Duringsurgicalproceduresitenablessmallpartsofthebodytobeopticallyenlargedtoenablefine surgicalinspectionsandprocedurestobeperformedwithoptimumprecision. Physiology Operatingmicroscopesareusedinmanydifferentapplications.Themainareasareneurosurgery, ophthalmology,plasticsurgery,gynaecology,ENToranyareawhereimageenlargementisrequired andtheinstrumentisaccessible. Thethreemaincomponentsarethe 1)Microscopebody, 2)Lightsource, 3)Microscopestand. Themicroscopebodyismadeupoftheeyepieces,binoculartube,beamsplitter,magnificationchanger, finefocuscontrol,objectivelensanddovetailconnectiontothemicroscopestand.Itisthebodythat performsalltheopticalmagnificationofsmallobjectstoenableaclearer,largerviewoftheoperating site.Thebeamsplitterenablesasecondviewerandacameratobeinstalledtogotoamonitor. Thelightsourceismostoftenintheformofacoldlightsourcemountedonthestandwithfiberoptics directingthelighttotheoperatingsitehighlightingtheobjectoftenfrom2differentdirectionstoreduce shadows. Themicroscopestandisaseriesofcounterbalancedswivellingjointsthatcanbesmoothlymovedtothe optimumpositionforviewingtheneasilylockedtogiveasolidplatformfromwhichthebodycanbe mountedtoreducevibrationwhilemicroscopeisinuse. Pictureofequipment

Howitworks

OperatingMicroscope

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NoninvasiveBloodPressureMachinesBasics
Abbreviation/other names Whatdoes NonInvasiveBlood Pressure Monitormean? Whatdoesitdo? N.I.B.P

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Non=not Invasive=insidethebody NonInvasive=notinsidethebody Bloodpressure=thepressureofthebloodintheveins/arteries Itmeasuresthepressureofthebloodinthearteries SomeNIBPMachinesalsodisplayPulse(Heart)Rate. Whentheheartbeatsitpumpsbloodtothebodythroughthearteries.Thepumpingoftheheart,the volumeofthebloodandthediameterofthebloodvesselsalldeterminethepressureinsidethe vessels.Whentheheartcontractsthepressureincreasestothesystolicpressureandinbetween heartbeatsthepressurefallstothediastolicpressure.Theaveragepressure(meanpressure)is calculated. Acuffisplacedaroundthearmorlegandisinflatedwithairuntilthebloodflowinthelimbisstopped. Themonitorthenletstheairoutofthecuff,slowlydecreasingthepressure.Whenthepressureinthe cuffdecreasestothesystolicpressurethebloodstartstospurtthroughthearterycausingoscillations inthecuffpressure.Thisnoiseispickedupbyamicrophoneorpressuretransducer.Whenthe pressureisreducedtothediastolicpressuretheoscillationnoisestops.Thesystolicanddiastolic pressuresarerecordedasthepressuresinthecuffwheretheoscillationsstartandfinish.TheBlood spurtingthroughtheartery(betweentheSystolicandDiastolicPressures)coincideswithaHeartbeat Thetimeintervalbetween46BeatsismeasuredandPulseRateisthencalculated.

Physiology

Howitworks

Unitsofmeasurement mmHg Typicalvalues Systolic:120mmHg Diastolic:80mmHg Meanarterial:100mmHg Pictureofequipment

CriticareNIBP&SpO2

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OphtalmoscopesBasics
Whatdoes "Ophthalmoscope" mean? Whatdoesitdo? Physiology Ophthalmo=eyes Scope=toview Itisusedtoviewinsidetheeye

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Whenlightisshonethroughthepupiloftheeyetheinsideoftheeyecanbeviewed.Bylookinginthe insideoftheeye,anophthamologist(eyedoctor)candiagnoseproblemssuchascataracts,blindness anddamagetotheretina. Theophthalmoscopeconsistsofahandleandanopticalattachmentwithalightbulbandalens.There arebatteriesinthehandle,whicharesometimesrechargeable.Thelensintheattachmentfocusesthe lightindifferentwaysdependingonitsshape.Thelightisshonethroughthepupilsothedoctorcansee inside.

