A TECHNICAL REPORT

ON

STUDENTS’ INDUSTRIAL WORK EXPERIENCE SCHEME(SIWES)

UNDERTAKEN AT

UNIVERSITY OF MEDICAL SCIENCE TEACHING HOSPITAL LAJE, ONDO,

ONDO STATE.

BY

OJO AYOKUNLE STEPHEN

BIM/18/7681

SUBMITTED TO;

THE DEPARTMENT OF BIOMEDICAL TECHNOLOGY

SCHOOL OF HEALTH AND HEALTH TECHNOLOGY

FEDERAL UNIVERSITY OF TECHNOLOGY AKURE, ONDO STATE, NIGERIA

IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF

BACHELOR OF TECHNOLOGY (B. TECH) DEGREE IN BIOMEDICAL
TECHNOLOGY

JUNE, 2023.
 CERTIFICATION
This is to certify that Mr Ojo Ayokunle Stephen with the matriculation number BIM/18/7681
of the department of BIOMEDICAL TECHNOLOGY, FEDERAL UNIVERSITY OF
TECHNOLOGY AKURE, compiled this report based on his 21 weeks Students’ Industrial
Work Experience Scheme (SIWES) undertaken at university of medical science teaching
hospital, Laje, Ondo State.

……………………………….. ……………………………….
Name of Student Signature and Date

……………………………….. ……………………………….
SIWES Supervisor Signature and Date

……………………………….. …..…………………………….
Head of Department Signature and Date

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 DEDICATION
This report is dedicated to God Almighty for His sustaining power and grace bestowed on me
during my training period, to Him be all the glory.

ii
 ACKNOWLEGDEMENT
My greatest gratitude goes to God, the one who was, who is and the one who is to come, to
Him be all the glory. He has in His infinite mercy saw me through the programme.
I sincerely appreciate my parents, siblings and friends for being my sponsors and supporters
throughout the training.
I also like to recognize the impact and the efforts of my HOD and lecturers since my
academic pursuit began in this citadel of learning about four years ago.
My appreciation also goes to my trainer at biomedical department Engr. (Mr) Tunde,Engr.
Adedeji, Engr samuel, Miss Precious,Engr (Mrs)Bose and other members of staff at Uni-
Med Teaching Hospital, Ondo for the support, supervision and most especially the
opportunity given to me in their establishment and for helping me develop a broader horizon
about hospital equipment repair, fabrication and production, in relation to Biomedical
Technology.

iii
 ABSTRACT
This Industrial training report presents the experience gathered during my 6 months of
industrial training undertaken at University of Medical Science Teaching Hospital Akure,
Ondo State. My training was on Personal safety, equipment safety, trouble shooting, repairs,
maintenance of equipments of every section of the organization ranging from
sphygmomanometer, pulse oximeter, centrifuge, patient monitor, autoclave, physiotherapy
lamp, infant incubator, defibrillator, dialysis oxygen concentrator, suction machine, X-ray
machine etc. Also, knowledge and practical based of equipment troubleshooting was
acquired.

During this period, I acquired practical knowledge on how to troubleshoot, maintain

repair, replace and install some mechanical parts of some medical equipments.
This report discusses the technical skills and practical knowledge gained during the
training period and justifying the relevance of the scheme in equipping students with needed
technical competence to thrive in the real world.

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OUTLINE

Contents

CERTIFICATION....................................................................................................................I

DEDICATION.........................................................................................................................II

ACKNOWLEGDEMENT....................................................................................................III

ABSTRACT............................................................................................................................IV

LIST OF FIGURES...............................................................................................................VI

1.0 INTRODUCTION STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME

(SIWES)....................................................................................................................................7

1.1 BACKGROUND...........................................................................................................7

1.2 BODIES INVOLVED IN THE MANAGEMENT OF SIWES......................................8

1.3 ROLES OF GOVERNMENT AGENCIES IN MANAGEMENT OF SIWES

PROGRAM...............................................................................................................................8

1.4 ROLES OF EMPLOYERS IN MANAGEMENT OF SIWES PROGRAM...........9

1.5 ROLES OF STUDENT IN MANAGEMENT OF SIWES PROGRAM..................9

1.6 ROLES OF ITF IN MANAGEMENT OF SIWES PROGRAM...................................9

1.7 AIMS AND OBJECTIVES OF SIWES...................................................................10

1.8 BENEFITS OF SIWES..............................................................................................11

CHAPTER TWO...................................................................................................................12

2.0 ORGANIZATION PROFILE....................................................................................12

2.1.1 VISION STATEMENT................................................................................................12

2.1.2 MISSION STATEMENT...........................................................................................13

2.2 ORGANIZATIONAL CHART..................................................................................14

2.3 DEPARTMENT WITHIN THE HOSPITAL...............................................................15

2.3 VARIOUS SECTIONS OF WORKS AND MAINTENANCE....................................16

2.3.1 BIOMEDICAL DEPARTMENT.................................................................................16

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2.3.2 MECHANICAL DEPARTMENT.............................................................................18

2.3.3 ELECTRICAL DEPARTMENT...............................................................................18

2.3.4 CIVIL DEPARTMENT..............................................................................................19

2.3.5 PLUMBING DEPARTMENT................................................................................19

2.3.6 AIR CONDITIONING AND REFRIGERATOR DEPARTMENT.......................20

2.4. VARIOUS SECTION/WARDS WITH THEIR MAJOR EQUIPMENT..................20

2.4.1. RADIOLOGY...............................................................................................................20

2.4.2 PAEDIATRICS.............................................................................................................21

2.4.3 OPERATING THEATRE............................................................................................21

2.4.4 EMERGENCY/ACCIDENT........................................................................................22

2.4.5 ORTHOPAEDICS........................................................................................................22

2.4.6 RENAL UNIT/DIALYSIS............................................................................................23

2.4.7 CENTRAL STERILIZATION SUPPLY DEPARTMENT......................................23

2.4.8 LABORATORY............................................................................................................24

2.4.9 INTENSIVE CARE UNIT...........................................................................................24

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 1.0 INTRODUCTION STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME
(SIWES)
As a part of approved academic standards in the degree program for Nigerian Universities.
Prior to the establishment of the scheme, there was a growing concern among industrialists that
graduates of higher institutions lacked adequate practical background studies preparatory for
employment in the industries.
From observation and past experience, it is no mistake to conclude that theoretical knowledge
alone is not adequate to prepare an educated person for the world of work. Knowledge at times
can vaporize if not put into practice through training and hence the reason why education and
training are mutually dependent on each other in our society today. The need for student to
combine theoretical knowledge with practical skills in other to produce quality result is met by
the introduction of students’ industrial work experience scheme (SIWES), the importance of
which cannot be over emphasized. Industrial training is a period set aside not only for the
acquisition of skills but also for students to be exposed to industrial based practical on large scale
production on what has been thought theoretically in schools. The programme was charged with
the responsibility of moulding and preparing students for life outside the four walls of higher
institution. It is one of the requirements needed to be fulfilled by undergraduates before they can
be awarded a degree on completing their course of study.

1.1 BACKGROUND
The Student Industrial Work Experience Scheme (SIWES) was established by the Industrial
Training Fund (ITF) in 1973/1974 academic session to enable students of tertiary institution have
technical knowledge of industrial work, based on their course of study before the completion of
their program in their irrespective institutions. The scheme was designed to expose students to
industrial environment and enable them to develop occupational competencies so that they can
readily contribute their quota to national economic and technological development after
graduation.

7
The major benefit given to students who participate conscientiously in Students Industrial Work
Experience Scheme (SIWES) are the skills and competencies they acquire. The relevant
production skills remain a part of the recipients of industrial training as life-long assets which
cannot be taken away from them. This is because the knowledge and skills acquired through
training are internalized and become relevant when required to perform jobs or functions.

1.2 BODIES INVOLVED IN THE MANAGEMENT OF SIWES

The bodies involved are: The Federal Government, Industrial Training Fund (ITF). Other
supervising agents are: National University Commission (NUC), National Board for Technical
Education (NBTE) and National Council for Colleges of Education (NCE)
The functions of these agencies above include among others to:
 Ensure adequate funding of the scheme.
 Establish SIWES and accredit SIWES unit in the approved institutions.
 Formulate policies and guideline for participating bodies and institutions as well as
appointing SIWES coordinators and supporting staff.
 Supervise students at their places of attachment and sign their log-book and IT forms.
 Vet and process student’s log-book and forward same to ITF Area office.

1.3 ROLES OF GOVERNMENT AGENCIES IN MANAGEMENT OF SIWES

PROGRAM
The roles of government agencies in management of SIWES program are:
 To make it mandatory for all companies and parastals to offer the students an attachment
in their organizations
 To aid students financially
 To provide adequate funds to the industrial training

1.4 ROLES OF EMPLOYERS IN MANAGEMENT OF SIWES PROGRAM

The roles of the employers in management of the SIWES program are:

8
  To collaborate with the institutions in the preparation of job specification for the
approved courses of SIWES
 To allow the students have an uncompromising access to their facilities
 To appoint an industry-based supervisor for students on attachment
 To accept students for industrial attachment as stipulated by the Government

1.5 ROLES OF STUDENT IN MANAGEMENT OF SIWES PROGRAM

The roles of students in management of SIWES program are:
 To attend the institution’s SIWES orientation program before going for the training.
 To be regular and punctual at respective places of attachment
 To adhere strictly to all rules and regulation of the organization where student is attached.
 All forms given out to the students must be properly filled and submitted into appropriate
office(s) at the appropriate times during the SIWES program.

1.6 ROLES OF ITF IN MANAGEMENT OF SIWES PROGRAM

The roles of ITF in management of SIWES program:
 To formulate policy guidelines on SIWES for distribution to all participating bodies,
institution and companies involved in the scheme
 To process student’s logbook and ITF Form 8
 To receive and process Master and placement list from the institution and supervising
agencies
 To regularly organize orientation program for students prior to their attachment
 To disburse supervisory and bursary allowances
 They also provide insurance cover for students on attachment.

1.7 AIMS AND OBJECTIVES OF SIWES

The Industrial Training Funds Policy Document No. 1 of 1973 which established SIWES
outlined the objectives of the scheme. The objectives are to:

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  Provide an avenue for students in higher institutions of learning to acquire industrial
skills and experiences during their course of study.
 Prepare students for industrial work situations that they are likely to meet after
graduation.
 Expose students to work methods and techniques in handling equipment and machinery
that may not be available in their institutions. Also, the safety precautions involved while
working in industry, so as to protect and prevent themselves and environment from health
hazard.
 Make the transition from school to the world of work easier and enhance Students contact
for later job placements.
 Provide students with the opportunities to apply their educational knowledge in real work
situations, thereby bridging the gap between theory and practice.
 Enlist and strengthen employers involvement in the entire educational process and
prepare students for employment in Industry and Commerce (Information and Guideline
for SIWES, 2002).

