Health Equipment for Biomedical Applications

Health Equipment for Biomedical Applications

Health Equipment for Biomedical Applications

Urmila Embranthiri

Health Equipment for Biomedical Applications

Urmila Embranthiri

ISBN - 9789361521379

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Preface

The medical industry has come a long way in terms of the technology used in diagnosis, surgery, labs, etc. I often wonder about these amazing technologies which save countless lives every day, and then I decided to write this book to give you a complete understanding of medical equipment.

This is less of a book and more like a complete manual to make you familiarize with all the major biomedical technologies and equipment which are out there.

In the last section of the book, there will be a well-made list of troubleshooting guides to many medical types of equipment to help you out in case there is a problem.

Table of Contents

Introduction 1

1 Introduction to Biomedical Equipment 2

2 Types of Biomedical Equipment 4

2.1 Clinical Equipment 4

2.2 Diagnostic Equipment 5

2.2.1 ECG machine (Electrocardiograph machine) 5

2.2.2 Sphygmomanometer 13

2.2.3 Stethoscopes 22

2.2.4 Pulse Oximetry 30

2.2.5 Endoscopy 36

2.3 Therapeutic Equipment 44

2.3.1 Anesthesia Machine 45

2.3.2 Oxygen Cylinders and Flowmeters 61

2.3.3 Nebulizers 73

2.3.4 Electrosurgical Units (ESU) and Cautery Machines 83

2.4 Life Support and General Device 95

2.4.1 Infant Incubator 95

2.4.2 Defibrillator 108

2.4.3 Infusion and Syringe Pumps 124

2.4.4 Autoclaves and Sterilizers 133

2.4.5 Suction Machines 142

2.4.6 Tables (Operating theatre and delivery) 147

2.5 Exercise 150

3 Imaging Modalities 152

3.1 Ultrasound Scan 152

3.1.1 Parts 153

3.1.2 Different Types of Ultrasound 156

3.1.3 Imaging 158

3.1.4 Wave 159

3.1.5 Major Uses of Ultrasound 161

3.1.6 Modes 162

3.1.7 Attributes 164

3.2 X-ray Machine 166

3.2.1 X-rays Description 167

3.3 Components of X-Ray Machine 169

3.4 Exercise 174

4 Maintenance of Biomedical Equipment 175

4.1 Types of Medical Equipment Maintenance 176

4.1.1 Effective Maintenance Strategy 176

4.1.2 Types and Approaches to Maintenance

of Medical Equipment 177

4.1.3 Levels of Maintenance 178

4.2 Planned Maintenance of Medical Equipment 179

4.2.1 Setting Up a Complete System 179

4.2.2 Planning User Maintenance Tasks 181

4.3 Troubleshooting and Maintenance of

Biomedical Equipment 181

4.3.1 Anesthetic Machine 181

4.3.2 Autoclaves and Sterilizers 183

4.3.3 Ecg Machine 184

4.3.4 Electronic Diagnostic Equipment 185

4.3.5 Electrosurgical Units (ESU) and

Cautery Machines 187

4.3.6 Endoscopes 188

4.3.7 Infant incubators 190

4.3.8 Lamps 191

4.3.9 Nebulizers 192

4.3.10 Oxygen Concentrators 194

4.3.11 Oxygen Cylinders and Flowmeters 195

4.3.12 Pulse Oximetry 197

4.3.13 Scales 198

4.3.14 Sphygmomanometers 199

4.3.15 Stethoscopes 200

4.3.16 Suction Machine (aspirator) 201

4.3.17 Tables (Operating Theatre and Delivery) 203

4.3.18 Ultrasound Machines 204

4.3.19 X-Ray Machines 206

4.4 Disposal of Equipment 207

4.5 Exercise 208

Glossary 209

Appendix 223

Index 225

Introduction

This book is a complete manual on biomedical equipment, which is prevalent in modern times. The first section will classify the biomedical equipment and explain the working of each equipment. It will also explain the advantages, limitations, uses, etc. in this section.

The next section will delve into the equipment, which is imaging-based or imaging modalities.

Lastly, the book will focus on the maintenance and troubleshooting of all the equipment, which will be explained in the earlier chapters.

Chapter - 1 Introduction to Biomedical Equipment

Medical surgeries have been practiced for a long time, and in modern times, the use of various equipment has led to increased precision and better diagnosis.

Assistive technologies became central to medicine during the 20th century. Advances in science, engineering and manufacturing were applied to medical problems. Technologies such as hearing aids, artificial limbs and mobility aids became more sophisticated. Ventilators, pacemakers and other machines were developed to support, enhance or replace the body’s organs. The computer revolution in medicine: using computers was one of the most important technological changes in 20th-century medicine. They became central to medical care from the 1950s. Computerized machines in hospitals monitored patients continuously. They also enabled insurers and state-run health services to track patient records on a massive scale. Imaging techniques such as MRI or PET were possible because faster computers could reconstruct images of the body.

More diagnostic tests were developed because automated laboratory machines performed tests quicker and more accurately. So we must know some definitions: Health technology: The application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of life. It is used interchangeably with health-care technology. Medical device: An article, instrument, apparatus or machine that is used in the prevention, diagnosis or treatment of illness or disease, or for detecting, measuring, restoring, correcting or modifying the structure or function of the body for some health purpose.

Typically, the purpose of a medical device is not achieved by pharmacological, immunological or metabolic means. Medical equipment: Medical devices requiring calibration, maintenance, repair, user training, and decommissioning activities usually managed by clinical engineers. Medical equipment is used for the specific purposes of diagnosis and treatment of disease or rehabilitation following disease or injury; it can be used either alone or in combination with any accessory, consumable, or other pieces of medical equipment. Medical equipment excludes implantable, disposable or single-use medical devices.