Howitworks

Pictureofequipment

Ophthalmoscopes

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OtoscopesBasics
Whatdoes "Otoscope"mean? "Otoscope"mean? Oto=ears Scope=toview Whatdoesitdo? Howitworks Itisusedtoviewinsidetheearcanal Theotoscopeconsistsofahandlewithalightbulbandaconeshaped attachmenttoinsertintotheear.Therearebatteriesinthehandle, whicharesometimesrechargeable.Theattachmentisinsertedintothe earandisshapedsothattheusercanseeintotheearcanal. "Otoscope"mean? Oto=ears

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Whatdoes "Otoscope"mean? Pictureofequipment

Scope=toview

Otoscopes

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PatientMonitorsBasics
Abbreviation/other Bedsidemonitor,PhysiologicalMonitoringSystem,Vitalsignsmonitor name Monitor=tokeepacheckanddisplay. Whatdoesitdo? PatientMonitorsgathervitalmedicalinformationfromthepatient,displayitonascreenandalerts medicalstaffofanyundesirablehealthcondition.

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Physiology

Patientmonitorsrecordmanyparametersfromthepatientbyusingdifferentmethods.Theparameters canincludeECG,IBP,NIBP,temperature,SpO2,cardiacoutput,heartrate,respirationrate,respiratory gases,EEGandtranscutaneousbloodgasses. Themonitorgatherspatientdatausingvariousmethodsforthedifferentparameters(seesectionson ECG,IBP,NIBP,temperature,SpO2,cardiacoutput,heartrate,respirationrate,respiratorygases,EEG andtranscutaneousbloodgasses)Theinputsarethenamplifiedandprocessedandaredisplayedasa waveformand/oranumericalvalue.Alarmlimitscanthenbeadjustedtodesiredlevelstoalertthe medicalstaffofundesirablehealthconditions. Heartrate:beatsperminute(BPM), Bloodpressures:mmHg, Temperature:degreesCelsius(C),SPO2:%, CardiacOutput:litresperminute(L/min),RespiratoryRate: breathspermin(BPM), Respiratorygases:%orpartialpressuremmHg

Howitworks

Unitsof measurement

Typicalvalues

ADULT:HeartRate:5090BPM,Bloodpressure:120/80(100)mmHg,Temperature:37oC,SPO2:95 100%,CardiacOutput:6L/min,RespiratoryRate:12BPM,Expiredgases:Nitrogen79%,Oxygen17%, Carbondioxide4% Neonates:HeartRate:120180BPM,Bloodpressure:???Temperature:37oC,SPO2:9598%,Cardiac Output:??mL/min,RespiratoryRate:4080BPM,Expiredgases:Nitrogen79%,Oxygen17%,Carbon dioxide4%. Pictureofequipment GEMarquetteDash

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PhototherapyDevicesBasics
Whatdoes Photo=light "Phototherapy"mean? Phototherapy=Therapyusinglight Whatdoesitdo?

