20th DaY oF attachMent

Early in the morning, i started doing something different from what i usually do which is repairing 3-pin plug. After repaired 3 of them, i found out that usually the live wire disconnected from the pin which is one of the causes that make it malfunction. Sometimes malfunctioning of the power cord, the first thing that came across their minds is the device is spoilt as it is unable to turn on the device. Any malfunctioning of the devices' accessories is our responsibility to solve the problems

Went to a few places to preventive maintenance which are endoscopy, physiotherapy, diabetes and cell culture lab. Those devices that i saw it for the first time are maintenance unit, nerve stimulator and pH meter. For the maintenance unit, we will do a leakage current test and it is a type 1 class B. We only did the functioning check for the nerve stimulator as there is no power cord required for this device. For pH meter, we will do a leakage current test but since this is lab device, we using the IEC 0101 standard and it is type 2.

After lunch, i started doing the transferring of signatures to the computer. Due to my mistake, i accidentally erased all of the signatures. The mistake was press the synchronize button for a few times and i was suppose to press it once. Initially, the program hang so i thought press the button again will solve the problem. I did not know about it until the signatures were all gone so i seeked help from my colleague and know about my mistakes. Thankfully, i had a back-up file in the folder but i still lost 4 signatures.

Lastly, we return all 23 devices to the various wards, clinics and operation theares. Most of the devices were from ward 2 but yet we still spend about 1.5 hrs in returning the devices with a trolley. It is my first time returning such a large number of devices back to departments.

19th DaY of AttAcHmeNt

Did the leakage test for the syringe pump, TE 311. Usually the searching for the ground resistance value is using the probe in contact with the screws. However, i tried all of the screws and still unable to find the ground. With the help from my colleague, i found out that you have to place the probe on the screw which is on the circuit with ground wire connected to. It is like 60% that you will get a resistance of less than 0.2 ohm.

Went around to ward 2-5, 10, 12 and 13 to do preventive maintanence. We just found out that there are more devices required for maintenance than we expected. It caused a bit of confusion for us for a while. We still unable to find some devices that are listed so we only did a nebuliser, a few mattress pump units, a suction unit and a syringe pump, STC 523. Those devices that i just mentioned is what we are able to find from the various wards. While doing the mattress pump units, i just analyzed that two of them could not alternate the air flow from the openings.
2 causes for this problem to arise are the tubing connecting to the synchronous motor come off or the motor is malfunctioning. For this case, the tubings came off so we reconnect the tubing to the motor and secured the pump in the unit.

After lunch, we tried how to do preventive maintenance for a personal protection rescitator. It is the first time for my colleague and i doing the maintenance for it so we went to ask faz who is more experienced with the maintenance of devices since she works here longer than us. Before i start to talk about the maintenance, i will say a bit of it. We are doing maintenance for 3M jupiter mask and it protects the user from arbourne virus as the user will be breathing in filtered air. The atmospheric air is drawn and filtered by high efficiency filter with 0.3 microns. The filtered air will flow from device to a hook mask through a hose. The air will be flowing with positive pressure from the head to the chin as there is a opening for expired air to be released to the atmosphere. The atmospheric air is unable to enter the mask due to the positive air pressure in the mask. We were trying to complete all the maintenance for the Jupiter Mask as the hospital will be having a influenza exercise tomorrow but sadly, we could not finished on time.

Eighteenth DaY of AttAchMent

Remember i cleaning the stains made by grease and glucose? To my surprise, the infusion pump able to run very smoothly and quiet. It really shows that frequent thorough maintenance about to improve the functioning of the devices. I did my very first soldering job which was soldering two wires together as the wires are separated from the connector. After connecting wires together, I rememeber what i have learnt from EPS and reminded by my colleague, Lee Chong, that i have to put a plastic insulation on the exposed wires to prevent any damaging of the devices and short circuit it.

I required to do the function check for the defibrillator from physiocontrol, Lifepak 12 for Mr Sin. I was quite unsure what i have to do for it so i asked Lee Chong for any advices and being taught how to use the safety check by Mr Sin. The usual solution that will clear your doubts in the function check is the service manuals. They will tell you a lot about troubleshooting and maintenance. I had to do a leakage current test which is completely different as you have to enter the number of leads used and the type of the leads (e.g. type CF according to the device). maximum number of leads used for safety check is 5 leads so if the device has more than 5 leads, the safety test have done more than once. I used the defibrillator analyzer to measure the amount of energy delivered to the subject for various amount of energy (e.g. 200J)

