SUMMER TRAINING

ON

BIOMEDICAL EQUIPMENTS

SUBMITTED TO:Mr.OMPRAKASH HOD(BME)

SUBMITTED BY:KRITI ARORA 08EAEBM017

ABOUT THE ORGANIZATION

Max hospitals is one of the best hospitals in India. With over 800 beds and 8 hospitals in Delhi, it is Indias first truly integrated healthcare system. Max healthcare is known for providing superspeciality and tertiary healthcare services. Total healthcare ethos run through the corridors of Max. The hospital provides world class service standards with personalized care for patients. At Max they have 1500 physicians and 3500 support staff who deliver truly patient centric and excellence driven care.

ABOUT THE BIOMEDICAL DEPARTMENT :

The biomedical departments of Max healthcare in Saket, Gurgaon and Panchsheel are under the guidance of Mr.Alok Sharma. He is the Regional Head. The department is a very important part of the hospital. It plays a significant role in a hospital when it comes to equipments.

The various things are taken care of by the department : 1) Repairing of equipments. 2) Preventive maintainace and calibration of equipments. 3) Pooling of equipments. 4) Giving equipments on loan. 5) Attending calls for technical faults in equipments. 6) Installing of new machinery. 7) Providing training to nurses about using various equipments.

VARIOUS EQUIPMENTS IN A HOSPITAL :

The various equipments to be studied in a hospital are :

1) Syringe pump
2) Blood gas analyzer 3) Ventilator

SYRINGE PUMP
In Max hospital, syringe pumps of the company B.Braun are used. The model was Perfusor fm.
About the syringe pump: 1)The syringe pump is used to infuse drugs at a particular rate as prescribed by the physician. The Perfusor fm is used primarily for the highly precise, reproducible infusion of medication in large and small quantities. 2) The device permits extremely exacting delivery rate settings, and thus, optimal adaptation to any given requirements.

3) The drive system ensures reliable gripping of the syringe on pressing the appropriate key, which in turn makes for optimal start-up and considerably facilitates handling when inserting the syringe. 4) Nine -stage pressure limitation provides extra safety. Pressure values and trends are displayed during infusion.

5) Special functions broaden the scope applications.

6) Additional memory cards provide yet more functions.

For example, conversion to patient controlled analgesia. (PCA)

Work done on it :
In Max hospital, there are a number of syringe pumps for each department. When a syringe pump is not working or in case of a technical fault, it is sent to the bio-medical workshop. We, as trainees were supposed to assist our seniors in such cases. One of the main problems was of faulty control board. This was solved by opening the pump and checking the board or replacing it. Another problem was of faulty keypad. In such cases, the keypad was replaced. The calibration of the equipment was also done from time to time to ensure the proper working of the machine. Also, the battery was replaced as and when needed.

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ARTERIAL BLOOD GAS ANALYZER

In Max hospital, the blood gas analyzers used are of the company Radiometer and the model is ABL 800.
About ABG : The blood gas analyzer is used to measure various parameters of blood. The following parameters are measured by it : 1) pH 2) pCO2 3) pO2 4) Hb or Hematocrit 5) Lactate 6) Calcium 7) Magnesium 8) electrolytes such as potassium , sodium and chlorine

The following calculated parameters are also there : 1) Bicarbonate 2) Standard HCO3 3) Total carbon dioxide 4) Oxygen content 5) Oxygen saturation etc.

The results are usually available in 3 minutes. Main facilities in it are the touch screen monitor, external keyboard, mouse and barcode reader. The system is microprocessor based. And, it provides interfacing between the device and the computer. It works on windows 98. It has hard disk of about 80 GB. It has an high end color inkjet printer.

Now, an ABG has three solutions on the right hand side. They are cal 1, cal 2 and cleansing solution. On the right hand side we have two solutions. They are rinse solution and waste solution. These are replaced as and when needed.There are two gas cylinders as well which carry out the pumping action.The blood to be tested is sent in the Machine via an inlet. This inlet must be kept close all the time otherwise.

Work done on it :
Any kind of problem in ABG is informed to the user via system messages. Problems would mainly occur when any of the solution was less than 15 % in volume. Hence, they were replaced. However, the major problem was related to the quality check of the machine. So either manual or autocheck was done time to time.

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VENTILATOR
In Max hospital, the ventilators are of the company Maquet. And the models used are servo s and servo i. servo s can be used in the adult mode only while servo i may be adult or paediatric . A blue colored symbol is for adults and a pink colored symbol is for paediatrics.

About the ventilator :

A ventilator is used to provide artificial respiration to patients with non functional lungs. There are two modes in a ventilator viz controlled mode and supported mode. In controlled mode, there is a complete control of the machine. There is no role of the patient. However, the supported mode just supports the patient. There are two tubings for gas supply. The purely white tube is for oxygen and the black and white tube is for air. The air pressure lies between 3.8 to 4.2 bar.

 The

ventilator has an inspiratory and expiratory unit.

The monitor can be rotated 360 degrees. The ventilator start/stop button is on the monitor. There are 4 more buttons to adjust oxygen concenteration , PEEP (positive expiratory end pressure) There are four more soft keys to start breath, to increase oxygen breath and other two for holding inspiration and expiration.

The touch screen can also be navigated through the dial. Silence button is used to supress the alarm for two minutes. We can change the modes since maquet is user friendly. Entering patient details is also possible. Status button gives the status of the ventilator. It gives battery status, serial number etc. The ventilator can be used in invasive or non invasive mode. The former involves cuts whereas the latter uses masks to provide ventilation. The supporting arms support the patient circuit.

Work done on it :
The first and foremost requirement of a ventilator is the completing of the pre-use checkup. Ventilator is a critical machine. Anything happening to the equipment directly affects the patient. Hence, a self test is done. It is done to ensure that the machine is in proper working condition. Hence, what we mainly did was the pre use checkup. Any failure in the tests, resulted in technical faults thus making the ventilator unfit for use. The various tests were :

The various tests were :

1) Internal 2) Barometer 3) Gas supply 4) Internal leakage 5) Pressure transducer 6) Safety valve 7) Oxygen sensor 8) Flow transducer 9) Battery switch 10)Patient circuit 11)Alarm state

The ventilator needs AC supply and has batteries too. These batteries need when fully charged, deliver performance for 90 minutes. These were replaced as and when needed. Also, the oxygen cell was replaced when it was used up. An interesting case arose when the power supply board of one of the ventilators as not working well. It was deduced that the resistor in it was burnt. So, a new resistor was placed in it using de-soldering and soldering. Also there were problems when there was moisture in expiratory cassette. The expiratory cassette is used for one patient only. Then it is sterlized. It is washed and dried. A nebulizer can also be connected to the ventilator.

THANK YOU ..