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Thephototherapylightshineslightontothebabysskin.Thelightmustbethecorrectwavelength (colour)andthecorrectintensity(brightness).ItisusedfortreatingaconditioncalledJaundiceor Hyperbilirubinemia. Whenredbloodcellsdieandarebrokendown,achemicalcalledbilirubinisproduced.Normallythe bilirubinisprocessedbytheliverandexcretedfromthebodybythekidneysintheurine.Thebabys liversometimescannotprocessthebilirubinquicklyenoughanditbeginstobuildupintheblood. Bilirubinisdepositedintheskin,whitesoftheeyes,andmucousmembranes(forexampletheinside ofthemouth).Whenthisoccurs,thebabyappearsyellowandissaidtobeJaundiced.Usually Jaundicedisappearsin12weeksanddoesnotrequirespecialtreatment.Somebilirubinintheblood isnormalbutwhentheconcentrationrisestoohighitisdangeroushyperbilirubinemia.Anexcessive levelofbilirubincanleadtoseriousneurologicaldamagesuchasbraindamageandhearingloss. Duringphototherapythebabysskinisexposedtobluelight(420500nm).Thebilirubindepositedin theskinisphotoisomerised(changedshapebythelight)andbecomeswatersoluble.Thisisa similarchangethatoccursnormallyintheliver.Thephotoisomerisedbilirubinthendissolvesback intothebloodwhereitisexcretedfromthebodyinurine.Theuntreatedbilirubininthebloodthen depositsintheskinandtheprocesscontinuesuntilallormostofthebilirubinisremoved.This happensoveralongperiodoftime,usuallyseveraldays. Theeffectivenessofthephototherapydependson: theintensityofthetherapeuticlight thewavelength(colour)ofthelight thesurfaceareaofskinexposed Somephototherapylightsusewhitelightinsteadofpureblue.Whitelightcontainsallthecoloursbut itisonlythebluewavelengthsthattreattheJaundice.

Physiology

Howitworks

Unitsofmeasurement mW/cm2 Typicalvalues Wavelength=420500nm(withthemostimportantwavelengthof470nm) Intensity=8uW/cm2/nmto25uW/cm2/nm or0.65mW/cm2to2mW/cm2(withabluefilterof80nmbandwidth) Pictureofequipment

OhioRadiantWarmerwithPhototherapy

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PulseOximetersBasics
WhatdoesPulse Oximetermean? Pulse=thechangesinarterialbloodwitheveryheartbeat Oxi=oxygen Meter=measurement Pulseoximeter=devicetomeasuretherateandtheamountofoxygeninthe beatingarterialblood Thepulseoximetermeasurestheamountofoxygeninthearterialblood. Itmeasurestheamountofoxygenasapercentageofhaemoglobinmolecules thatareoxygenatedversusthetotalamountofhaemoglobinmolecules. MostPulseOximetersalsodisplayPulse(Heart)Rate. Haemoglobinisaproteininredbloodcells.Whenoxygenenterstheblooditis pickedupbythehaemoglobinandcarriedaroundthebodyattachedtothe haemoglobin.HaemoglobinwithoxygenattachedtoitiscalledOxyhaemoglobin.

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Whatdoesitdo?

Physiology

Howitworks

Apulseoximeterprobeconsistsof: 2lowpowerLEDs:InfraRed940nm&Red660nm Onephotodetector Theinfraredandredlightisshonealternativelythroughsometissue(finger,foot,toe,earlobeor nose).Asthelightispassedthroughthetissuesomeofitisabsorbed.Theamountoflightabsorbed changeseverytimetheheartbeatsasthebloodpulsespastthesensor.Thelightisabsorbed differentlybyhaemoglobinandoxyhaemoglobin.Thelightintensityoftheinfraredandredlightis measuredbythephotodetectorafterithaspassedthroughthefinger.Thepulseoximetercalculates thepercentageofhaemoglobinwhichitoxygenated.SpO2=Oxyhaemoglobinx100%Total HaemoglobinThetimeintervalbetween48HeartBeatsismeasuredandfromthataPulse(or Heart)Rateiscalculatedanddisplayed.

Unitsofmeasurement SpO2:%,Pulserate:BeatsPerMinute Typicalvalues Adults95100%5090BPM Neonates9098%120180BPM Pictureofequipment

DatexTuffSatPulseOximeter

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RadiantWarmersBasics
Abbreviation/other names Whatdoesitdo? Physiology Openincubator(forinfants) Patientwarmer(foradults)