1.8 BENEFITS OF SIWES

 It affords the student an opportunity to learn how to function in multidisciplinary teams.
 Students learn how to effectively communicate within the working environment.
 It provides the opportunity for students to understand professional and ethical
responsibility.
 The scheme provides an opportunity for the industries to evaluate prospective employees
and give healthy feedback to the institutions.
 It gives opportunity for the student to reinforce the theoretical knowledge acquired in
classrooms using practical knowledge acquired in the industry.
 Provides the student with an opportunity to apply their theoretical knowledge in real
work situation thereby bridging the gap between theory and Practical.
 Provides an avenue for students in tertiary institutions to acquire industrial skills and
experience in their course of study.
10
 Expose students to work methods and techniques in handling equipment and machinery
that may not be available in universities.
 Familiarizing the student for the working conditions they are likely to meet after
graduation; and
 Make the transition from the university to the world of work easier and thus enhance
student’s contacts for later job placement.

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 CHAPTER TWO

2.0 ORGANIZATION PROFILE

The University of Medical Sciences teaching hospital Complex, Ondo (formally called mother
and child hospital, Ondo) is located in the centre of Ondo, Ondo state in Nigeria .it was
established in 2015 by the Ondo State Government as part of its vision to provide world class
healthcare services to its citizens. The institution is a state of the art tertiary medical facility that
offers a wide range of medical services including diagnostic, therapeutic and rehabilitation
services.
At present, it is the biggest hospital in the state and serves as a referral centre to all other public
and private hospitals within and even outside the state. The hospital functions are mainly to
provide facilities for diagnosis, curative, preventive and rehabilitative services in medical
treatment. The hospital has facilities for primary, secondary and tertiary levels of health care.
The hospital also serves as clinical training centre for the school of nursing, midwifery and
health technology; it has been a major centre in training of medical, dental, pharmacy and other
paramedical internees. The hospital makes use of the various diagnostic and supportive or
therapeutic modalities available to it for modern and proper patient care. It is a place that upholds
sound scientific basic of modern medical practice in the provision of effective health care
delivery.
The hospital is involved in the comprehensive management of health problems of patients. It has
a 270 bedded hospital with facilities for 24 hours’ services in all its various department. The
hospital is headed by the chief medical director.

2.1.1 VISION STATEMENT

A well-motivated workforce committed of ensuring professional, proficient, effective and health
services to humanity

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 2.1.2 MISSION STATEMENT
The mission is to provide satisfactory, affordable, prompt and quality health services; to our
client in a conducive environment

Figure .1 UNIVERSITY OF MEDICAL SCIENCES TEACHING HOSPITAL COMPLEX

LOGO

13
 2.2 ORGANIZATIONAL CHART
A simplified organization structure of the University of Medical Sciences teaching hospital
Ondo, Ondo state is shown below. Exact information about the number and job description of the
company’s employees cannot be provided here because of the confidentiality policy of such a
sensitive institution.

PHYSICIAN IN CHARGE

(PIC)

HOSPITAL SECRETARY MAINTENANCE AND

RESUSCITATION
(DIR OF ADMIN) WORKS DEPARTMENT
RADIOLOGY

AUDIT BIOMEDIAL
DIALYSIS

ACCOUNT CIVIL
A&E

CHILDREN WARD LAUNDRY

LABORATORY PLUMBING
FIGURE .2. ORGANIZATIONAL CHART

PHYSIOTHERAPY MECHANICAL

ELCTRICAL

2.3 DEPARTMENT WITHIN THE HOSPITAL

1. Accident and emergency (A&E)
2. Administrative
3. Anaesthesia
4. Clinical physiology
5. Community health
6. Dietetics and nutrition
7. Dental department

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8. Ear, nose and throat (ENT)
9. General outpatient department
10. Health information management
11. Internal medicine
12. Maintenance
13. Nursing
14. Obstetrics and gynaecology
15. Ophthalmology
16. Pathology
17. Pharmacy
18. Physiotherapy
19. Radiology
20. Surgery
21. Paediatrics
22. Theatre

2.3 VARIOUS SECTIONS OF WORKS AND MAINTENANCE.

2.3.1 BIOMEDICAL DEPARTMENT

Biomedical units/ department is a department that is specialised in repairs,

installations, maintainance, replacement of faulty equipments, calibrating and
recommending equipments for the hospital which cut across all wards in the hospital
raging from smaller equipment like pulse oximeter to bigger machine like Magnetic
Resonance Imaging [MRI : Biomedical Engineers use engineering principles to solve
health related and medical problems. They do a lot of research in conjunction with life
scientists, chemists, and medical professionals to design medical devices like artificial
hearts, pacemakers, dialysis machines, and surgical lasers. Some conduct research on
biological and other life systems or investigate ways to modernize laboratory and clinical
procedures. Frequently, biomedical engineers supervise biomedical equipment
maintenance technicians, investigate medical equipment failure, and advise hospitals

15
 about purchasing and installing new equipment. Biomedical engineers work in hospitals,
universities, industry, and research laboratories.
Biomedical engineers work closely with life scientists, chemists and medical
professionals [physicians, nurses, therapists and technicians] on the engineering aspects
of biological systems. Duties and responsibilities vary from one position to another but,
in general, biomedical engineers:

The tools/machineries used include.

1. Screw driver [ flat & star]

2. Spanner
3. Plier
4. Wrench
5. Allen keys
6. Cutter
7. Blower
8. Soldering Iron. plate 1: Biomdecal tools
9. Sucker
10. Digital multimeter etc.

16
Figure3. Tools / machineries.

2.3.2 MECHANICAL DEPARTMENT

Mechanical department is an engineering department that provide solution to hospital
generators and vehicles. The also recommend a better product of generator and vehicle for
the hospital.

The tools/machineries used include.

17
 1. spanner
2. wrench
3. flow meter
4. hydraulic floor jacks
5. hand saw
6. jumper cables
7. pliers
8. eyeglasses or goggles
9. hammer
10. chisel

2.3.3 ELECTRICAL DEPARTMENT

This is an engineering department that deals will hospital electricity and electronics used
in the hospital. They install wires and some electronics and they provide solution to any
faulty electronics, they also recommend a better products for the hospital like wall socket,
lamp holder, bulb etc. also transmit lines and wires for installation of new medical equipment
like theatre lamp. The tools / machineries used include.

1. Digital multimeter
2. Tester
3. Screw driver [flat & star]
4. Spanner
5. Insulation tape
6. ladder

2.3.4 CIVIL DEPARTMENT

Civil department deal with construction of works such as concrete, brick masonry,
levelling, woodwork, floor works plastering etc. every construction tool is necessary to
achieve good results in the whole project. The application of planning, designing,
constructing, maintaining, and operating infrastructures while protecting the public and
environmental health, as well as improving existing infrastructures that have been neglected.

The tool/ machineries used include.

18
 1. ladder
2. crowbar
3. End frames
4. Chisel
5. Helmet
6. Hand saw
7. Float
8. Wedge
9. Straight edge brushes
10. Sledge hammer

2.3.5 PLUMBING DEPARTMENT

Plumbing department conveys fluids for a wide range of applications. Plumbing uses
pipes, valves plumbing fixtures, tanks and other apparatus to coveys fluid. The major
categories of plumbing systems are:

 Portable cold and hot tab water supply

 Plumbing drainage venting
 Sewage system and septic systems
 Fuel gas piping
 Water supply and water drainage pipe for machine that constantly use water e.g dialysis
machine
The tool/ machineries used include.
1. Wrench
2. Plunger
3. Plumbing tape
4. Tubing cutter
5. Washers
6. Hacksaw
7. Drill and hole-boring bits.

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2.3.6 AIR CONDITIONING AND REFRIGERATOR DEPARTMENT
The air conditioning and refrigeration department deal with the removing and fixing
of air condition for some machine that can be overheated like x-ray machine. The also
chill indoor air, taking advantage of physical law: when a liquid converts to a gas [ in a
process called phase conversion].

The tools/machineries used include.

1. Screw driver [ flat & star]

2. Spanner
3. Pliers
4. Gauge meter
5. Allen keys
6. Cutter
7. Blower
8. Soldering Iron.
9. Sucker
10. Digital multimeter etc.

2.4. VARIOUS SECTION/WARDS WITH THEIR MAJOR EQUIPMENT

2.4.1. RADIOLOGY
Radiology is the medical discipline that uses medical imaging to diagnose and treat
disease with human body.
Their equipment are.
 X-ray machine
 Magnetic resonance imaging [MRI]
 Diagnostic ultrasounds
 Mammography
 Microprocessor
 Computed tomography scan.

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2.4.2 PAEDIATRICS
Paediatrics is a branch of medicine that involves the medical care of infants, children and
adolescents.
Their equipment are:
 pulse oximeter
 Sphygmomanometer
 Weighing scale
 Baby incubator
 Infant radiant warmer
 Phototherapy lamp
 Oxygen concentrator
 Suction machine
 Nebulizer

2.4.3 OPERATING THEATRE

This is a facility within a hospital where surgical operations are carried out in an aseptic
environment.
Their equipments are.
 Theatre bed
 Anaesthetic machine
 Suction machine
 Patient monitor
 Pulse oximeter
 Sphygmomanometer
 Oxygen cylinder
 Scrub
 Oxygen concentrator
 Blood warmer
 Theatre lamp

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2.4.4 ACCIDENT AND EMERGENCY.
This is the department where a serious, unexpected, and often dangerous situation
requiring immediate action are attended to.
Their equipments commonly used are:
 Patient monitor
 Pulse oximeter
 Suction machine
 Defibrillator
 Stretcher
 Humidifier
 Oxygen concentrator

2.4.5 ORTHOPAEDICS
This is a medical specialty that focuses on the diagnosis, correction, prevention, and
treatment of patients with skeletal deformities. Disorders of bones, joints, muscles,
ligaments, tendons nerves and skin. These elements make up the musculoskeletal system.
Their equipments commonly used are:
 X-ray viewer
 Wheelchair
 Orthopaedics bed
 Sphygmomanometer
 Patient monitor
 Pulse oximeter

2.4.6 RENAL UNIT/DIALYSIS

In machine, dialysis is the process of removing excess water, solutes, and toxins from the
blood in people whose kidneys can no longer perform these functions naturally.
Their equipments commonly used are:
 Dialysis machine

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  Suction machine
 Pulse oximeter
 Sphygmomanometer
 Stethoscope
 Physiotherapy
 Shortwave diathermy
 Therapeutic ultrasound
 Tread mill

2.4.7 CENTRAL STERILIZATION SUPPLY DEPARTMENT

The central sterile services department [CSSD] is an integrated place in hospitals and
other healthcare facilities that perform sterilization and other actions on medical equipment,
device and consumables for subsequent by health workers in the operating theatre of the
hospital and also aseptic procedure e.g catheterization, wound stitching and bandaging in
medical, surgical, maternity or paediatric ward.

