fifth day of my attachment

Today is more of delivering repaired equipment devices to various wards than staying in the workshop to do the documentation of the service report and quotation. quotation is like a record of what we bought as spare parts and when we received them. The cost of batteries for the equipment can be like 100 times of what we bought in the supermarket. It definitely tell me that medical devices are not cheap. I went to the intensive care unit and saw the baxter infusion pump. It is pretty different from the normal infusion pump that i got to see in the workshop as it has 3 channels instead of 1 so the baxter able to transmit 3 types of fluid to the patient's body. However, it is least commonly used in hospitals as there was a case that a patient died due to the sudden shut down of the device which mean the fluid stopped transmitting.

i was being told by my colleague that there are a few antennas on the ceiling of the ICU ward as it enables the nurse to monitor the patient's measurement of the bed-side monitor like their SpO2. Not only that, they also able to monitor the patient even when they are out of the ward but within the hospital compound. pretty interesting i think.

Fourth day of my attachment!!! Loving it!!!

The first thing that i did in the department todae is trying to get a feel of how to do the occlusion and flow test for the infusion pump by using a infusion device analysis series ( a testing device for infusion pump). I tried to do some troubleshooting before doing the test for the pump. Mr Toh told me not to touch the internal components of the pump when it is on as a huge current is passing through the device. i realised that the a mesage "Er3" is indicated on the pump. I did not have a clue what error was that so i went to ask around and they told me to the service manual has the answer to it. i went to flip through the pages of the service manual and found out that "Er3" means error 3 which indicating to the user that the air in line detector is dirty. i went to clean it and i solved the error. after that, Lee Chong and i did the preventive maintenance as it has to be done once in a year. Infusion pump belongs to the Class I and type B so we have to use the probe to place on its ground after the plug of the pump placed on the device test analyser. The analyser is able to print and transfer the record of the leakage current test to the computer.

I was being taught how to transfer the signatures that we collected from all the staff nurses after returning them the devices to the computer. It is pretty tedious as you have to name each signature according to the work order code of the devices.

There are two new equipments that were brought to Alexandra Hospital. one is on trial while the other is bought by the hospital. it is like a great exposure to new devices. i finally get to know how commissioning is like. the vendor will send a person to the department, test the equipment and tell the technician or engineer how it operates. The two equipments are ultrasound scanner and a device that able to do fine operation on patients. These two equipments are pretty interesting. one of them is like having a colour touch panel. I got to try a ultrasound therapy unit. you will really feel the heat generated by the device. It is like quite fun.

I just found out that not only resistors have colour code, the oxygen tank also have colour codes (for example: blue for nitrogen). Different type of oxygen tank has different positioning of the pins ( the distance between the pins) to let the user know which type of oxygen flowmeter is able to use for releasing the tank to supply the patient with it. In hospitals, the have a central control system that supply air such as pure oxygen near their bed which uses a wall attachment. It is pretty similar to the oxygen tank as it has colour codes to let you know wat air is being supplied and the locking device of the attachment varies with the type of air.

third day of attachment

i believed that i mention about the infusion pump in my previous post. There are 3 different types of pump which are infusion pump, syringe pump and pump driver. The accurancy that each pump has is 5%, 3% and 1% respectively. The device that is being used for diabetic patients is insulin pump which is able to be programmed to deliver certain amount of insulin at a specific time. There is another pump which is the patient controlled amount infusion pump. It is used for patient who will suffer a lot of pain due to terminal stage of illness. when they feel the pain, the will press a button that allow a certain amount of drug to be inserted into patients. It is programmed that no matter how many times the patient pressed the button for a period of time, only a amount of drug will be inserted to the patient once. i was being told how the syringe pump able to sense the type of syringe by the diameter of the syringe and how feeding pump able to sense the rate of the drop using infra red sensors.

i got a chance to update the programme with new medical equipment and did quotation of the parts that are purchased by Alexandra hospital. i was also being taught how to do the documentation of the service report in the programme to update the preventive maintenance of the devices.

i went around the hospital with my colleague after nurses called BME department about the devices being faulty. when we went there, most of the time is the cable got loose or the device is battery low. Something really interest me today. It is the Physiotherapy device which is the therapy unit. It seems similar to the muscle stimulator. After i got back to the department, i went to ask Mr Sin more about the therapy unit. i found out that it is used to speed up the healing process and there are 5 types which are electrical, vacuum, shortwave, ultrasound and microwave. The therapy unit do have combination of two or more type. OSIM has devices which are similar to the electrical and vacuum therapy unit. vacuum therapy unit uses suction that are being placed on a specific part of the body while the electrical uses plates to transfer current to the body. The electrical and vacuum therapy unit uses current while ultrasound , shortwave and microwave uses frequency to produce a heat treatment.

second day of attachMent

During the morning, Mr Sin introduced me to a few analyser devices such as defibrillator analyser and NIBP monitor tester. For the defibrillator analyser, 2 electrodes are placed from the defibrillator to the analyser. There are two swtiches on the analyser. One switch is able to let the user to select "CARDIO", "ENERGY" or "AED" while the other allow the user to select normal heart rate or fibrillation. If the switch is switched to "CARDIO", the analyser is testing the cardiac synchronise of the defibrillator. If it is switched to "ENERGY" and other switched to the fibrillator mode, the analyser will measure the energy delivered for the shock to it and the defibrillator will print out the waveform from fibrillation to normal heart rate.