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Aradiantwarmerisusedtokeepthepatientscoretemperaturestableat37C.Therearedifferent radiantwarmersusedforinfantsandadults. Thecoretemperatureofthehumanbodyneedstobekeptataconstanttemperatureof37degrees Celsius.Prematureinfantsneedtouseaslittleenergyaspossibleinkeepingwarmorcool,usingitfor growthinstead.Ifthetemperaturegoestoohighortoolow,thentheorganscanbedamagedand illnessordeathcanresult. Theradiantwarmerisusedinanumberofdifferentsituations:towarmababydirectlyafterbirth,to regulateababystemperatureduringlongtermcareinhospital,tokeepthepatientwarmduringor aftersurgery,tokeepapatientwarmwhentheyareminimallycovered(becausetheyarehavinga procedureorneedtobeaccessible)

ReadthephysiologysectiononInfantIncubatorsforamoredetailed explanationforinfantthermoregulation. Howitworks Thepatientliesonabedwiththeskinexposed.Theradiantwarmerelementispositionedabovethe patient.Thewarmerelementemitsinfraredradiation,whichisabsorbedbythepatientsskinand warmsthepatient.Theairaroundthepatientdoesnotneedtobewarmbecausetheradiantenergyis absorbeddirectlybytheskin. Unitsofmeasurement DegreesCelsius Typicalvalues Pictureofequipment 3437Cskintemperature 3637Cforcoretemperature http://www.fphcare.com/neonatal/warming.asp

F&PinfantWarmer

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RippleMattressBasics
Abbreviation/other names Whatdoes Alternatingmean? Whatdoesitdo? Physiology Alternatingpressurepad

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Alternating=Tooccurbyturns. Prevention,treatmentandmanagementofpressuresores. Whenpatientsarelyinginbedforlongperiodsoftimetherearepointsontheirbodythatpushontothe mattressharderthanotherpoints.Duetothepressureonthesesitesthebloodflowinthetissueis reducedwhichresultsinthetissuedying.Thisisknownasapressuresore.Pressuresoresarevery painfulandtheytakealongtimetoheal.Topreventandtreatpressuresoresaripplemattressisused beneaththepatienttorelievethepressureonthetissueandallowbloodflowinthetissue. Aripplemattressconsistsofanalternatingpressurepumpandaspecialairmattress.Themattress consistsofgroupsofcellswhichcanbepressurisedanddepressurisedinturn.Thepumppushesair intothecellsatdifferenttimessothatdifferentmattresscellsarepressurisedalternately.Thisallows thepatienttobeincontactwiththemattressonlywhenthatcellispressurised.Bloodcanflowtothe tissuesneartheunpressurisedcells.Sointimeallcellsreceiveblood.

Howitworks

Unitsofmeasurement Pressure:mmHg Typicalvalues 2080mmHg Pictureofequipment

MattressandControlUnit

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FlindersBiomedicalEngineering
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ShortwavePhysiotherapyMachinesBasics
Abbreviation/othernames Whatdoes "Diathermy"mean? Whatdoesitdo? Physiology ShortWaveDiathermy Dia=through Thermo=temperatureheat Theuseofshortwaveradiofrequencyforheattherapy

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RadioFrequency(RF)isusedtopenetratedeepintothebodytissuetostimulatebloodflow andtoheatthetreatedarea.Theheatingeffectonpartsofthebodythathavebeenexposedto RFmaylastupto90minwithatemperatureincreaseof1to2C.Treatedtissuecanhave increasedcirculationwithoutstressingthetissuefrommovementorexercise.Theapplications ofshortwavetherapyareforrheumaticdisordersforjointsandmuscles,inflammatorydisorders oftherespiratoryorgans,thekidneysandurinarytractsandalldisordersresultingfrompoor circulation. Shortwavediathermyisanelectricalfieldthatoscillatesatvaryingfrequenciesanddifferent wavelengthsandisappliedtoapatientbycapacitorfieldtreatmentorcoilfieldtreatment.The oscillatingfieldsproducedistortionofmolecules,rotationofdipolesandvibrationofions.The movementofthemoleculesandionsgeneratesheatwithinthetissues.TheRFfieldcanbe continuousorpulseddependingontheapplication.Atimerisofteninstalledforlengthof treatment. Withcapacitorfieldtreatment,thetreatmentsiteisplacedbetweentheplatesofacapacitorand becomesthedielectric.TheRFenergyisdiffusedthroughthepartofthebodylocatedbetween theplateelectrodes.Heatisdevelopedintheentirediffusedarea. WithcoilfieldtreatmentthegeneratedRFflowsthroughacoilinaninsulatedhousingthatis appliedtothebodystreatmentsite.AnRFmagneticeddyfieldarisesaroundthecoilthatis transferredintoheatatthetreatmentsitethatdecreasesinintensity,thedeeperthefield penetratesintothesite Watts,Hz,pulsewidth Upto400Wcontinuous,900Wpulsed,27.12MHz,400mspulsewidth.