Their equipments are:

 Autoclave
 Washer disinfectant
 Bed pan washer

2.4.8 LABORATORY
A laboratory is facility that provides control conditions in which scientific or technological
research, experiments and measurements may be performed.
Their equipments commonly used are:
 Centrifuge
 Water bath
 Microscope
 Refrigerator
 Glucometer

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2.4.9 INTENSIVE CARE UNIT
An intensive care units [ICU] provides the critical care and live support for acutely ill and
injured patient.
There equipment are:
 Ventilator
 Humidifier
 Oxygen concentrator
 Patient monitor
 Pulse oximeter
 Sphygomanometer
 Infusion pump

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3.0 PROJECT UNDERTAKEN AND EXPERIENCE GAINED
3.1 Hazards and Safety in the Biomedical Industry
3.1.0 Specific Hazards
There are a number of major hazards that any problem situation can fall under. Electrical,
mechanical, ergonomic, chemical, biohazard, temperature, radiation, psycho social and
miscellaneous are all categories that adequately encompass most situations encounter able.
 Medicine: Medical examination rooms, waiting areas, drug use and access, patient
monitors, anaesthetic equipment, treatment tables or operation chairs, patient transport
and continuous/non-continuous monitoring, scales, implanted devices, diagnostic
ultrasound equipment, X-ray or MRI equipment, non-medical electronic equipment,
accessories, reprocessed equipment, and all related items or situations that are directly
attributable to the visit to the office, recovery, rehabilitation, and follow-up process
 Dentistry: applicable items above as well as hand tools: drills, scalers, accessories and
water source/flushes
 Physiotherapy: applicable items above, as well as weightlifting equipment, ultrasound
equipment, interferential/TENS units, rehab objects, force measuring/exerting equipment,
wax bath, and acupuncture
Most of the above equipments can be hazardous to the operators/users which includes the
engineers, doctors, nurses etc.
3.1.1 Electrical
Electrical danger happens whenever any path is formed from an electrical source to a patient and
may cross their body in such a way or intensity that causes discomfort or damage to tissue. The
problem with electrical hazards, and why it is such a danger, is because electricity is an invisible
hazard that is hard to immediately protect yourself from. All electrical devices that have
preventative maintenance (PM) performed on them will undergo an electrical safety test that
ensures that the device is not at risk of shocking your patient or practitioner.
3.1.1.1 Electrical Sources
There are many sources of electrical hazards that can be roughly categorized as damage, defect,
bridging and induction.

25
  Damage is pretty straightforward. This can happen due to breakage in the cable, causing
the metal to be exposed when it is normally safely behind insulation. This is usually
obvious, but the exposed portion may be too small to immediately see, or the exposure
may be hidden under a desk (a metal one) and the desk suddenly becomes like a big
wire. A device that has this problem may cause unexpected operation of unknown effect.
Internal damage to a cable will cause that which it is connected, to operate in an
abnormal fashion, and the entire safety of the device itself can be called into question
because a cable does not meet expected standards.
 Defect is the result of inadequate standards or actions performed during the material
sourcing, manufacturing, assembly, distribution, receiving, operation, or servicing. This
source of hazard is greatly minimized when the device is connected in some way to
accreditation, servicing, or safety checks, which work in a chain; if a qualified
practitioner is overseen by a qualified body, that qualified body expects qualified service
personnel to identify if the equipment meets manufacturing and operating standards.
 The third category of electrical hazard occurs during what is known as shorting or
bridging. Regular facility service checks, practice guidelines, and common sense largely
takes care of this hazard. All devices are assessed to be safe with regards to this
bridging/spill and if they are not, the hazard is identified and will usually follow with a
recommendation of corrective measures including changes to room construction,
electrical wiring, inclusion of special wall plugs or the relocation of equipment.

3.1.2 Mechanical Source

Mechanical hazards are anything physical that can impact with force, puncture, rub, or scrape
that causes pain, bruising, cuts, or discomfort. These can be blunt, sharp, rough, pointy, or even
smooth in nature that may still cause harm. The injury can result from trip, fall, gravity,
stationary situations, or user caused situations. These incidents can also be pneumatically,
electrically or mechanically driven in nature with or without user input. Manufacturers typically
go to great lengths to ensure that their products are the safest and most comforting things to deal
with, and any deficiency in this department is caused by either age, normal wear, misuse, or
neglect.

26
3.1.2.1Mechanical Wear, tear, and age
Aged equipment becomes a problem as the protective padding separating the patient from the
device degrades through use, cleaning agents, and time. Older (ancient) equipment may just not
have been designed properly or before patient/manufacturing standards were less strict. Through
use, vinyl, plastic, leather, and other types of materials will have grooves made in them, crack, or
lose their safety efficacy. To stop these things from happening, ensure the following is done:
 Be mindful of surfaces that come into contact with patient’s skin and what repeated use
will do to these
 Assess the cleanliness of surfaces and accessories to see if they’re appropriately clean
and done so with manufacturer recommended cleaning agents or chemicals
 Lubricate joints, articulating surfaces, clean rust and check weld joints
 Check if cleaning procedures are being followed up with a wipe and dry, ensuring no
build up in cracks or creases
 Check if stoppers, brakes, levers, springs, pistons, and other safety features are present
and how effective they are in performing their intended purposes
 Physically place yourself in the patient’s position and thinking “Am I okay to use this on
myself?”
Over time, equipment is just going to slowly break down and one may not be able to check these
things yourself at a quick glance, or even from the outside. Bolts, washers, joints, brakes,
springs, levers, pistons, motors, assemblies, covers, membranes and other miscellaneous things
may need to be replaced regardless of how great one ise at treating the equipment or how often it
gets used.
3.1.2.2 Mechanical Misuse
It is almost impossible to objectively evaluate your own practices, procedures, and way of doing
things, so, for this reason, it is imperative to seek guidance from external sources. Firstly, one
should always have an open and honest dialogue with patients, admin, technicians, and other
staff members so that they feel comfortable critiquing practice and equipment. For normal
practitioners, regardless of experience, misuse does occur for a number of reasons: a difference
between product manufacturers/models, not reading the manuals or habit. Habit is the strongest

27
of all the sources of misuse because if something is easier and ‘seems right’, regardless of
whether it is, cognitive forces have a peculiar way of allowing someone to convince oneself
everything is going to turn out great. Setting the equipment up to its standard state (levers,
brakes, leveling objects, and otherwise calibrating a device) is something we recommend to do
each time unless requested not to. In some cases, this may require longer time on site, because if
things are left well enough alone, they should remain where they were originally set.
3.1.2.3 Mechanical Neglect
As well intentioned as most people may be, there are those who do cut corners, skip steps, and
do not follow the advice of people who have the best intentions for the outcome of the safety of
your patients.
3.1.2.4 Mechanical / Electrical / Hydraulic / Pneumatic actuation
Certain devices will have their operation controlled by levers, dials, or control panels that will
activate other types of units. The commonality between these things is a mechanical effect: a cast
saw blade with a faulty bearing, an elliptical with an off-balanced flywheel or a treatment bed
with a weak piston will all produce physical impacting as a result of their condition. These
modalities or applications are critical because they may fail without any prior warning, as is the
nature of high pressure, speed, or torque items. These items are normally not problematic if they
don’t show external decay and properly give the full range of motion but they do need to be
assessed for the nuances of their characteristics.
3.1.2.5 Mechanical Protection
Almost all of these things can be prevented by replacing worn assemblies, padding, and
bumpers, but there are some instances where one has to get creative. If a situation arises that
causes discomfort there are ways of adhering padding to a surface that didn’t originally come
with protection, which is most commonly required for older equipment or accessories.

3.1.3 Biological Hazard

It may or may not be obvious, but a few things need to be said about the basics bio hazards so we
know what we’re getting into. Germs, bacteria, viruses, disease, illness, flu, infections,
pathogens, contamination and sickness are all ways to describe the mechanisms that can cause
internal and external conditions that are transferable from person to person 36. Antiseptics are

28
substances that kill or otherwise render these unfriendly organisms harmless. A very important
thing to always keep in mind is that all antiseptics target broad or specific pathogens based on
their ingredients, shelf-life, and application. It’s imperative that you understand these things
before using them where you do because the active ingredients can harm tissue, damage surfaces,
or be useless to properly sterilize a surface against something you need to sterilize against. and
protection of equipment from cleaning agents.
3.1.3.1 Biological Source
Pathogens will exist in large amounts in certain biomes and regions because they aren’t
inherently bad, and provide a vital role in making up the world that we live in; they’re just
another form of life like plants. You have bacteria in your gut that help you digest certain
compounds, viruses play a role in evolution, and some are just opportunistic; stumbling upon a
human by mistake. Infrequently, things like flu or large outbreaks will jump across large
populations of people, dormant, until it affects people especially vulnerable to it, or it happens to
grow strong enough to be noticeable. .
3.1.3.2 Biological Effect
Due to how numerous and intricate pathogens are, it’s hard to give a comprehensive explanation
on what this will do to any given person. Somebody may be immune to it, while another will
have an immediate reaction and will fall noticeably ill. There are even some people that get these
viruses and bacteria that will remain infected for a long time before it’s discovered that they have
them inside their bodies. There are types of people who are especially vulnerable to infection
because they have compromised immune systems and will react much more strongly than others
and become sicker quicker even from basic germs. The only thing beyond this really worth
knowing is that it’s vital that as little possible transfer of pathogens occurs because we must
assume the worst-case situation happens (a super sick person is going to infect a really
vulnerable one).
3.1.3.3 Biological Protection
As mentioned before, there are a number of products suited toward different pathogens and for
different surfaces. These are numerous and application/manufacturer specific, but a few basic
protocols38 39 40 can be adhered to result in the best outcome:
 Cheaper is not always better: Trusted brands will have longer shelf life and efficacy.

29
  Your product may damage material: Products that are heavily comprised of single or
basic chemicals will corrode screens, plastic, leather or vinyl.
 You need to dry things off: The antiseptics are meant for cleaning purposes, meaning that
they are applied, the pathogen is killed, and you have to dispose of the bodies. Don’t
leave equipment wet to dry on their own!
 Germs are sneaky: Cracks, creases, and joints are where they like to hide, and will spread
even if the surrounding surface is sterilized.
3.1.4 Chemical Hazards
Chemical hazards encompass any substance that is made up of a chemical compound or element
that is present in small to extreme quantities. This includes stored cleaning agents, solvents,
solutions, particulate matter, aerosolized compounds or gases. The manufactured items on this
list are covered by WHIMIS41 and extensive documentation is available on how to handle, store,
use, and treat contact with anything approved that is searchable. Things that are not covered fall
under OHS, fire, or environmental types of safety measures. Like biohazards, TRH is not fully
equipped to advise on the particulars on these hazards and it is strongly recommended to fully
understand your WHIMIS sheets and supporting product documentation.

3.1.4.1 Chemical Source

Sadly, the main cause of problems with this type of hazard is improper education, storage, and
handling. Broadly speaking, if you do not know the specifics of what chemical you are dealing
with, you should not be using it. Any unmarked container needs to be disposed of, and in its
place, a substance that is clearly marked and certified should be used and stored appropriately.
You should don any PPE to protect your hands, arms, face, eyes, ears, or any other part of your
body that may come into contact with this chemical. When in doubt, gear up or ask somebody.
3.1.4.2 Chemical Effect
The outcome of a chemical coming into contact with a person depends on the nature of the
specific chemical. It can be inhaled, imbibed, or enter the body through the skin. Regardless of
how things have worked for you in the past, some individuals may even lose consciousness by
being in the proximity of certain substances, and it is very important to keep in mind the

30
extremes: like how some people react violently to slight exposure to peanuts. Chemicals can also
damage equipment resulting in premature failure, damage, annoy patients, or discolor clothing.
3.1.4.3Chemical Protection
Proper storage eliminates most of the hazard potential, including clearly marked containers and
any and all locking mechanism afforded by the particulars of the environment. PPE is mandatory
for workers needing to use it, should always be accessible, and not be damaged / expired in any
way. The final measure that is not always present around chemicals is the means to rapidly treat
an exposure. This measure will vary based on the chemical in question, but the most common
treatments available are eye wash stations for eye exposure, first aid kits for a chemical burn or
related effects of exposure, EpiPens for allergic reactions, suction and ventilation solutions for
choking and esophageal obstructions and readily available oxygen for certain inhalation types.
Again, it bears repeating that having a full understanding of the substance in question is
imperative, as some chemicals are worsened by use of eyewash water, inducing vomiting (some
first aid courses of action), and some burns being worsened by the quick application of water.