He also introduced me to this programme that stores history of the maintenance of devices available in Alexandra Hospital. i was taught how to update the work files in the programme after repairing the devices.

i was given chance to repair some devices with guidance from my colleague, Lee Chong. Actually, i just remove the filter of the suction regulator, amending the mattress of the alternating pressure pump system and connecting the tubing back to the air pressure control pump as the air is not dispensing from the air outlet. The alternating pressure pump system is being used for the bed-ridden patient to have blood circulation as they do not have much movement on bed. The air pressure control pump will have two air outlets that allow alternate flow of air. This causes the alternating movement of the inflatable mattress that helps to promote blood circulation.

I was being introduced two two new devices that i did not learn it in school modules. they are aspirator and suction regulator. There are two type of aspirators which one is making use of the driven motor and the carbon fins while the other making use of diaphragm. There is a regulator that allows the user to vary the pressure of the vacuum. The aspirator need to be connect to the electrical power supply. For the suction regulator, it depends on the suction central control system. The suction regulator available in Alexandra Hospital mainly used for general suction such as phelgm. There are three type of suctions available. they are thoracic, surgical and gastrointestinal suction.

Lee Chong also taught me how to test the infusion pump using the infusion pump analyser. before going in details about the way to test the pump, the pole cramp and the cover must be removed as the adjusting knob is inside of the pump. The two tests carried out are checking of the occlusion and flow of the fluid. He also took me around the hospital while returning the repaired devices and show me what i am suppose to do if i am given the similar task.

The rest of the day, i read the manuals of the devices which i believe will help me in my attempts of repairing the devices with guidance of my fellow colleagues.

first day

First day of the attachment seems quite fun. However, I was lost in the hospital as I am not sure where the human resources management is. After asking a few nurses, I finally get there. It seems like I am not the only one doing attachment in Alexandra Hospital as there is another girl who got attached to another department. After getting my nametag, one of the human resource personnel took me to the biomedical engineering workplace.

It is pretty cozy as the place is like a hut and the people there are pretty nice. MR Sin introduces some equipment that are used for safety checking such as the safety test analyzer which I believe that I will do it for my experiment in the next semester. MR Sin asked one of his colleagues to demonstrate how to use the equipment. Before demonstration, he told me that there are two safety guidelines to follow. The two guidelines are CEI IEC 60601-1 for the medical devices and CEI IEC 1010-2-020 for equipments for laboratory uses. For the medical devices, there are three classes that are class I (there is ground), class II (double insulation which means that it does not have a metal material on the external surface of the devices) and class IP (having a internal power supply). Sub-branches of these 3 classes are B (Body), BF (Body Float) and CF (Cardiac Float). These can be found on the label of the devices. For laboratory equipments, there are only two classes that are different from the medical devices. They have class II and I. However, they are using two probes as ground whereas medical devices using 1 probe for the safety test. For testing, we have to insert the 3 pins plug of the device to be checked to the safety test analyzer. If it is a class I, insert the ground plug to the ground of the analyzer. We have to key the type of the class that the device belongs to. After that, key in the devices serial number. Last but not least, press “Automatic” in order for the analyzer to test the devices itself. The history of the safety testing will be updated in the computer. This is done once in a year. We have to stick a sticker on the devices to indicate that we have checked it before.

MR Sin introduced me to the infusion pump that is being used for drugs such as morphine. There is a sensor in the pump. It will beep if there is no fluid flow that means there is air in line. This will result in discomfort to the patient.

The manuals of the medical devices are kept in 6 cabinets alphabetically. Inspecting the devices and applying license for some devices such as lasers and x-rays do commissioning of medical devices. Some devices are repaired either in the hospital or sent for repairing. Those equipments that are sent for repairing due to the spare parts are costly.

My senior, Afiq, dropped by to introduce the project that I have to do here which is collecting 14 Diabetic type 2 subjects which have neuropathy. This means that diabetic patients having numbness in the feet. He some sort of teach me how to write a medical protocol which we are not taught in poly so it is pretty much a new thing for me. He also taught me how to calibrate, capture and export the foot scan from the software and the experiment should carry out.