57th Day Of AttAchMent

Before the start of a friday morning, there is an event for Earth Day (ENvironmental friendly day). A few telematches played against different department even Mr Liat, CEO of Alexandra Hospital, were involved. The telemaths allowed us to have a better understanding on saving the earth.

After clearing all the doubts of the list, we embark our " journey" of preventive maintenance today. We did a few device maintenance as most of the devices are unable to be located. Since it is the second day of the month, we just have to make good use of the time phase to complete the task given to us. I got to see the older model of BP device and pulse oximeter. Both of them still making use of LED display and only have single function unlike the latest model which comprised of more than one functions.

Around after lunch, devices keep on coming in to the workplace for repair. Within 1 hour, there were about 5-6 devices. most of them were sphygonomometers. The tetious part was changing the reservoir as you have to draw all the mercury out from it. There is a possibility that mercury poisoning if dealing with it carelessly.

56tH DaY oF aTtAchMenT

Actually, today marked the start of my june's preventive maintenance. However, there is some complications of the list of devices due for maintenance. Some of the devices on the list had done maintenance 4-5 months ago. I feel that the system generates the work for it as the system is not being updated of change in schedule. Therefore, we did repair for the whole day.

We got informed by a staff nurse from MICU that the result of temperature test for blood analyzer indicates failed. Temperature test is always required to be done before inserting the cartridge of patient's blood sample. Different temperature varies the accuracy of the result. The temperature test is checking on the atmospheric temperature. We did the electronic component test and it also indicated failed. we initially thought that may be the connector and the temperature card got contaminated by the blood stains as we saw the trace of blood on the device. We wore gloves to clean the devices that dealing with blood samples to prevent any transmission of diseases. After cleaning, the analyzer indicates sensor error after inserting the temperature card so i feel that after thoroughly cleaning will make it worst? Lee Chong even went to SICU to get another temperature card to check whether the problem lies with the card. That's what we called troubleshooting. After several of failed attempts, we tried using a new edge connector to check whether the problem lies with it. We spent close to 1 -2 hours in finding the problem. After i inserting the temperature card tightly with the connector, the result of both tests indicates passed so most probably the contact is not really good or blood stained on the sensors. The most common problem is the spinner lost. It is used to keep the roll of paper in place. However, it will be thrown after the roll of paper had finished.

I got to see a therapy unit that exercise and encourage blood circulation of patient's legs. It is called passive motion unit. It was being sent down to the workplace as it was unable to turn on. We still trying to analyze the fault before making any decision of buying a new component board or microswitch.

55Th DaY of AttachMent

There were a couple of repair in the morning. There were a nebuliser and sphygonomometer being sent down. Both of them seems rather simple repairs as they involved in changing the certain parts of the devices.

Between 10 am to 11 am, i followed Faz to emergency medicine to mount brackets for 11 propaq as sister wanted the propaq to be able to place on a metal pole for 2 reason which are taking less place and easy to transport from a place to another. However, it is time consuming to do all 11 propaq at one go.

Around 2:30 pm, Elson from Mandarin came to do commissioning for 4 equipments which 2 of them are for trial and the others are being bought by us. One of the is the latest model slit lamp, BQ 900, and the other is laser unit, IRIDEX. For the slit lamp, they just do the physical checks like the brightness and intensity of the light being shined onto the eye. He did the power measurement test for the laser unit. The tolerance for the laser unit is about +/-20 % of the stated values ( 200W, 500W, 1000W, 2000W). Both of them would have safety test required. Slit lamp is for diagnosing of human eye while the laser unit is used to perform ophthalmic surgery.

54tH DaY oF ATtAchMent

The workload for today was quite alright as i got to do commissioning and updating of system.

Firstly, We took close to 3 hours to complete the whole commission of the latest model of anaesthesia unit with monitor. This model having the same function but more advanced than the older anaesthesia unit which is also from Datex-Ohmeda. Why do i say that? This model is digital and having touch screen panel whereas the older model is analog and no longer available in the market. I could say that the latest model has the latest softwares in the market and it is the first device that launched in singapore which is bought by Alexandra Hospital. It is more precise in terms of adjusting the amount of gas compared to the older version which is using flow tube. Therefore, the user using the older model only able to gauge the amount roughly. However, the new model allows user to adjust the amount more accurately like 5.32 L/min.