3.1.5 Temperature Hazards

Hazards relating to temperature extremes are not as prevalent as other types but there are still
some things to keep in mind broadly as well as in specific applications that are easily addressed
but are very time and attention sensitive. Overheating and correct temperature monitoring is part
of some device’s checks, but not all. With respect to temperature monitoring and regulation,
TRH’s equipment is calibrated to be highly accurate not only for long term stasis but temperature
increases during device operation.
3.1.5.1 Temperature Source
There are both intended and unintended extreme hot and extreme cold situations to be aware of.
For intended heated situations in therapeutic or interventional applications, you have warming
baths: water heated pads for pain or therapy, wax, hypothermia treatment, freeze guns or
freezers. Unintended situations arise when thermal regulation of an electronic device is
unchecked but also occurs when equipment is run for a long period of time, especially when
there are powerful bulbs involved.
3.1.5.2 Temperature Intended

31
In all of these listed situations, it’s important to follow the manufacturer’s guidelines on
operating temperature and adjust the dial accordingly. All heating solutions should be monitored
for temperature to ensure that your device did not suddenly lose thermal regulation and that it is
an appropriate temperature for treatment that meets medical or therapeutic guidelines. An
example of what can go wrong is that if you adjust the dial to be hotter than usual, then change
the water from sludgy dirty water to pure distilled water, you may be much over or under
temperature (depending on the device)
3.1.5.3 Temperature Unintended
Temperature regulation is attained in heating elements by having the temperature sensed and the
current to the temperature generator shut off when the target value is achieved. When
temperature is unregulated in its generation, there should be some kind of alarm of shut-off
regulator; if this is not present or defective, fire, burns or explosions may result. For certain
devices.
3.1.5.4 Temperature Effect
The most obvious effect of high temperature is immediate or gradual 1st, 2nd, and 3rd degree
burns. Something that will also cause a negative effect is higher than normal temperature that
will affect things like hydration, cause long term tissue or nerve weakening, loss of fertility or
causes cell death. For certain devices, a technician will check if there are especially hot areas that
will cause apparent or actual burning (or burning sensation).
3.1.5.5 Temperature Protection

 The best way to protect against unintended temperature abnormalities is to ensure your
equipment is regulated and measured and alarms in some manner if it is outside your
intended temperature range. If the temperature is not avoidable.

 Introduce thermal barriers between the heat and the patient, making sure not to enclose
the heat source which could result in fire.

 Introduce extra cooling to the heat source or some form of heat sink and generally
making sure the heat source is free of dust and is properly ventilated.

32
  Finally, shutting off the unit in between treatments and making sure power is off when
the unit is finished being used for the day.

3.1.6 Radiation Hazards

Radiation is a broad term, but largely has its root in electromagnetism as it relates to light, and in
particular, high energy light. Lasers, x rays, discussion surgery, ultrasound, UV light therapy and
magnetrons are devices that utilize high energy light or voltage sources to accomplish diagnostic,
surgical, or therapeutic goals.
3.1.6.1 Radiation Effect
Consequences of exposure to radiation vary based on the modality but:
 Laser therapy will produce high energy UV or IR light that can damage the retina’s
cones/rods, cornea and capillaries in the eyes45. Higher than usual laser therapy is
sometimes used to heat tissue but will not burn unless exposure is outside of procedure
parameters (Wattage/wavelength).
 X ray diagnosis only involves the application of a beam for about a 10th of a second and
total dosage is usually relatable back to how much background radiation somebody
would have had to passively get exposed to in order to get an equivalent dose. Exposure
levels are acceptable for how often it is likely to occur. People at risk for certain cancers
are more likely to develop problems than others but is still ultimately very low and risk
advantageous for diagnosis. The safe practice regarding X rays is regulated very well.
 -Ultrasound is largely minimal risk as the sound wave generated only heats tissue but
could potentially harm a fetus. Excessive treatment times, older ultrasound applicators or
machines, or damaged/ uncalibrated equipment will have higher or lower dosage than
expected, depending.
 UV light (UVB) is used to treat psoriasis and vitamin deficiency as well as even lower
level UV for jaundice in newborns. Tanning beds harm the skin in a similar way to
overexposure to a very particular component of natural night which causes melanoma and
other forms of cancer
 Magnetrons or pulsed electromagnetic fields affect cell membranes and ions in tissues in
a not-fully-understood manner which has impact on tissue growth, growth impediment
and other changes. There are varying effects on mood as well. The field is most effective

33
 near the center and anywhere inside the coil and doesn’t extend far beyond that.
Additionally, as mentioned before in the electrical section, this is called induction and is
present in high-energy situations involving coils or power supplies.
3.1.6.2 Radiation Protection
 Laser: goggles and retinal displacement (look away!)
 X ray: limit repeated exposure, lead vest, and protective shielding
 Ultrasound: distance, proper use of contact medium (ultrasound gel), and warm-up
 UV light: avoiding direct exposure
 Magnetrons: distance
3.2 Electronic Components And Their Function

 Resistor
 Capacitor
 Inductor
 Transformer
 Integrated circuit
 Diodes
 Transistor
 Relay
 Switch
 Fuse
 Microcontroller

3.2.1 Resistors

A resistor impedes the flow of electricity through a circuit.

 Resistors have a set value.

34
 Since voltage, current and resistance are related through Ohm’s law, resistors are a good way
to control voltage and current in your circuit.

3.2.2 Capacitor

 A capacitor stores electrical energy.

 This pool of electrons is available for electronic components to use.

Capacitance is measured in Farads. The small capacitors usually used in electronics are often
measured in microfarads and nanofarads.

35
3.2.3 Inductor

An inductor is a passive electronic component that stores energy in the form of a magnetic field.
In its simplest form, an inductor consists of a wire loop or coil. The inductance is directly
proportional to the number of turns in the coil. Inductance also depends on the radius of the coil
and on the type of material around which the coil is wound.

3.2.4 Transformer

A transformer is a passive component that transfers electrical energy from one electrical circuit
to another circuit, or multiple circuits.

36
 Transformers are most commonly used for
increasing low AC voltages at high current
(a step-up transformer) or decreasing high AC voltages at low current (a step-down transformer)
in electric power applications, and for coupling the stages of signal-processing circuits.

3.2.5 Integrated circuits (ICs)

An integrated circuit, or IC, is

small chip that can function as an amplifier, oscillator, timer, microprocessor, or even computer
memory. An IC is a small wafer, usually made of silicon, that can hold anywhere from hundreds
to millions of transistors, resistors, and capacitors.

These extremely small electronics can perform calculations and store data using either digital or
analog technology.

37
3.2.6 Diodes.

A diode is a two-terminal electronic component

that conducts current primarily in one direction
(asymmetric
conductance); it has
low (ideally zero)
resistance in one
direction, and high
(ideally infinite)
resistance in the
other.

3.2.7 TRANSISTOR

38
A transistor is a semiconductor device used to amplify and switch electronic signals and
electrical power.

3.2.8 Relay

A relay is an electrically operated switch. It consists of a set of input terminals for a single or
multiple control signals, and a set of operating contact terminals.

39
 3.2.9 Switch.

a switch is an electrical component that can

disconnect or connect the conducting path in an
electrical circuit, interrupting the electric current or diverting it from one conductor to another.

3.2.10 Fuse.

It is an electrical safety device that operates to provide overcurrent protection of an electrical

circuit. It’s essential component is a metal wire or strip that melts when too much current flows
through it, thereby stopping or interrupting the current.

40
3.2.11 Microcontroller.

It is a small computer on a single metal-oxide-semiconductor (MOS) integrated circuit (IC) chip.

A microcontroller contains one or more CPUs (processor cores) along with memory and
programmable input/output peripherals. Program memory in the form of ferroelectric RAM,
NOR flash or OTP ROM is also often included on chip, as well as a small amount of RAM.
Microcontrollers are designed for embedded applications, in contrast to the microprocessors used
in personal computers or other general purpose applications consisting of various discrete chips.

41
3.3 DIATHEMY MACHINE

Introduction

Diathermy is electrically induced heat or the use of high-frequency electromagnetic currents as

a form of physical therapy and in surgical procedures. The earliest observations on the reactions
of high-frequency electromagnetic currents upon the human organism were made by Jacques
Arsene d'Arsonval.

42
Diathermy is commonly used for muscle relaxation, and to induce deep heating in tissue for
therapeutic purposes in medicine. It is used in physical therapy to deliver moderate heat directly
to pathologic lesions in the deeper tissues of the body.
Diathermy is produced by three techniques:
 ultrasound (ultrasonic diathermy)
 short-wave radio frequencies in the range 1–100 MHz (shortwave diathermy)
 microwaves typically in the 915 MHz or 2.45 GHz bands (microwave diathermy)
the methods differing mainly in their penetration capability.It exerts physical effects and elicits a
spectrum of physiological responses.
The same techniques are also used to create higher tissue temperatures to destroy neoplasms
(cancer and tumors), warts, and infected tissues; this is called hyperthermia treatment. In surgery
diathermy is used to cauterize blood vessels to prevent excessive bleeding. The technique is
particularly valuable in neurosurgery and surgery of the eye.

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Mechanism of Action

Diathermy uses very high frequencies (around 0.5-3 MHz) of electrical current. This allows
diathermy to avoid the frequencies used by body systems generating electrical current, such as

skeletal muscle and cardiac tissue, allowing body physiology to be broadly unaffected during its
use.

The radio-frequencies generated by the diathermy heat the tissue to allow for cutting and
coagulation, by creating intracellular oscillation of molecules within the cells. Depending on the
temperature reached, different results occur: at 60oc, cell death occurs (fulgurate), between 60-

44
99oc, dehydration occurs and the tissues coagulate, and at around 100 oc, the tissues vaporise
(cutting).

Due to the small surface area at the point of the electrode, the current density is high, producing a
focal effect and allowing the tissues to heat up rapidly. In monopolar diathermy, as the current
passes through the body, the current density decreases rapidly as the surface area the current acts
across increases. Consequently, this allows for focused heating of tissues at the point of use,
without heating up the body systemically.

TYPES OF DIATHERMY

1. Monopolar
2. Bipolar

Monopolar vs bipolar

The configuration of the diathermy devices can be either monopolar or bipolar; both actions
require the electrical circuit to be completed, but vary in how this is achieved.

In monopolar action, the electrical current oscillates between the surgeon’s electrode, through the
patient’s body, until it meets the ‘grounding plate’ (typically positioned underneath the patient’s
leg) to complete the circuit.

In bipolar diathermy, the two electrodes are found on the instrument itself. The bipolar
arrangement negates the need for a dispersive electrode, instead a pair of similar sized electrodes
are used in tandem. The current is then passed between the electrodes.

