29th Day Of attAcHment

I am unable to do preventive maintenance today since my colleague who is doing it with me is on leave. However, i get a chance to do troubleshooting and repair of medical equipments. I am happy in a way as i get to see the internal components.

The devices that i handled today are syringe pump (STC 523), infusion pump (STC 508) and PCA pump (Graseby 3300). When i troubleshooting the syringe pump and infusion pump, i followed the troubleshooting flowchart that they provided in the service manuals. After inspection of the devices, i did the occlusion and flow test to see whether the reading is out of range. Basically, doing troubleshooting not only able to detect the errors, it is to ensure the device is able to run smoothly and working well. The problem for that two devices is that the alarms keep sound. I meet this problem when i did not place the tubing in between the infra red sensors which are air in line detector. The blocking of fluid will result occlusion detector to alarm. After having the functional check done, they seems working alright.

Whereas for the PCA pump, the problem is the display is not clear so Faz went to change the batteries to see whether it is the battery problem. After doing it, the same problem arised. I continued from there and start to see whether there is any blown fuse using multimeter to check the continunity. The fuse seems alright. i am unable to find the problem so went to ask Mr Sin and he told me display circuit is wearing out. I have to call and buy the display circuit from the vendor. The bad news is it will only arrive after 6 weeks as it will be imported from overseas. For the time being, the pump will be sent back for usage until the circuit arrives.

28th DaY of AttAchMent

Second Day and also the last day of training of the 840 ventilator. The trainer, Mr Liew Kwok Meng, talked more about the extended self test which is done after the standard self test. You have to press the "test" button when the 3 indications turns red after you on it in order to go to the extended self test. There are various calibration and tests to be done. However, for PVT, you need a PTS 2000 and a software to do the test. Since AH does not have these following items, PVT can not be done. There is a bottle of soapy solution, snoop, which is used for checking any leaks.Mr Liew demostrated the working pressure test by to check the pressure of oxygen and medical air. If the pressure is off the limit, you have to adjust the cranks just on top of the oxygen sensor.

Mr Liew gave us some troubleshooting to do. For my group, we have error messages such as ventilator inoperative, expiratory out of range and SM leaking. Firstly , for "ventilator inoperative" message, The O-ring in the filter is missing so we told Mr Liew the problem and he gave us the o-ring. Secondly, the connection between the inspiratory and expiratory port is not fully connected so we remove the socket and reconnected it. Lastly for the "SM leaking" message, we took quite some time figuring out the problem and found out that the o-ring for the oxygen sensor gone missing and told Mr Liew about it. After all the troubleshooting, we have to do SST and EST all over again to check for any error. Before dismantle the parts of the ventilator, make sure to check what kind of error it is and all connections are totally connected.

Lastly, the training ended by Mr Derrick Ng giving the certificates to the trainees and taking group pictures. It is a wonderful experience in Tyco for 2 days.

27th DaY of AtTaChMeNt

Went to Tyco healthcare with Mr Sin and Lee Chong for 840 Ventilators training as it usually caused problems to the users and technicians. It is a 2 days intense training due to time constraint. There are other engineers and technicians from various hospitals beside AH which are TTSH, NUH, CGH, Mount Elizabeth and Gleneagles. There are also two foreign engineers from brunei and china respectively to make a trip here to learn the operation and technical area of the venilator. I am happy that i get to see my classmates, marcus and fu hai. It has been a long time since i last saw them. They seems like enjoying their IAP there.

Firstly, we did ice breaking by introducing ourselves and using of this model ventilator. Before i start to introduce myself, some of the employees of tyco knows that i am their friend. I found out that i am not the only one who did not do the maintenance tests and try out the equipment.

Secondly, the head of the service engineering department, Mr derrick Ng, gave an addressing speech before Mr Liew taking over the training. He talked about the various individual part of the device and the function of it. From there, he started to talk more about the various valves such as inspiratory valve, expiratory valve and safety valve. One of the safety features is when the exhaust is being blocked or obstructed, the safety valve will be turned on as the volume is beyond the limit that the user set for the airway volume and start to release the air from the device.