Howitworks

Unitsofmeasurement Typicalvalues Pictureofequipment

Comfotherm

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TreadmillsBasics
Whatdoesitdo? Physiology Atreadmillisamotordrivenmovingplatformabletoadjustedinspeedandalso elevation.

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Treadmillsareusedforstresstestingwherethepatientisexercisedbeyondtheirnormallimit andthecardiovascularsystemiscloselymonitored.Theaimofthistestistorevealany abnormalitiesintheheartsfunctionunderstress. TreadmillsarealsousedinPhysiotherapyasaformofexerciseforrehabilitationafterinjuryor surgery. TheTreadmillconsistsofawidebelt,whichcanbedrivenatvariousspeedsbymeansofan electricmotor. Theinclination(angle)oftheplatformcanalsobeadjustedbymotordrivenfeetatthecontrol endsothatthepatientiswalkinguphill. Thecontrolpanelallowsforadjustmentsinspeed,elevation,durationandcalculatestime distancewalkedenergyused.Itmayalsohaveaheartratemonitorfitted. Ifthetreadmillisusedforstresstestingadditionalmonitoring,suchasanECGmachine,is utilised,maximisingpatientsafetyanddatacollection.

Howitworks

Typicalvalues Pictureofequipment

Speed=1.5to16km/h Elevation=0to10%

Treadmill

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UltrasoundBasics
Whatdoes "Ultrasound"mean? Ultra=Highorextreme Ultrasound=soundwavesabovethefrequencydetectablebyhumanears Physiology

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Ultrasoundorultrasonographyisamedicalimagingtechniquethatuseshighfrequencysound wavesandtheirechoes.Itisusedtoformanimageoforgansortissueinsidethebodynon invasively.Thetechniqueissimilartotheecholocationusedbybats,whalesanddolphins. Ultrasoundisalsousedasaphysiotherapytreatmentwherethesoundwavesareusedtowarm muscletissuedeepinsidethebody.

Howitworks

Theultrasoundmachinetransmitshighfrequency(1to10MHz)soundpulsesintothebodyusing aprobe.Theprobehasspecialcrystalsthatgeneratethesoundwavesandalsodetectsound wavesreflected. Whenthesoundwaveshitaboundarybetweentissues(e.g.betweenfluidandsofttissue,soft tissueandbone)someofthesoundwavesarereflectedbacktotheprobeandtheresttravelon furtheruntiltheyreachanotherboundaryandarereflectedback. Thereflectedwavesaredetectedbytheprobeandrelayedtothemachine. Themachinecalculatesthedistancefromtheprobetothetissueororgan(boundaries)usingthe speedofsoundintissue(1,540m/s)andthetimeofeachecho'sreturn(usuallyintheorderof millionthsofasecond). Themachinedisplaysthedistancesandintensitiesoftheechoesonthescreenandformsatwo dimensionalimageliketheoneshownbelow.