Bipolar is most commonly used in operations of the digits (to avoid monopolar current focused
over a smaller region), in patients with pacemakers (to avoid electrical involvement with the
pacemaker), or in microsurgery.

Cutting vs Coagulation

The main two settings of diathermy are cutting and coagulation.

 Cutting uses a continuous waveform with a low voltage. In cutting mode, the electrode
reaches a high enough power to vaporise the water content. Hence it is able to perform a

45
 clean cut but is less efficient at coagulating. The cutting mode focuses heat at the surgical
site, using sparks being the more focussed way to distribute heat; the cutting mode should
therefore be used with the tip slightly away from the tissue.
 Coagulation alternatively uses a pulsed waveform with a high voltage. In coagulation, the
waveform is at a lower average power, not generating enough heat for explosive
vaporization, but enough for thermal coagulation. The tip should be held slightly away
from the tissue, however the sparks are spread over a wider area causing charring rather
than cutting.
 There is also a mixed (or blend) mode, acting in between as both cutting and coagulating,
however this is not widely used

Principle of Surgical diathermy-

Cutting• High frequency currents (in the range of 1-3 MHz) can be used in operating rooms for
surgical purposes involving cutting and coagulation. • Surgical diathermy machines depend on
the heating effect of electric current. • When high frequency current flows through the sharp
edge of a wire loop or band loop or the point of a needle into the tissue (Fig. ), there is a high
concentration of current at this point. • The tissue is heated to such an extent that the cells which
are immediately under the electrode, are tom apart by the boiling of the cell fluid. • The
indifferent electrode establishes a large area contact with the patient and the RF current is
therefore, dispersed so that very little heat is developed at this electrode. • This type of tissue
separation forms the basis of electro-surgical cutting.

46
Laparoscopic Diathermy

In laparoscopic surgery, insulated equipment must be used and checked regularly to ensure it is
intact. Not insulated metallic equipment can potentially create an alternative electrical pathway,
so should be kept at a safe distance from the active electrode.

Capacitive coupling can occur when alternative current is passed from an insulated instrument to
a non-insulated one through a capacitor. Metallic trocars should therefore have good contact with
the abdominal wall to avoid burns, and non-conducting trocars must ensure they are in good
condition to avoid burns.

Why are high frequency currents safe?

• 1-3 MHz is quite a high frequency in comparison with that of the 50 Hz mains supply.

47
• This high frequency avoids the intense muscle activity and the electrocution hazards which
occur if lower frequencies are employed.

• The power levels required for electro-surgery are below the threshold of neural stimulation
provided that the diathermy frequency is in the radio-frequency range.

• When the frequency is at least 300 kHz, both the faradic and the electrolytic effects are largely
eliminated during the flow of current through the human tissue.

• This allows the exclusive utilization of the thermal effect in high frequency surgery providing
both the applications for cutting and coagulation.

Advantages of using high frequency currents

1. The separation of tissues by electric current always takes place immediately in front of the
cutting edge and is not caused by it.

2. Electric cutting therefore, does not require any application of force. Instead it facilitates
elegant and effortless surgery.

3. The electrode virtually melts through the tissue instantaneously and seals capillary and other
vessels, thus preventing contamination by bacteria.

4. A simplified method of coagulation saves valuable time since bleeding can be arrested
immediately by touching the spot briefly with the coagulating electrode.

Electrodes used

• The bi-polar technique is used in most of the applications involving surgical diathermy. • The
high potential terminal of the diathermy is connected to the cutting electrode which is mounted
in an insulated handle.

• The cutting electrodes are available in a variety of shapes, the choice depending upon the
nature of application.

• Lancet electrodes are normally used for cutting applications

• Needle electrodes are preferred for epilation and desiccation.

48
• Loop electrodes are employed for exsecting (or opening up) channels and extirpating growths,
etc.

• The active electrodes for coagulation purposes are of ball type or plate type.

• In electro-surgery, the surgeon is able to switch the high frequency current on and off himself.

• This can be done with a finger-tip switch in the electrode handle or a foot switch

Limitations

 In monopolar mode, good contact between the patient and the ground plate is essential. If
this surface area is decreased, for example if the ground plate slips partially off the
patient, then this can result in severe burns. Fortunately, many modern machines monitor
impedance and will stop working if this occur.
 The ground plate should be positioned as close to the operative site as possible, however
it should not be placed over a bony prominence, metal prosthesis, distal to a tourniquet,
over scar tissue, on hairy surfaces, or on pressure points, to minimize the risk of burns.
The plate should also be kept dry.
 There is also the theoretical risk of smoke and contaminant inhalation when using
diathermy, to both surgeon and theatre staff, hence appropriate masks should be used in
well ventilated areas.

Contraindications

 Implantable devices such as pacemakers and spinal cord stimulators are at risk of damage
from the electrical current in diathermy. This can lead to failure of the device, however
this risk is reduced with the use of bipolar (instead of monopolar).
 In-situ defibrillators can also interpret the diathermy current ads VF and potentially lead
to shocking the patient. Consequent needs to be deactivated prior to surgery

49
3.4 DENTAL CHAIR MACHINE

Introduction to dental chair.

The dental chair is the focal point of treatment and patient's comfort which is why its function
and form are of equal importance.

It is a specifically designed medical device intended to support a patient's whole body like a
recliner, but articulated, so that the dentist can recline patients to virtually any position.

The dental chair consist of specific parts that include :

 A seat
 Headrest
 Backrest
 Armrestsc
 Spittoon
 Aspirator/inhalation system
 Oral light
 Pedal.

Functions of the parts listed above.

The seat, headrest, backrest and armrest are there for easy maneuver and comfort of the
patient.
Spittoon
It is the container that is placed next to the dental chair so you can rinse and salivate
during the process.
The cuspidor is made with porcelain, it is removeable, autoclavable and it is removeable
so that it can be cleaned in a much simpler way.
Aspirator system/ inhalation system.

50
The aspirator is a small tube used to suction the saliva that accumulates in the mouth or
small particles of the cavity. Both the aspirator system and cuspidor are placed to the left
of the chair in the case of right-handed, and vice versa if left-handed.
Pedal.
It serves to activate the rotation of the different instrument, for example regulating the
chair or activating the water of the water group.
Instrument tray or table.
It holds all needed instruments for the dentist to work with.
Oral light.
It is another of the basic elements that all dental equipment must have. It is a high
intensity lamp that concentrates the entire beam f light inside the patient's oral cavity to
be able to work without any type of problem.

51
 Working principle of a dental chair.

The dental chair mainly adjusts the patient's body position in the whole treatment
machine.
It mainly uses low-voltage 24V power supply, upper and lower motors, keypad, foot-
controlled switch and so on are connected with the controller through wires. When the
controller is energized, the doctor can control the rise and fall of the chair frame or the tilt
of the back of the chair by using the foot-controlled switch or keypad to adjust to the
treatment position required by the doctor.
The dental chair control switch starts the motor to operate and drives the transmission
mechanism to make the corresponding parts of the dental chair move according to the
treatment needs, the manipulation and control of the switch can press the twist and the
dental chair can complete the movement of ascending, descending, bending and resetting.
Advantages
 Dental chair is comfortable and does not put pressure on the patient's nape.
 The armrests can be flipped down, so the patient doesn't have trouble getting in and
out of the chair.
 The backrest and chair are also built to be slim yet anatomical, this makes it easier for
professionals to maneuver around the chair as it is not bulky and blocky.

Disadvantage.

Dental chair works with electricity. So, it is not self-dependent.

Maintainance
There is no doubt that careful maintenance and regular service is imperative in order to make the
full use out of your dental chair. Having routinely maintained dental chair and well-trained staff
is the key to managing a dental chair.
With regular service and maintenance, dental chairs can last up to 15 years and more. The actual
service life of a dental chair is also influenced by the environment, extent of use, cleaning and
maintenance frequency, preventative maintenance of normal service "wear and tear"
components.

52
Busy practices tend to see shorter equipment lifespans as these dental chairs are more heavily
used.
Extending the lifespan of a dental chair requires meticulous care and regular maintenance,
conducted by experienced service engineers. Making sure that routine maintenance services are
completed on the dental chair can help you make the most out of your chair investment.
Training staff on how to properly use and maintain equipment can also reduce the likelihood of
damage and high-cost repair.

THINGS TO DO TO MAINTAIN THE DENTAL CHAIR

Daily
 Regular flushing through hand pieces and air/water syringes
 Lubricate dental chair parts
 Disinfecting after each patient
 Run suction cleaner
 Clean out delivery unit traps
 Drain and wipe out ultrasonic cleaner
Weekly
 Change traps on the delivery units
 Check and replace O-rings on handpiece couplers
 Check and replace gaskets on handpiece
Monthly
 Clean and replace plaster trap
 Clean model trimmer
 Clean the panoramic/cephalic cassettes and intensifying screen
 Check nitrous oxide systems and emergency oxygen units to ensure that they are working
properly and do not need to be replaced or repaired
 Check, clean or replace master trap
CONSIDRATIONS TO repair A dental chair or replace it
There are a few considerations to make before replacing a dental chair:

1. Review the chair's age and reliability over the past year, taking in consideration how old
the chair is. If it is more than 10 years old, and has been failing repeatedly, reconditioning

53
 the chair may not be worth the money and effort. Eventually you may still need to replace
the chair after getting it reconditioned.
2. Is there any remaining warranty coverage? If so, it may be worthwhile to have the chair
repaired.
3. Evaluate the amount of lost revenue due to equipment downtime. Have you been seeing
more and more disgruntled customers lately? Is the chair's productivity declining? It may
be expensive to replace a dental chair, but it may cost even more to repeatedly incur
repair expenses. Having downtime is also losing revenue and losing trust in your
customers.
4. Have an honest discussion with a trusted and experienced service engineer. engineers at
are able to provide professional and most cost-effective advice for you when weighing
out the costs of continual repairs compared to purchasing a new dental chair.

3.5 An oxygen concentrator

An oxygen concentrator is a device that concentrates the oxygen from a gas supply (typically
ambient air) by selectively removing nitrogen to supply an oxygen-enriched product gas stream.
The medical concentrator is a type of concentrator that supplies oxygen with a purity of at least
90% for any flow rate. If it fails to meet this criterion, then it can not be considered as a medical-
grade concentrator.

Handling of the Oxygen Concentrator

 The oxygen concentrator produces a high amount of oxygen. Oxygen helps in rapid
burning. So, you should not place the machine near the fire/ kitchen. Similarly, smoking,
use of petroleum products, lubricants, grease, etc, should not be allowed near the
machine.
 Operate the machine in an open space. Maintain a gap of at least 2 feet between the
machine and the wall of the room.
 Place the machine on the floor. Do not place it on top of the table, bed, etc. Else, the
machine might fall due to the vibration created by the compressor of the machine.