Chapter - 2 Types of Biomedical Equipment

There is various biomedical equipment to assist in medical procedures, and it is important to classify them correctly. Classification of medical equipment is down is various ways, and we shall discuss the most popular and general classification.

This is the classification of biomedical equipment:

1. Clinical Equipment

2. Laboratory Equipment

3. Research Equipment

4. Other Equipment

2.1 Clinical Equipment

The diagnosis and treatment of any illness or disease are done in a clinic or a hospital, and the equipment used to assist these processes are called clinical equipment.

There are many times of clinical equipment, and they are given below:

a. Diagnostic equipment

b. Therapeutic equipment

c. Surgical equipment

d. Life support equipment

2.2 Diagnostic equipment

Any type of equipment whose primary purpose is to help doctors detect and diagnose diseases, for example, ECG, EMG, EEG, Ultrasound machines, X-ray machines, CT Scanners, MRI machines, Endoscopes.

These types of devices are virtually the most important equipment because it helps in the identification of the problem so that it is solved appropriately.

A list of important diagnostic equipment will be explained below.

2.2.1 ECG machine (Electrocardiograph machine)

Electrocardiography is the process of recording the electrical activity of the heart over a period of time using electrodes placed on the skin. These electrodes detect the tiny electrical changes on the skin that arise from the heart muscle’s electro-physiologic pattern of depolarizing during each heartbeat. It is a very commonly performed cardiology test.

Fig. 2.1 – ECG machine

Source: IndiaMART.in

It is mainly used to address the heart-related problems and also used in other ways such as:

a. Diagnose and assist in treating some types of heart disease and arrhythmias.

b. Determine a patient’s response to drug therapy.

c. Reveal trends or changes in heart function.

ECG unit

ECG voltages measured across the body are on the order of hundreds of microvolts up to 1 mill volt. ECG unit consists of a low noise circuit (filters) and instrumentation amplifiers. Early ECG units were constructed with analog electronics, and the signal could drive a motor to print the signal on paper. Today, the ECG unit uses analog-to-digital converters to convert to a digital signal that can then be manipulated with digital electronics (computers).

Electrodes

An electrode is a conductive pad in contact with the body that makes an electrical circuit with the ECG. The most common electrode used for an ECG machine is the silver and silver chloride electrode because it is stable when exposed to biological tissue.

Cables

Cables are flexible wires which are used to connect the electrodes to the ECG unit securely and to transmit the electricity.

Each electrical signal begins in a group of cells called the sinus node or senatorial (SA) node. The SA node is located in the right atrium (AY-tree-um), which is the upper right chamber of the heart. In a healthy adult heart at rest, the SA node sends an electrical signal to begin a new heartbeat 60 to 100 times a minute. From the SA node, the signal travels through the right and left atria. This causes the atria to contract, which helps move blood into the heart’s lower chambers, the ventricles. The electrical signal moving through the atria is recorded as the P wave on the ECG. The electrical signal passes between the atria and ventricles through a group of cells called the atrioventricular (AV) node.

Fig. 2.2 – Physiological steps of a heart

Source: biologicaldictonary.com

The electrical signal then leaves the AV node and travels along a pathway called the bundle of His. The signal spreads quickly across your heart’s ventricles, causing them to contract and pump blood to your lungs and the rest of your body. This process is recorded as the QRS waves on the ECG. The ventricles then recover their normal electrical state (shown as the T wave on the ECG). The muscle stops contracting to allow the heart to refill with blood.

Fig. 2.3 – ECG electrical circuit

Source: maximintegrated.com

Measuring the ECG

Electrocardiographs record small voltages of about one mill volt (mV) that appear on the skin as a result of cardiac activity. In a conventional 12-lead ECG, 10 electrodes are placed on the patient’s limbs and the surface of the chest. The overall magnitude of the heart’s electrical potential is then measured from 12 different angles (leads) and is recorded over a period of time (usually 10 seconds). In this way, the overall magnitude and direction of the heart’s electrical depolarization are captured at each moment throughout the cardiac cycle.

Positioning of electrodes

The positioning of electrodes is very vital for the accurate results of ECG. There are usually 6 electrodes in an ECG, and the placements of these electrodes are usually placed similarly everywhere.

The leads used in an ECG machine can be divided into two types, bipolar and unipolar. The bipolar leads record voltage difference between two electrodes, but unipolar leads record the voltage difference between a reference electrode and the body surface to which they are attached.

Leads are broken down into three sets:

• Limb leads

• augmented limb leads

• Primordial Leads

The 12-lead ECG has a total of three limb leads and three augmented limb leads and six primordial leads that lie on the perpendicular.

Fig. 2.4 – Placement of electrodes

Source: cablesandsensors.com

Operating Steps

• After the electrodes are attached to the patient, ask the patient to relax and breathe normally, and to lie still and not to talk when you record the ECG.

• The user selects automatic or manual lead switching, signal sensitivity, frequency response range, and chart speed.

• In some units, the operator can choose the lead groupings, their sequence, and the recording duration for each group. Press the RECORD button.

• Observe tracing quality. The machine will record all 12 leads automatically, recording three consecutive leads simultaneously.

• Some machines have a display screen so that you can preview waveforms before the machine records them on paper.

• If any part of the waveform height extends beyond the paper when you record the ECG, adjust the normal standardization to half standardization.

ECG Machine Types

• The 12-lead ECG is the standard ECG machine used for medical diagnostic testing.

• A 5-lead ECG machine uses