Pictureofequipment

UltrasoundImage

Ultrasound

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VentilatorBasics
Whatdoes "Ventilator"mean? Physiology Vent=anopeningallowinggastopassintooroutof. Ventilator=adevicethatassiststhepassingofgasintoandoutofthelungs

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Howitworks

Alllivingcellsinthebodyuseoxygen(O2)andproducecarbondioxide(CO2).Oxygenisdeliveredto thecellsandcarbondioxideistransferredawayfromthecellsviathecirculatingblood.Theoxygen consumedbythecellsneedstobereplacedandthecarbondioxideneedstoberemovedfromthe blood.Thisoccursinthelungs:oxygenintheairinhaledintothelugsistransferredintothebloodand carbondioxideistransferredfromthebloodintothelungsandisexpired. Inspiredaircontains79%Nitrogen,20.96%Oxygen,0.04%CarbonDioxide.Expiredaircontains 79%Nitrogen,17%Oxygen,4%CarbonDioxide. Aventilatormixesoxygenandairtorequiredlevelsandthendeliversittothepatientviaspecial tubingcalledabreathingcircuit.Thegasfromtheventilatorishumidifiedandheatedinthe breathingcircuitbeforeitgoestothepatient.Theventilatorincreasesthepressureinthebreathing circuitsothattheairispushedintothelungsforinspiration.Theventilatorreducesthepressureso thattheairinthelungscanbeexpiredandtheexpiredairisventedtoatmosphere.Numerous ventilatorparametersareadjustableandaredeterminedbythedoctorpriortoattachmentandduring operationonthepatient,someoftheseinclude: ModeofventilationCMV(controlledmandatoryventilation),SIMV(synchronised intermittentmandatoryventilation),CPAP(constantpositiveairwaypressure). TidalVolumethevolumeofairinspiredwitheachbreath Respiratoryratehowmanybreathsperminute(BPM) O2concentration Flowrate Airwaypressure Minutevolumethevolumeinspiredandexpiredinoneminute

Alloftheabovearemonitoredandhavevariousalarmadjustablelimits Unitsofmeasurement Pressure:cmH20,mbar.Volume:millilitres.Oxygen:%.Flow:litre/min. Typicalvalues Pictureofequipment Adults:tidalvolume,6001200ml,flow3050litre/min,resprate12BPM Neonates:tidalvolume=100200ml,flow=610L/minresprate=60BPM

DrgerMicrovent

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XRayMachinesBasics
Whatdoes "Xray"mean?

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MobileXRayorFixedXRay(GeneralScreening,Angiography,Fluoroscopy,MammographyandCT Scanners) InanXRaytubeanelectrongunfireshighenergyelectronsatatarget.Thisproducesphotonsof electromagneticinterferencecalledXRays

Whatdoesitdo? Physiology Howitworks

XRaysaredirectedthroughthebodyontoafilmresultinginapicture (calledanXRay)oftheinternalpartsofthatpartofthebody TheHumanbodyhasdifferentdensitiesoftissue,Hard(egBonesandtendons)andSoft(egSkin, MuscleandInternalOrgans).TheXRayisusedtoformanimageofthedensetissueinthebody.

TheXRaytubeisplacedononesideofthepatientandafilmisplacedontheotherside.AstheX Rayspassthroughthebodytheyareabsorbedmorebythehardtissuethanthesofttissue.TheX RaysthatarenotabsorbedtravelthroughthebodyandhittheXRayfilm.TheXRayfilmisexposed lessintheareaswheretheXRayshavebeenabsorbedbythehardtissueandwhenthefilmis developedtheseareaslooklighter.ThisgivesaverygoodpictureoftheBonesandTendonsinthat partofthebody. Unitsofmeasurement XRaysaremeasuredphotographically.Therearetwocommonsetsofunits,RadsandSieverts (typicallymilliSieverts,mS) XRayMachineOutputsaremeasuredwithtestequipmentinkilovolts(kV)andmilliampseconds (mAs)HighervaluesofkVandmAsproducemoreXRaysthanlowervalues Typicalvalues TheoutputrequiredofanXRayMachinedependsonthethicknessoftheBodypartbeingXRayed. Higherpowerisneededforthickerparts(egaChestXRayrequiresmorepowerthananArm) Outputsvaryfrom70130kVand2095mAs Pictureofequipment

MobileXRay

FixedXRay

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