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  Keep the machine in a clean environment. This will increase the life span of the machine.
 Clean the humidifier bottle with clean water. I recommend you not to use tap or filtered
water in the bottle. Instead of that, you can buy distilled water from the market.
 In the case of any problem with the machine, consult with the service engineer. Do not
open the machine on your own.
Components of the Oxygen Concentrator
 Compressor
 Sieve Bed (Zeolite Tower)
 Filters
 Tubes
 Four-Way Directional Valve (Solenoid Valve)
 Cooling Fans
 Pressure Sensor and Pressure Regulator
 Accumulator Tank (Oxygen Tank)
 Flow Meter (Rotameter)

Working Mechanism of oxygen concentrator

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First of all, air from the atmosphere goes inside the compressor through the filters. The piston
inside the compressor will pressurize the incoming air and sends it to the four-way directional
valve. This pressurized air will release heat. So to cool it down, a cooling fan is used. Through
the valve pressurized air goes to one of the sieve beds. The sieve bed consists of zeolite powder
which allows oxygen to pass through it. The pressure in the sieve bed is analyzed by the circuit
board. When certain pressure is reached, the circuit board allows four-way directional valves
(solenoid valve) to change the direction of airflow. Now the air goes to the other sieve bed for
filtration. While this process is going on, the other sieve bed will depressurize and gases such as
nitrogen and water vapor will release back to the atmosphere. You need two sieve beds so that
they can supply oxygen continuously.
Filtered dry oxygen will then accumulate in the accumulator tank. It consists of a dial pressure
gauze and a pressure sensor. The pressure sensor is used for safety purposes i.e. when the oxygen
reservoir becomes full then the air compressor stops working. From the accumulator tank, some
amount of oxygen goes through the circuit board to check its purity. A major portion of the
oxygen goes through the rotameter. It helps to regulate the amount of oxygen output. Then it
comes out of the machine at a controlled rate through a humidifier.
Reasons for the vibration of the oxygen concentrator
You need to be careful about the noise that your concentrator makes. This is because it will give
you an idea about the current situation of your machine. Some of the reasons could be because
of the:
 Age of your machine
 Low voltage from the power supply. The compressor will have difficulty operating.
 Air leakage from the pipes or the solenoid valves.
Maintenance of Oxygen Concentrator
(Factors affecting the output of the oxygen concentrator)
 Check the output of the concentrator with the help of an oxygen analyzer or you can also
use the pulse oximeter.
1. Machine does not operate
If the machine does not turn on, then it can be because of the malfunctioning of the power cord,
switch, fuse, or mainboard. If such a problem occurs, then make sure to replace the
malfunctioned part.

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Generally, you will find a 3-5 A fuse. Similarly, the switch will be of 4- pins. You can check the
continuity of the switch. But, I recommend you to cross-check it with a new one, instead of fully
trusting the multimeter.
2. Filters
You will find three types of air filters in the oxygen concentrator. The outer dust filter filters the
dust particles. It also protects the inner HEPA filter. You can clean this filter with soap and
water.
You need to replace the HEPA filter periodically (at least twice a year).
There is also a bacterial filter.

3. Zeolite Tower (Sieve Bed)

A pair of zeolite towers lies within the concentrator. After continuous use of the concentrator,
the effectiveness of the tower keeps on decreasing. Lumps of the zeolite may be formed
within the tower. Besides that, there can be leakage at the outer layer of the zeolite tower. So,
you to cross-check the zeolite tower in that case.
The orifices of the zeolite should not be exposed to the environment. Else the dust and dirt can
contaminate the zeolite powder. Besides that, atmospheric moisture can lead to the formation of
a cluster of powder.

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4. Tubing
There are several flexible tubing inside the concentrator. Due to the high pressure of air, friction
developed within the machine, the tubes may rupture. Thus, in that case, there might be air
leakage. So, you need to replace the tubes in that case.
5. Compressor
The compressor may not be working properly. This can be because of 4 main reasons. The
capacitor, washer, piston, or the bearing of the compressor may have been damaged. If possible,
you can replace these components separately. Else, you need to replace it with a new one. The
compressor operates at 240 VAC. Similarly, the capacitors might operate at 6 µF, 10 µF, 15 µF,
etc. You can directly give an AC supply to the compressor and check it. In the case of the
capacitor, I suggest you cross-check it with a new one.

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the compressor of the Oxygen Concentrator
6. Solenoid Valve
The solenoid valve operates on a set of zeolite towers. When a certain pressure in the oxygen
tank is reached, the valve makes a click sound. After that, the path of the oxygen changes in
another direction. After the click sound, the unfiltered gas (eg. nitrogen), returns from the zeolite
tower to the valve. Then it goes to the environment. You can hear a different sound when the
unnecessary gases return to the environment.
If the valve does not make a click sound, then you can manually supply 12 VDC to the valve and
check it. Similarly, if the output from the compressor does not meet the required air pressure
then the valve may not operate even after making a click sound. So, you may need to cross-check
both the compressor and the solenoid valve.
7. Fan
The fan is needed for the cooling of the compressed air released by the compressor.

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If the fan stops working, then the temperature of the pipes will rise up. This will cause the burn
and breakdown of the pipes. After that, the atmospheric air will directly enter the zeolite tower.
So, it will soon be contaminated and will expire.
If the temperature of the concentrator increases beyond the normal level, then the problem might
be with the fan. In such a case, you need to replace the fan with a new one.
8. Flowmeter
The problem may arise in the flowmeter (rotameter). In such a case, there will be a decrease in
the flow rate from the machine. Also, the oxygen purity may decrease. So, you need to take extra
care with the flowmeter.
Sometimes the float will get stuck at the base of the flowmeter. In such a case, you can shake the
flowmeter by removing it from the machine. You may even use a higher gust of air to force it to
move. If the knob or the glass layer is damaged or broken, then you need to replace the
flowmeter with a new one.
Even for the same capacity of the rotameter, the size and thickness can differ from one company
to another. So, as far as possible make use of the rotameter of the same model.
9.Zeolite( Al2SiO5)

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Zeolite tower consists of zeolite. It is a naturally occurring, crystalline, microporous compound.
Nowadays, these compounds are also synthesized to form a powder.
1. Working Mechanism of zeolite
It is based on the process of adsorption. When gas or liquid passes through the zeolite surface,
smaller-sized molecules pass through the surface while larger-sized molecules are adsorbed by
the surface.
2. Zeolite for Adsorption

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Zeolite is the major source of filtration in the oxygen concentrator. The most widely used zeolite
for the oxygen concentrator is zeolite 13X. You will find zeolite inside two of the zeolite
towers.
When compressed air is passed through zeolite powder, oxygen passes through it. Other gasses
such as nitrogen and argon having higher molecular size get adsorbed by the power.
Life Span of zeolite
Generally, the life span of zeolite powder is above 2 years (in the case of an oxygen
concentrator). However, if you do not handle the sieve bed properly, then it can expire within
few days.
3.6 NEBULIZER
What Is a Nebulizer?
A nebulizer changes medication from a liquid to a mist so you can inhale it into your lungs.
In medicine, a nebulizer] is a drug delivery device used to administer medication in the form of a
mist inhaled into the lungs. Nebulizers are commonly used for the treatment of asthma, cystic
fibrosis, COPD and other respiratory diseases or disorders.
They use oxygen, compressed air or ultrasonic power to break up solutions and suspensions into
small aerosol droplets that are inhaled from the mouthpiece of the device. An aerosol is a
mixture of gas and solid or liquid particles.

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Types of Nebulizers
There are three main types of nebulizers:
 Jet. This uses compressed gas to make an aerosol (tiny particles of medication in the air).
 Ultrasonic. This makes an aerosol through high-frequency vibrations. The particles are
larger than with a jet nebulizer.
 Mesh. Liquid passes through a very fine mesh to form the aerosol. This kind of nebulizer
puts out the smallest particles. It’s also the most expensive.
NOTE, One needs to talk to the doctor about whether a mouthpiece or a mask is right for you or
your child. Face masks, which fit over the nose and mouth, are often better for children under 5
because they breathe through their nose more than older children and adults do.
How TO Use a Nebulizer
Before starting, gather your supplies:
 Air compressor
 Nebulizer cup
 Mask or mouthpiece
 Medication (either unit dose vials or bottles with measuring devices)
 Compressor tubing
Then, the following steps follows;
 Put the air compressor on a flat, sturdy surface. Plug it into a grounded (three-prong)
electrical outlet.
 Wash your hands with soap and water, and dry them completely.
 Put medication into the nebulizer cup. Most comes already measured in unit dose vials. If
you have to measure it yourself, use a separate clean measuring device for each
medication.
 Assemble the nebulizer cup and mask or mouthpiece.
 Connect the tubing to both the aerosol compressor and the nebulizer cup.
 Turn on the compressor to make sure it’s working the way it should. You should see a
light mist coming from the back of the tube.

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  Sit up straight on a comfortable chair. If the treatment is for your child, they can sit on
your lap. If you’re using a mask, put it on. Be sure it’s comfortable and secure. If you’re
using a mouthpiece, put it between your or your child's teeth and seal the lips around it.
 Take slow, deep breaths. If possible, hold each breath for 2 or 3 seconds before breathing
out. This lets the medication settle into your airways.
 Continue until the medication is gone. The nebulizer will make a sputtering noise, and the
cup will have just a little liquid left in it.
 If you get dizzy or jittery, stop the treatment and rest for about 5 minutes. Continue the
treatment, and try to breathe more slowly. If you keep having problems during
treatments, tell your doctor.
MAINTENANCE OF A Nebulizer
It’s important to clean and disinfect your nebulizer equipment to prevent infection. Clean it in an
area away from smoke, dust, and open windows.
Follow these instructions for cleaning of a nebulizer:
 After each treatment, rinse the nebulizer cup thoroughly with warm water, shake off
excess water, and let it air-dry. At the end of each day, wash the cup and mask or
mouthpiece in warm water with a mild detergent. Rinse it thoroughly and let it air-dry.
You don’t need to clean the compressor tubing.
 Every third day, after washing your equipment, disinfect it with either a vinegar/water
solution or a disinfectant solution. To make the vinegar solution, mix ½ cup of white
vinegar with 1½ cups of water. Soak the equipment for 20 minutes and rinse it well under
a steady stream of water. Shake off the excess water and let it air-dry on a paper towel.
Be sure it’s totally dry before storing it in a zippered plastic bag.
Storing
 Cover the compressor with a clean cloth when you’re not using it. Wipe it with a clean,
damp cloth if necessary.
 Don’t put the air compressor on the floor, either for treatments or for storage.
 Store medications in a cool, dry place. Some need to be kept in a refrigerator, and others
should be kept out of the light. Check them often. If they’ve changed color or formed
crystals, throw them out and replace them.
Other tips

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  Always have an extra nebulizer cup and mask or mouthpiece on hand. If you get a
breathing treatment in your doctor’s office, ask for the tubing, cup, and mask.
 Follow the equipment directions on checking, cleaning, and replacing the filter on the air
compressor.

ADVANTAGES OF Nebulizer

1. Nebulizers are especially good for infants’ or small children’s asthma medications. They
may be easier to use with young children.
2. They’re are helpful when one have trouble using an asthma inhaler or need a large dose
of an inhaled medication.i.e They are easier to use when you are having an asthma attack,
since you don’t need to take deep breaths while using one.
3. patients can inhale their prescribed medication directly into the lungs,
4. It give patient fast relief from inflammation
5. It allowing them to breathe easier.
6. Multiple medications can be delivered at the same time.

Disadvantages of nebulizers

1. Nebulizers are usually not as easy to transport as an inhaler.

2. They often require a stationary power source.
3. Delivery of medications takes longer through a nebulizer than through an inhaler.