There were quite a few safety features which i know a few of them from the Mr chew from Datex. Two of them are located at the vapourizer. Firstly, you have to press the button located behind the cap in order to adjust the volume by turning. Secondly, there is a lock to secure the vapourizer. If you did not close the lock, the vapourizer will not function at all. The last safety feature that i know which is when the nitrous oxide gets too high ( even slightly higher than the oxygen volume), the device will stop. Something good about this device is it uses gas module instead of oxygen sensor to monitor the oxygen level. Oxygen sensor is electro-chemical cell which performance will deteroriate after a while so it has to be changed after a year the most ( depends on how often the device is being used). However, using gas module that is paramagnetic ( making use of magnet) is more cost-effective as the performance will always be as good as a new bought device unless the gas module is badly damaged for some unforseen causes.

53tH DaY oF AtTaChMenT

I did a battery test for syringe pump as the battery test failed on last friday. Therefore, i charged it for a day at least. While doing the battery test, i went to various places to find any suction unit or pumps required to have in-house maintenance and lent endoscopy department a loaner gastrioscope as they were lacking scopes. Sometimes, Olympus would send their field service engineer to either do the repair there or bringing the scope back for servicing. Loaner scope would be given if the scope is sent for servicing. After walking a few wards, i found out that almost all of the intermittent suction unit had been done on janunary 2006 so we could skipped all of the suction unit that required for maintenance.

Replaced 2 6V rechargerable batteries for laderal suction unit as it was reported unable to run on batteries. It has been quite some time since they last changed the batteries, it is time for me to change them.

I started doing the list for the preventive maintenance for june including the type and class of the devices for reference in doing the safety test.

Commissioning of 5-6 types of devices which parts that combined to form an endoscopy system 3 endoscopes ( 2 gastroscope and 1 fibroscope). We did the necessary test, safety test. The engineer did extra two tests which are brightness test and leakage test ( done only for the endoscopes) . Firstly, the engineer will use a meter th at measures the brightness and reading must be above 150. Secondly, the leakage test was done by pumping air into the scope and check for any leakage. If there is, the meter will drop drastically. A video converter is required for fibroscope as the user unable to see the image clearly on the LCD monitor and processor is only used for this scope. That's the reason why it only able to display the image in black and white. This system is the latest model and only two hospital have it. The other hospital which is NUH. The only common problem was printer tends to be not working quite often.

52Th DaY of AtTaCHmEnt

Days working in Alexandra Hospital seems pass by quite fast and i am quite used to the things that i am dealing with. I truly enjoyed my attachment there.

Since it is close to the month of june, I started to do maintenance for infusion and syringe pumps which are due next month. Since the maintenance for the pumps are more time-consuming and not much repair to be done, i brought down a few pumps to the workplace. There are 3 terumo pumps and about 8 graseby PCA pumps to be done. There was one pump that i have trouble in adjusting the occlusion limit as usually it will be "M". I searched through the service manual but it did not show the adjustment of limit so i asked Faz and Lee Chong. After pressing the buttons, i finally know how to adjust it.

Rememeber the displayed assembly that i order from IDS for the graseby 3300 PCA pump a month ago? I just received it in the morning and glad that i can start practising my soldering skill. However, when i opened the package, the layout for the pin header on the board is for 16 pins which is different from the older boards but the weird part is the manufacturer gave me a 15 pin header. Mr Sin and i suspect that one of the pins is not in use. I called up Tuan, service engineer from IDS to clear my doubt. He did not know about it so he has to call the manufacturer to double check it. I find that there is another possibility which is i gave the wrong part number. I only about to know a few days later at least.

There is a talk at the auditorium at 3:30pm. It was about how Alexandra Hospital able to follow Toyota car production in terms of their productivity and efficiency as CEO of AH believes that most of the empolyees do not know about the engineering area and paying too much attention how to provide the best service to the patients. I strongly agreed with what CEO said as the only way that provides revenue to the hospital is giving the patients deepest impression in terms of service to keep them coming.