Lastly, we tried to do the worksheets 1 and 2. worksheet 1 is mainly the operation and what type of errors will the device has. worksheet focus more on the Standard Self test.

26th DaY of AttAchMent

Spent about 2 hours doing preventive maintenance for Day surgery and lab. For Day Surgery, we did jupiter masks and electrosurgical unit (type 1 class CF) . On the other hand, we also did centrifuge. i start to get used to identify the class and type of various devices. The preventive maintenance that we done for this centrifuge is slightly different as have to measure the speed at different rpm instead of doing it once. There are two parameters that the user is able to adjust which is duration and the speed. You can't stop it immediately when you turn it off. You have to press "brake" button to slow down the speed before turning it off.

Went to Endoscopy to replace a lamp for light source, CLV-U40 which is a Olympus Model, in the afternoon as they called Faz to drop by. While on our way to endoscopy, she told me that the lamp looks like normal lamp that you can purchase it any supermart. However, the price of this lamp is like at least 500 times the price of normal lamp. She taught me how to replace the cermax lamp by removing heat sink with the lamp in between. Before replacing it to the heat sink, you have to apply a white cream on the metal surface of the lamp to have even distribution of the heat produced around the area to prevent overheating. After that, place the new lamp in between the heat sink and screw it back. Lastly, placed it into the device and closed the side door of it. The safety feature is when the side door is not properly closed, the device will unable to emit light. There is a timer on the device that will indicates whether it has been used for 500 hrs.If the lamp is used for more than 500 hrs, the light being emitted will be very dim so it is recommended to change at least every 4 months and depends on how often it is being used.

25th dAy of AttAchMent

Spent the whole morning doing preventive maintenance at ward 3, 5, clinic C and G.

Ward 3

• Transport physiologic monitor (model: propaq)

we did the leakage current test which is a very important and also essential test so far. For monitor, we checked whether the SpO2 probe and the cuff is working or not.

Ward 5

• Defibrillator ( HP model)

It is my first time seeing this defib as usually i get the chance to deal with lifepak 12 or 20. There are lots of tests to be done for this device as we spent about 40 minutes trying to do the preventive maintenance with the service manual by our side.

The tests are:

• Energy delivery test ( measure the energy delivered by using defibrillator analyzer)
• control test (checking whether the buttons and adjust knob are working)
• testing of defib ( checking the duration to charge, amount of delivered energy in joules, impedence and peak current in amperes)
• calibration (using 300J to check whether the calibration is good or bad)
• ECG monitor test(using 1mV, 1-10Hz sine wave to check and "DIAGNOSTIC" and "MONITOR" result must be 1000 +/- 10% )

SOC C

• Video player/recorder
• Colour video monitor
• Camera control unit

The 3 devices are from sony. Only leakage current test has to be done.

SOC G

• Light source
• Colour video monitor
• video recorder/player
• colour video printer

Light source provides light for the endoscope which is plug into the device. Colour video printer is from stryker. Usually, the video recorder will record the patient's screening.

Finally, i had 8 size D 1.5 v energizer batteries and replaced them with the old ones. Surprisingly, it does not work as i am unable to turn the device on with skillreporter so most probably the connection of the cable is wrong. i Found out that the connection of the cable to the connector and socket has to be correct. I re-solder the wires in the connector to the correct locations and placed the wires correctly on the socket. It was able to work in the sense that it can be turn on by the skillreporter but not all the time and the LEDS in the microheartsim are flashing which indicates communication failure. trying my best to figure and solve the problems by tomorrow.

A device is sent from preventive maintenance for the vendor which is a lactate analyzer to measure the amount of lactate found in the blood for atheletes. Amount of lactate concentrated in a body depends greatly how active the person is. Lactate decreases for more active people. Buffer solution is used for this device. It consists of potassium chloride. It is used for flushing the blood away and diluting the blood sample. The most common problem arised for this device is the tubing will wear and tear.