TROUBLESHOOTING A NEBULIZER
Compressor Does Not Operate
1. Check to see that the plug is firmly into a grounded outlet.
2. Verify there is power to the outlet by plugging a lamp into it.
3. If none of the above solves the issue, call Oxygen One at 262-521-2202 for additional
assistance.

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Limited Air Pressure is Coming Through the Tubing from the Nebulizer or Nebulizer
Seems Clogged

1. Check the air inlet for obstructions and change the inlet filter as necessary.
2. Check the tubing and mouthpiece for obstructions.
3. Check all connections and reassemble nebulizer kit as instructed.

Nebulizer Treatments are Taking Longer than they Usually Do

1. Check the air inlet filter. Replace the filter if discolored or wet.
2. Check tubing/mouthpiece for obstructions and change as necessary.

3.7 SUCTION MACHINE

What Is a Suction Machine?

A suction machine, also known as an aspirator, is a type of medical device that is primarily used
for removing obstructions like mucus, saliva, blood, or secretions from a person’s airway. When
an individual is unable to clear secretions due to a lack of consciousness or an ongoing medical
procedure, suction machines help them breathe by maintaining a clear airway.
In practice, care professionals use suction machines as an integral part of a treatment plan when a
patient’s airway is partially or completely obstructed. Some common uses include:

 Removing respiratory secretions when the patient is unable to

 Assisting a patient that is vomiting while seizing or unconscious
 Clearing blood from the airway
 Removing a foreign substance from a patient’s windpipe and/or lungs (pulmonary
aspiration)

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Since they can be used in conjunction with other medical technologies to treat a variety of life-
threatening conditions, aspirators have become a mainstay in both pre-hospital and in- hospital
settings.

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SUCTION MACHINE
History of the Aspirator
The first conventional aspirator was introduced by a cardiologist named Pierre Carl Edouard
Potain in 1869. His aspirator was a manual machine that used a pump to drain abscesses and
fluid buildup in the chest, with the goal of preventing heart failure. When electricity became
commonplace and reliable, suction machines transitioned from manual devices to electrically
powered devices. However, until the late 1970s, aspirators were extremely large and were often
permanently affixed to a wall.
In time, many other types of aspirators were invented. Today, several types of suction devices
are available for use or rent by both hospitals and patients.

 Manual suction devices — Manual devices do not use electricity, and their design can
be as simple as a handheld bulb that’s used to expel mucus from a child’s nasal cavity.
They’re often used in emergency settings since they don’t require electricity to function
and are usually small and portable. However, it is difficult to use manual suction devices
consistently and effectively over a long period of time.
 Stationary suction machines — For decades, stationary devices were the most common
machines, as they were reliable, effective, and consistent. However, their lack of
portability left a lot to be desired. Patients couldn’t be treated with a stationary suction
machine during transport and it could only provide emergency care within a hospital’s
four walls.
 Portable suction machines — Portable suction machines are growing in popularity due
to advances in aspirator and battery technology. Portable aspirators are designed to be
lightweight and easy to move or transport, making them perfect for both patients and
medical professionals.

Manual, stationary, and portable suction machines all have their place in a modern care
environment. Each has its own set of strengths, and medical professionals may utilize multiple
types of suction machines during different phases of treatment.

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Common Uses for Suction Machines

Suction machines are often used when a patient is experiencing liquid or semi-solid blockages in
their pharynx, trachea, or other oral cavities. However, the ideal suction device may vary
depending on a patient’s condition. Here are a few scenarios where patients or professionals may
use a portable suction machine.
Ongoing Patient Care
Patients may require portable suction machines in their home if they are unable to clear
their own secretions for a variety of reasons. This includes patients who are receiving
palliative care and find it difficult or impossible to clear their own secretions, individuals
with chronic illnesses (COPD, ALS, cystic fibrosis, bronchiectasis, etc.), or patients who
have undergone a tracheostomy.
Pre-hospital
Portable aspirators are very common in a pre-hospital setting, as they play a crucial role
in helping emergency responders establish ABC (airway, breathing, and circulation). In
practice, pre-hospital providers often use portable suction machines to treat a variety of
patients. This includes trauma victims with blood in their airway, overdose victims with
vomit in their airway, and other victims that are experiencing a respiratory emergency.
In-Hospital
Most hospitals have rooms that are outfitted with stationary, wall-mounted suction
machines. Care teams often use stationary aspirators as a part of standard procedures such
as tracheostomies, sinus-related ailments, and tonsillectomies.
However, hospitals often have a few portable devices for certain use cases. For example,
if a patient needs an aspirator but there is no wall-mounted aspirator in the patient’s
room, the care team will locate and retrieve a portable aspirator instead of moving the
patient to another room. Additionally, they’re used to treat patients outside of a room
when hospitals are at capacity.

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Types of Suction Machine

There exist different types of suction machine named according to area of application such as for
pediatrics, O and G, and for general use. Similarly, some are electrically, vacuum and battery
operated. Another category of suction machine are high or low pressure.
Low pressure suction machine is useful in gastrointestinal drainage such as bleeding in the
stomach or intestines. The low pressure suction should drain the body fluid in a continuous
manner without damaging the underlying soft tissues.
However, the most commonly among suction machine is the electric types. Good for different
characterised accuracy and ease of use. This type is usually portable and last longer.

Different Components of Suction Apparatus

The three important parts of a suction apparatus could classified as:

 Source of Vacuum which is basically a vacuum pump;

 The Reservoir which includes one or two suction bottles or canisters and
 The Delivery Tubing which is a length of flexible plastic tubing which may include a
nozzle or a catheter.

Equally important components which makes a suction pump complete are:

 Bacterial Filter;
 A Vacuum Gauge;
 Vacuum Control Valve and
 Vacuum Cut off Valve and
 Moisture or Debris Trap.

The efficiency of a suction machine depends on the displacement or the volume of air the pump
is able to move. This is usually expressed in liters per minute (l/min). Meanwhile, efficiency is
also affected by negative pressure produced by the pump with particular regards to the time
taken to achieve it.

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How Portable Suction Machines Work

Portable suction machines generate negative pressure, which is channeled through a special type
of plastic connecting tube called a single-use catheter. The negative pressure creates a vacuum
effect that pulls any blood, mucus, or similar secretions out of the throat. The secretions are then
automatically dispensed into a collection jar.
In order to generate negative pressure and remove secretions, portable suction machines rely on a
few key technologies. Here is a shortlist of the most common components within a suction
machine.

 Disposable or rechargeable batteries — Suction machines are outfitted with powerful

batteries to ensure that they can provide suction capabilities when a reliable power source
is not available.
 Suction/vacuum pump — The vacuum pump is often located inside of the aspirator.
This is what causes negative pressure and is necessary for a functioning suction machine.
 Connection tubing — This connects the vacuum pump to the collection canister. It
should never touch the contents within the collection canister.
 Sterile patient tubing — Patient tubing attaches to the suctioning tip and carries the
patient’s secretions into the collection canister. Sterile patient tubing should be properly
disposed of after each suctioning session.
 Disposable canister — The disposable canister holds the patient’s secretions and often
provides overflow protection capabilities in case too much fluid is suctioned out of the
patient. This canister should be disposable to ensure all parts of the suction machine
remain sterile.
 Power cord — Portable suction machines come with a power cord that can be used to
charge the machine when you’re close to a power outlet.
 Filters — Ideally, a disposable canister should support the use of bacteria/viral filters to
prevent contamination within the aspirator’s inner components. Certain filters may also
be used to protect against dust and dangerous gases that can damage the machine.

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Once all components are accounted for and applied, activate the machine. Users can select a
continuous or intermittent suction mode and adjust the level of suction to ensure all secretions
are being cleared. Care teams using the ZOLL 330 Aspirator can also select the “Smart Flow”
feature, which will help the machine function quietly during patient care. This minimizes
distractions for the care team and patients alike.

How to Set Up/ Install a Portable Suction Machine

Before using a suction machine, make sure you have received appropriate training for the device
and read the official product manual associated with your aspirator. Since different aspirator
varieties have different features, only an official product manual will provide the most precise
guidance.
While you are preparing the suction machine for use, make sure you have a few critical items. If
these components are not available, the suction machine may not work as intended.

 A power supply (for some machines, a 12-V DC automotive cable will also suffice if
external power is available)
 A disposable collection canister
 Aspirator-to-canister connective tubing
 Patient tubing (also known as the aspirator circuit)
 A suction catheter or surgical suction accessory (the appropriate accessory depends on
the procedure)
 Spill control solidifiers to safely dispose of liquid biohazards

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  Any additional accessories that are required for the procedure and approved by the device
manufacturer

Once you have all the necessary parts to begin the suctioning process, prepare the machine for
use. The general process for setting up a suction machine begins with inspecting the outer
components, such as the power cord, for any defects and damages. If all the pieces are in proper
working order, connect the aspirator to a power source. For the ZOLL 330 Aspirator, lock the
power cord into place by aligning the cord’s connecter with the triangles on the machine. If a
power source is not readily available, make sure the machine is fully charged before you begin
using it.
Next, attach the collection canister and tubing to the suction machine. Begin by securing the lid
on the collection canister by pressing firmly on the entire perimeter of the lid until it is
completely sealed. Then, attach the pour spout cap firmly on the lid’s pour spout. Next, secure
the collection cap to a basket or other container to deter spills — secure it with a hook-and-loop
fastener if necessary. Once the container is set up, attach the connection hose to the aspirator’s
vacuum port and the vacuum port on the collection canister; attach the sterile patient tubing into
the canister’s patient port.
At this point, the aspirator can be turned on with a power button or power switch. When it turns
on, the suction machine should begin a self-check to ensure all internal systems are working
properly. This includes alarm conditions, pneumatic system function, internal communication,
and the power system.
Double-check that you have followed the guidelines outlined in the product manual, and make
sure that all exterior components (canister, tubing, fittings, etc.) are firmly connected. Then,
verify that the machine is receiving the right kind of power. For the ZOLL 330 Aspirator, an
external power icon will appear if it is drawing power from an external power source. If a slash
appears, the cable or power source is not providing power to the aspirator.
Once the machine is on, perform an operational test to ensure the device is performing correctly.
First, select “Surgical Suction” on the start menu. The suction machine will begin channeling
negative pressure. Test the vacuum level by pinching the suction tubing and watching the
vacuum gauge. It should rise to the surgical vacuum level (± 2 mm Hg + 8%). If it is higher or
lower, make sure you are fully obstructing the opening when you pinch the tubing. If not, check

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again to ensure the tubing and collection canister are assembled securely. If the vacuum level is
not appropriate despite everything being assembled correctly, your aspirator may need servicing.
Contact your device manufacturer for further guidance.

