24th DaY of attachMent

Continue with my soldering of the resusci anne skillreporter............................
I have to get the cable done as soon as possible as the manikin is in the workplace longer than the usual standard period of time for repair time which is 1 week. Trying to places the 8 conductors on to the PCB socket but the wires seems to be unable to stay in the socket. After a few failed attempts of securing the wires to the socket, i finally did it. While doing the continunity test, i found out that the positioning of the conductors got mixed up while i do soldering. only 2 of the wires are positioned correctly so i have to remove the others from the socket to place the correct location on it. Did the continunity test again and i found out that contact between the socket to the connector is bad as the alarm do not sound. One of my colleague suggested that i should remove the insulation of the wires to have better contact so i did according what he said and it works. I used silicon glue to secure the wires positioned on the socket and prevent it to short to another wire.

Finally done with my cable so i wanted to try whether it works. After plugging the connector into the manikin, i realised that it is low batt. May be i forgot to off the manikin after using it? Anyway, my colleague order the size D energizer batteries (1.5V) so i just have to wait for them to be delivered.

The department seems so empty as about 4 devices are taken to be placed in the storeroom for MMD. Since the first day i came to BME, there is always devices coming in to our department for commissioning so got used in having a few devices around.

Mr Sin had a meeting with us about the auditing on next tuesday. He briefly told us what we have to know like where is the procedures for BME located in intranet of Alexandra Hospital, house keeping, working safety, lock- out safety, the ISO guidelines and 20 basics of Alexandra Hospital.

Lastly, Lee Chong and i delivered back the repaired devices.

23th DaY of AtTaChMent

Had a 2-hours training with a vendor, IDS Medical, on syringe drive, MS16A and MS26. There are two types of syringe drive which cater the different needs of the patients. They are two very simple devices as they only consist of a small PCB board. One is for daily rate while the other is for hourly rate. Both of them have the same function which is injecting certain amount of insulin or some antibiotics at a known rate in mm. You must be how to convert the ml to mm? There is a meter located at the bottom left of the device. The recommended type of syringe range is 12ml to 35ml and type of battery is 9V energizer and duracell. These 2 battery brands are strongly reccomended due to their longlasting lifespan as the patient required to wear the device for days. By the way, it is a ambulatory device. The trainers talked about the application and technical area of it.

For applications, she talked about the function which is injecting at certain rate as some patients required to take certain amount of insulin or antibiotics every few hours. Therefore, this device is used to save the hassle. The disadvantage is that there is no control of the number of times that the patient press the boost button for MS26 device and it will pump at a certain rate. However, the pumping of solution can be stopped after a certain number of times that the patient pressed. It is to prevent overdosage. The usual 2 problems are miscalculation and adjustment of delivery rate.

For technical, the trainer talked about troubleshooting and the usual problem arised like the LED flash rate is not within 21+/-5 secs and the thrust test failed. Most of the solution to the problem is adjust the R9 and R5. You can either adjust the resistors from the cover or internally.

Did commissioning of a electrical stimulator. It requires a digital oscilloscope and test load. There are 5 different waveform tests are carried out to check whether the system is operating. It is also a therapy unit that will be used in the rehabilitation.

I did soldering for the cable of resuci Anne skill reporter since yesterday. I spend almost a day doing it as it is my first time solder the wires to a 8-pins connector. I met a few problems as the pins are uable for me to place a bit of solder on it. Therefore the contact between the pin and the wire is not really good. Sometimes no matter how much solder i place on the soldering iron when trying to solder the wire to the pin, the solder seems unable to stick to the pin. It got pretty frustrating as the wire coming off. After finished soldering, i feel like i have done something that makes me proud of

22th DaY of atTaChMent

Trying my best to figure out the problem that cause the suction regulator unable to turn on by itself when swtiched to intermitten mode. After 2 hours, my colleague just assembled the whole devices by screwing back the screws. Surprisingly, it works and we just have to adjust the duration for the "off" and "On" mode. Transmitten mode range for off is 7-12 secs and for on is 15 to 20 secs. i like to correct what i said about the devilbiss suction unit. It is an aspirator which has the similar function as suction regulators but it is electrically powered and has a compressor in it. Both of them have the maximum pressure of -300 mmHg for wards and intensive care units as they are used to clear the airways. However, in operation theatres, the maximum pressure used is -760 mmHg. The reason of using such a high pressure for vacuum is to suck the blood, tissues and etc during a surgery.