I have been doing function check for the infusion pump STC 503 for the past 3 weeks. Since there are preventive maintenance for the syringe pump TE 311 and STC 523 for this month, i was pretty glad that i am able to learn more of the pump. The steps of function check for the syringe pretty much different from the infusion pumps. There is no delivery limit for the syringe button so you only have to adjust the delivery rate which are different for occlusion and flow. As what i have learnt for infusion pump, the delivery rate is always 300 ml/hr for occlusion and flow. However, the delivery rate for occlusion setting is 50 ml/hr and 70 ml/hr for flow setting ( for TE 311). For STC 523, both of the settings is 50ml/hr. Syringe pump have to check whether the buttons are working, the LEDs lighting up and alarms for nearly empty and occlusion. Always using a 50 ml syringe for the function check and also check whether the pump is about to detect the size of it by the diameter.

Lastly, i got the chance to see more devices that the hospital has while doing preventive maintenance. The one that i find quite interesting is the ultrasound doppler which is used to measure the blood flow and Hear Rate at that instant. It generates sound that indicates the blood flow.

SevenTeenTh Of AtTaChMeNt

The first thing i ever did for the day was doing function test for the STC-503 Terumo Infusion Pump which are the usual few tests. I tried to align the rod with the screw together but always able to align it temporarily so went to ask my colleague for help. He succeed in repairing the jammed tubing clamp. seems pretty impressive though as Faz tried for an hour yesterday. While testing the flow, there is noise generated around the stepper motor area. It seems like there are friction between the teeths of 2 gears. This will disturb the flow delivered to the patient and the accuracy of the device. The only solution is take the stepper motor out of the device and aligning the gears. After that, you have to fix it back to the other parts and turn it on to check whether there is any noise. If there is, repeat the process until the gears are moving fit in nicely and moving smoothly. Before doing all the above, i have to clean the gears, "fingers" and ball bearings. It took me close to an hour to remove the stains made by glucose and grease. It was very difficult to remove the stain especially between the teeths of the gears. i tried using the scrub but it removed a bit of it. The alternative way of doing it is using tweezer and alcohol pad to remove them.

Continue with the preventive maintenance.......
I was being asked whether i have done the function test for STC-508 which is the second generation of the infusion pump. I did not really know whether there is any different settings to be done for the test. To my surprise, the settings are the same as STC-503. The only difference in doing the function test for the pumps is the location of the components for occlusion and flow adjustments. the component for the occlusion adjustment located on the top of the device after you dismantle it. It is called VR2 which is the middle potientiometer. while, the component for flow located at the back of the device and it is also another potentiometer. STC-508 using microprocessor.

Did commissioning of a dialysis machine in the MICU with transmedic. The differences between this and the latest version of it are the latest machine has colour touch panel and more idiot proof as it has step-by-step instructions for the user to know the placing of tubing and etc.

sixteenth DaY oF AttAchMent

Today marks the beginning of the month for preventive maintenance. There are close to 200 devices for this month. I simply could not wait to start doing preventive maintenance as i will be able to see a lot of equipments that i may not know. Firstly, before starting doing it, we had to print the maintenance list for easy reference, note down the various class and types and whether it is under warranty or contract. If the device is under contract, we had to call up the vendor and asked them to send someone down to collect the device for maintenance. It is either the nurses will bring the devices down or we collect them personally.

We started off by collecting all of the Terumo Ear Thermometers that are listed for calibration so we spent about 2 hours in collecting them. I went to the Dental Department to collect the non-invasive blood pressure device too. After collection, my colleague taught me how to calibrate it using a master thermometer which is quite accurate and Terumo calibrator which use a heater control to maintain the air inside of it to be approximately 40 degree. The calibrator has a timer which allows the user to know when to measure the temperature using the ear thermometer.

There is a commissioning of a shockwave therapy unit. I got to meet another first batch senior having attachment in United BMEC. They had frequency check and power check of the devices. The interesting part is they used neon light to check the presence of the output. When the device is switched to impulse mode, the neon light placed near the tubing of the probe will start flicking for 15 pulse per minute. There is also a dummy load to test the power. There are 3 70 watts bulbs in the load. The safety features of the devices are the timer and the clicking sound of the adjusting knob of intensity. They also use a frequency counter to perform the frequency check.

Amos from United BMEC meet up with me to collect the foot scan and the computer to demostrate to nurses and doctors who are having training in NUH. i was surprised to see yao te, my senior working under this company as i do not know about it. Told Him what i know about the software such as her to do a foot scan.

Lastly, i was told to do maintenance for the 6 infusion pumps and do some minor repairing like align the rod with the screw as the the tubing clamp don't seems to work again for one of them. i hope Faz will get well soon and have speedy recovery as she accidentally sprained her neck.