42nD DaY Of AtTacHmEnT

I will have my final touch on the device by have the necessary tests which are the usual flow and occlusion tests to ensure the accuracy. I have to be meticulous dealing with medical devices.
After doing the tests several of times to get the readings within the range stated in the service manual, the tubing clamp seems to give me problem again. The clamp do not seems to close when i close the door. The clamp will close to stop the fluid from flowing once the user close the door. There will be a "ta" sound and that's how i differentiate whether the clamp is working. I bent the rod with a plier but it seems that the rod will not align with the screw after i close the door for the third time. We will try to open and close the door for 10 times to ensure the rod and screw are secured and aligned properly. I tried all means to align the rod and screw including adding silicon gel to secure it. Thankfully, it works by doing that. After running the tests for the last time, i concluded that it is working fine.

There was a commissioning for rehab devices such as treadmill. The vendor, Dynaforce sent to maintenance engineers down to do the commissioning. Actually, they came a week ago but they were clueless about the proper checklist of tests they are suppose to do and the safety class type for it earlier on. The leakage current test can not be done as it required taking the module out in order to test and definitely there will an amount of current leaking. There will be two metallic plates on the handle that have sensors beneath it to detect the heart rate of the patient. Heard from the vendor that it is more difficult to sense the heart rate from female as they have higher fats percentage. Some treadmills are running on DC while others running on AC. There will be more current leaking for DC compared relatively to AC. While it is running, a bigger size person holding back on the track, the current will flatuate like crazy. Therefore, i concluded that there are lots of factors to consider for the current leaking. After discussing with the vendor, they will give us more detailed checklist and the tests that done in the factory at Hong Kong.

41 DaY oF ATtaChMent

How's today in Alexandra Hospital?? All i can said that it is quite busy but i pretty enjoy working with such wonderful family. Sometimes, the workload for the day may seems hectic but the enjoyment of the learning and the chances of maximising my knowledge gained from Alexandra Hospital are always given by Mr Sin. I am pretty much grateful because of him.

Once again, i did repairing for today. Before starting on my repair on infusion pump and otoscope, i transferred all the signatures to the system and updated some work files on what i had done yesterday like replacing of the oxygen flowmeter. Called up some vendors for quotation to replenish some spare parts in the storeroom. I got a repair assigned by Mr Sin which is the "Battery" LED did not light up when battery is in use. The first thing that came to my mind was to search for the service manual to find the cause. There were 3 causes which are LED defective, connector 9 to connector 19 need to be checked and HIC circuit faulty. I was quite lost while i found out the causes so i asked Mr Sin for some guidance. He taught me how to test the connection of the diode to the IC. i kind of spent half a day to figure out the connection and components as there are at least 30-40 components on the circuit. I got to know a new symbol for relay. Relay is being used for the device to swtich to ac supply when the plug is connected to electrical supply automatically. When the plug is connected, the relay will toggle to the connection that initiate the LED for ac supply to light up. After checking, the diode seems to be working fine. However, the connection from the IC to the jumper which also connected with "battery" LED don't seems to be connected so Mr Sin decided that just change the whole PCB board that has the LEDs. I just hope that the infusion pump will operate fine tomorrow.

Lastly, i just changed the lamp bulb for otoscope as the complaint is the bulb blown.

40th DaY oF aTtAchMent

After doing the maintenance for pumps for the past few days, I only left pumps from SICU. Unfortunately, I only able to find the graseby 3100 syringe pump as most of the terumo syringe and infusion pumps are used by the patients. When I reached there, I found out there are more patients than usual so I tried not to take the terumo pumps as they may be needed. The ward seems pretty much hectic as each nurse as to take care one or more patients at a time including the nursing officer of the department. It is the first time that I saw hem being so busy.

For today, I did more repair than maintenance since many pumps are unable to be brought down for maintenance. I got to see commission of the single flowmeter from Allied healthcare. There were 30 flowmeters being bought by us so it took gary oon from star medical close to 2 hours to complete the checking of device. They had their own calibration analyzer and a leakage tester which is a bottle. The flowmeter is being calibrated at 50 PSI. They will measure each LPM marking on the flowmeter and the tolerance of it is like +/- 1 of the stated value. For the leakage test, the flowmeter will be connected from the oxygen tank to the tester which is half filled with water. If there is a leakage, bubbling will occur.

Operation theatre at level 3 passed me the PCA pump, Graseby 3300 yesterday due to the start button unable to initiate the infusion. I tried turning it on and it seems alright but after doing a few times, I met the same problem as the end user who is doctor and nurses. Therefore, I asked Mr Toh for guidance and he told me mostly probably it is the user did not know how to use it. Mr Sin then came in and told me that there are two causes that may arise this problem which are the incorrect settings done by the user and the cover did not closed properly. Sometimes, there will be some error message displayed but the user will just ignore it. There are many safety locks for this device due to its function which is injecting morphine to the patient. It is necessary to have locks to prevent over dosage of morphine. If over dosage occurs, the particular nurse to administrate it will have to be reported and unable to continue her/his job as a nurse.

Lastly, a flowmeter sent to BME for repair as the complaint from ward 13 was that the metal ball in the meter unable to drop to zero when the knob is totally closed. Usually, we will change the whole flowmeter with their oxygen gas probe unless it is the internal glass tube is broken.

39th DaY oF aTTaChMent

I did what i have done for the past few days as trying my best to master the maintenance for almost all of the pumps. Surprisingly, i did 6 pumps before Mr Sin took me to the radiology department where the radiographer and radiologist will be there to do some scanning and diagnosis. The department consist of two levels. Level 2 is mostly for commerical purposes which means doing a general scanning like fracture. Level 1 consists of MRI, CT and x-ray for more serious cases. Some of the radiographers introduced the various devices such as MRI, CT and X-Ray in terms of operation and functions. The most amazing thing is the radiographer in charge of MRI asked me to enter the room where it is located. He brought a bunch of keys and asked me to feel the strength of the magnetic force. I actually placed the keys slowly to the MRI and felt the magnetic pull from the key. When you held the keys near to it, so near that you are able to see the keys floating.

Next location we went is the CT scan room. CT that we had only able to have a slice per revolution means more radiation exposure and slower to obtain the desirable number of slices. At first, CT will have a rough scan on the patient in order for the radiographer to select the region of interest that he likes to capture. It usually measure from the head to the pelvis and the distance will be in mm which is being calculated by the software.

Lastly, we went to the x-ray room. The radiographer told me that the only difference from the x-ray machine that they have it there compared to the level 2's is the cassette. In the cassette, there is a film that image is being captured on. For level 1, the film is reusable for quite a number of times which we can say it is more cost effective. If the image is not well-captured, you can erase it before developing it out. However, for level 2, the film only for once use so it is like the film in our camera once you capture, you can't remove it so it will consider a waste film if the image is not well-captured.

In Alexandra Hospital, there is this device that able to upload the film by putting it into the device and allow the radiographer to adjust the best type of brightness for the image in order to optimise the clarity of the image. The images will then be stored into the server allows radiologist and doctors to view it. However, it is yet to be done for the image to be viewed at the patient wards so far it is only accessible to that department for now.