There is a commissioning of 2 equipments on trial which are automatic lensmeter (CLM-3100) and automatic projector. automatic lensmeter is used to measure the power of the lens which we also called the degree of refractive of the lens. The projector is used for eye check up like asking you to look at a few letters and asked you to identify the image. This projector has more than 40 templates of images which varies from alphabets to images of animals. May be i should try to operate the devices tomorrow to get a better understanding of them and their operations.

Mr Toh briefly told us the ISO auditing which is held every 2 - 3 yrs. Employees will be asked to answer questions about safety such as fire safety. There is a Lock- Out safety which talks about what you should do if the devices is faulty.( nurses have to put a tag that "says do not use" and stating the problem on it or use a electrical lock-out if the cable is unable to be removed from the device). He also talk about the preventive maintenance of the weighing machine for lab and pharmacy. We have to do 3 tests for it which are linearity, repeatability and weight loading ( to know where the load cells are placed). It is using a vacuum fluorescent display which emits light and consists of fluorescent tubes bent to the same of the 7-segments. It uses high voltage to ionise the air in it to allow it to bent. LED 7 segments also emit light. However, the LCD display absorb light which is used for the calculator display. It is cheaper than the vacuum fluorescent display and do not use much of energy.

21st DaY of aTtacHmEnt

Found a suction unit device which is from Sunrise Medical. I was totally curious about how different the device is compared to the others. The only difference that i have found from my observations is it has a vacuum regulator knob that allows the user to adjust the vacuum level. For the transmittent suction units, it can either be turn on or off and at the fixed vacuum level. All suction unit has the same function which is to sucking the extra fluid from the body such as phlegm around the pharynx region.

Went around to emergency. ward 13, 10 and 7 to do preventive maintenance. However, we only able to find 3M jupiter mask, blood gas analyzer and tonometer ( we usually call it "tonopen"). We just did the temperature and EQC test for the blood analyzer. For the tonopen, we did calibration for it.

Before talking more about the tests for the blood gas analyzer, it has a touch screen panel and allows user to view the present and past records of the patients. It requires a cartridge to be inserted to the device. The blood sample is then released from the syringe onto the cartridge. The device will analyze each individual gas level in the blood sample such as the amount of carbon dioxide, oxygen and etc. For the temperature test, there is a temperature card provided so we just have to insert the card and it will self-analyzed it. After analyzing, it will printed out the result indicating passed or failed. It will do the same for the EQC test without the temperature card.

The calibration for tonopen may seems easy but i did not get it initially. After trying for a few times, i finally get how the calibration works. Calibrations has to be done before every use.

Steps for calibration:

• Pointed the device down and press the button twice
• Point the device up if "up" indication is shown
• It will indicate whether the calibration is done correctly. ( either "Good" or "Bad")
• press the button once and "8888","----" and "====" will appear on the screen one after another.
• The tonopen will then be ready to use.

Mr Sin took me to the MICU and talked to me about the different types of monitors and ventilators. For the monitors, the siemens model has configuration and modulator while philps only have modulator which means that it has different module of parameters such as spO2 inserted to the device. The advantage that siemens has over the philips is siemens model able to behave like a transport monitor and data collected during the transport will not be lost as it has templates of different heart cases installed in it. However, the better the device is, the more expensive it will get.

For the ventilator, the ventilator used in intensive care unit has both volume and pressure control. oxylog 2000 has only volume control while the bipap is pressure control. bipap is used when the patient is able to initiates the breathing on his own.