How to Clean a Suction Machine

A suction machine has many parts, so frequent cleanings are an absolute necessity. Ideally,
medical professions should clean an aspirator after every use while wearing personal protective
equipment to protect against hazardous waste, and then clean the reusable parts in regular
intervals to ensure the aspirator and its components are free of dangerous contaminants.
The good news is that many aspirator parts are single use. Consult your product manual to
determine what can be reused and what should be disposed of after use. With the ZOLL 330
Aspirator, the collection canister, canister lid, and associated suction tubing should be discarded
after use. Make sure all single-use parts are disposed of in accordance with hospital and local
protocols for medical waste.
For regular cleaning, wipe down the unit’s housing and vacuum port with a damp, soapy cloth,
and then dry it with a lint-free cloth. To disinfect after use, dampen a cloth with a 10% bleach
solution and thoroughly clean the housing and vacuum port, taking care to ensure no liquid gets
inside the aspirator. Finally, ensure the aspirator is completely dry before storing or reusing it.
There are some compounds that should not come into contact with a suction machine. Do not
allow grease or oil to enter the system or coat the reusable components of your aspirator, and do
not expose the inside of the aspirator to excessive amounts of water. Additionally, avoid using
hydrocarbon or abrasive cleaners on your suction machine, as they may damage the casing or
components.
Always refer to your aspirator’s product manual or cleaning instructions to confirm that your
device has been cleaned properly.

Common Faults with Suction Machines

 Cut-off valve failure

 Improper seal of the suction bottle
 Soiled filter and

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Similarly,

 Leaky capacitor
 Power Switch failure
 Fuse blown or circuit breaker tripped off and
 Blocked catheter

TROUBLE SHOOTING A SUCTION MACHINE

Machine is not plugged in or is not turned on.

 Plug machine into a working 3-hole outlet.
 Press ON/OFF switch to turn machine ON.
Suction pressure is not properly set.
 Make sure suction pressure is set as instructed by your PHS Clinician.
1. Turn machine ON.
2. Block end of Suction Tubing.
3. Read outer numbers on Pressure Gauge.
4. Use Control Knob to adjust to desired Safe Suction Pressure.
LOW or NO pressure at Regulator Port
 Turn machine ON. Use finger to completely cover Regulator Port. Check suction
pressure by reading outer numbers on the Pressure Gauge. Turn Control Knob to adjust
pressure to desired Safe Suction Pressure level.
 If LOW or NO suction pressure, call PHS.
 If pressure is at desired Safe Suction Pressure, continue to next step.
LOW or NO pressure at end of Filter

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  Connect one end of the 3 inch Tygon Tubing to the Regulator Port and the other end to
one side of the Filter. Turn machine ON and feel for suction on the side of the Filter
without the Tygon Tubing.
 If there is LOW or NO suction, replace Filter with a new one and recheck suction
pressure.
 If pressure is at desired Safe Suction Pressure, continue to next step.

LOW or NO pressure at Patient Port

 Connect one end of the 10 inch Tygon Tubing to the free end of the Filter. Connect the
other end to the Elbow Adapter on the Vacuum Port of the Canister lid. Turn machine
ON. Feel for suction at the Patient Port on Canister lid.
 If there is LOW or NO suction:
1. Dump contents of Canister, if full, into toilet. Tap the Overfill Float on Canister lid to
make sure it moves up and down.
2. Make sure there are no cracks in the Canister. Throw out cracked Canister and replace
with new one.
3. Make sure the Canister lid is firmly attached.
 If pressure is at desired Safe Suction Pressure, continue to next step.
LOW or NO pressure at end of Suction Tubing
 Connect Suction Tubing to Patient Port on Canister lid. Turn machine ON and feel for
suction at open end of the Suction Tubing.
 If LOW or NO suction, throw out Suction Tubing and replace with new Suction Tubing.
Recheck suction pressure.

PATIENT MONITOR

patient monitor is an electronic medical device that consists of one of more monitoring sensors,
a processing component(s), and a screen display (also called a "monitor") that provide and record
for medical professionals a patient's medical vital signs (body temperature, blood pressure, pulse
rate and respiratory rate) or measurements of the activity of various body organs such as ECG

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monitors, anesthesia monitors, or EKG monitors. Multi-parameter patient monitors support the
conduct of patient care in doctors’ offices, outpatient facilities, hospital operating rooms, hospital
critical care facilities, and during EMS and non-emergency ambulance transport. There may also
be a need for bedside measurement of vital signs in low-acuity post-anesthetic care and during
sleep studies. Patient monitors are used to monitor adults, pediatrics and neonates.

The present patient monitoring systems in hospitals allow continuous monitoring of patient vital
signs, which require the sensors to be hardwired to nearby, bedside monitors or PCs, and
essentially confine the patient to his hospital bed. Even after connecting these systems to
particular patient, a paramedical assistant need to continuously monitor and note down all the
vital parameters of a given patient by keeping track of all of his/her records manually. Adopting
such a method is error prone and may lead to disaster in the case of a human error. In the current
proposed system the patient health is continuously monitored by the Mobile multi patient
monitoring system and the acquired data is transmitted to a centralized microcontroller using
Wireless Sensor Networks.

A Bluetooth transceiver is connected to every patient monitor system that consumes very low
power and is extremely small in size. These are specifically designed for low power
consumption, with minimal circuit components intended for small packet, long distance range
applications and typically consist of a low power controller with minimal resources and interface
capabilities. These Bluetooth is having a data transfer rate of about 10 m. So the Wireless Sensor
Networks seem to be a perfect fit for remote patient monitoring. To improve the accuracy and to
increase the efficiency of the above processes a real time patient monitoring system based on
Wireless Sensor Networks and a centralized microcontroller is integrated with a Bluetooth
module is designed. This paper describes an independent system that automatically logs vital
parameters of patients for easy access. The data is accessible to doctors through mobile device
for convenience if needed.

BLOCK DIAGRAM:

The following figure shows the block diagram of Bluetooth based personal medical kit. Slight
fluctuation in the normal heart rate, body temperature can be measured to the help of this
medical kit. It will forward data to the microcontroller where it will be compared with normal
value of body temperature and heart rate. Depending upon the parameters considered by monitor,

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if it finds any parameter disturbed the result is send to the doctor and he may immediately take
the necessary section. Thus without wasting the time patient can be treated whereas sending the
report can be done using Bluetooth. Bluetooth based heart rate monitoring and the display
system is a portable and a best replacement for the old model stethoscope, which is less efficient
It is a combination of a HIGH POWER LED based heart rate monitor interface with a Bluetooth
module to transmit the heart rate of patient to a remote location. The functioning of this device is
based on the truth that the blood circulates for every heartbeat that can be sensed by LED.
Depending upon the rate of circulation of blood the heart beat per minute is calculated. This
calculated value is communicated to the person through a Bluetooth to the receiver which are
interfaced to it. Bluetooth based heart rate monitoring and the display system is a portable and a
best replacement for the old model stethoscope, which is less efficient.

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: block diagram of patient monitoring system

It is a combination of a HIGH POWER LED based heart rate monitor interface with a Bluetooth
module to transmit the heart rate of patient to a remote location. The functioning of this device is

based on the truth that the blood circulates for every heartbeat that can be sensed by LED.
Depending upon the rate of circulation of blood

Applications and Scope :

This Patient Monitor is a multi-functional instrument designed for monitoring the vital
physiological signs of adult and pediatric patients. With the functions of real-time recording and
displaying parameters, such as ECG, heart rate, non-invasive blood pressure, functional oxygen
saturation, end-tidal CO2 concentration, respiration rate, body temperature, and so on, it allows
comprehensive analysis of patient’s physiological conditions.

The overall structure and working theories

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The patient monitor, which performs physiological parameter measurement through different
modules, is a product of module design. It consists of six modules: ECG module, NIBP module,
SpO2 module, CO2 module (optional) and the main unit.
1. The ECG module collects the heart rate, respiration waveforms through the ECG leads &
electrodes and collects the temperature data through the temperature probes as well.

2. The SpO2 module collects the data of pulse rate, pulse oxygen saturation (SpO2) and SpO2
volume waveform via the SpO2 probe.
3. The NIBP module collects the blood pressure data, including the diastolic, systolic and mean
arterialpressure through the NIBP cuff. The cuffs are designed for adult, infant and neonate
respectively, and the NIBP measurement has two modes: adult, infant and neonate.

4. The CO2 module collects the date of respiration rate, EtCO2, InsCO2 through the sampling
tube.
5. The main unit consists of main board, multi-function board, and the keyboard. The multi-
function board performs the data communication among the main board, ECG module, SpO2
module, NIBP module, and CO2

HOW TO READ A PATIENT MONITOR

The sensors connected to the patient's body carry the information that is displayed on the patient
monitor. You can read the parameters such as heart rate, blood pressure, body temperature,
oxygen saturation displayed on the machine. Here's how you can interpret the numbers shown in
the display -

Heart Rate: Typically, the resting heart rate of a healthy adult is between 60-100 beats per
minute.

Blood Pressure: Blood pressure numbers in the range 120/80 are considered to be normal.

Body Temperature: Temperature is reported in degrees Fahrenheit or degrees Celsius. It can be

anywhere from just under 98 degrees F to a little over 99.

Oxygen Saturation (SpO2): It is the measure of the amount of oxygen in the patient's blood.
The SpO2 is normally 95 or higher.

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Respiratory Rate (RR): A resting adult typically breathes 12 to 16 times a minute. It is reported
in breaths per minute.

PARAMETERS OF PATIENT MONITOR

ECG: An electrocardiogram (ECG or EKG) records the electrical signal from your heart to
check for different heart conditions. Electrodes are placed on your chest to record your heart's
electrical signals, which cause your heart to beat. The signals are shown as waves on monitor.

Body temperature: The normal body temperature of a person varies depending on gender,
recent activity, food and fluid consumption, time of day, and, in women, the stage of the
menstrual cycle. Normal body temperature can range from 97.8° F (36.5°C) to 99°F (37.2°C) for
a healthy adult.

Respiratory rate: The respiration rate is the number of breaths you take each minute. The rate is
usually measured when you are at rest. It simply involves counting the number of breaths for one
minute by counting how many times your chest rises. Respiration rates may increase with
exercise, fever, illness, and with other medical conditions. When checking respiration, it's
important to also note whether you have any trouble breathing.

Normal respiration rates for an adult person at rest range from 12 to 20 breaths per minute.

Blood pressure: This is a measure of the force on your arteries when your heart is beating
(known as systolic pressure) and when it’s at rest (diastolic pressure). The first number (systolic)
should be between 100 and 130, and the second number (diastolic) should be between 60 and 80.

Oxygen saturation: This number measures how much oxygen is in your blood, on a scale up to
100. The number is normally 95 or higher, and anything below 90 means your body may not be
getting enough oxygen.

Maintenance of a Patient Monitor

Check & clean the filter: Checking the filter of your patient monitor is important because the
build up of debris, dust or other particles could damage and drastically shorten the life of the
monitor. Cleaning the filter weekly is necessary to ensure it is free of debris.

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Wipe the monitor:Wiping the monitor down weekly will further ensure that the equipment is
clean and free of dust or debris which could work its way into the machine.

Check the water traps:The monitor’s water traps need to be checked and emptied frequently
and after each and every surgical procedure. An overfull water trap could ruin the patient
monitor.

Calibrate per manufacturer’s specifications:Having your patient monitor calibrated is vital to

the life of the monitor. You will need a certified technician to calibrate your machine for you.
To find a certified technician, please click here.

Have preventative maintenance performed:Having preventative maintenance performed on

your machine is not only wise but also necessary for the life of your machine. Preventative
maintenance ensures that your machine is in correct working condition and that it doesn’t have
any foreseeable problems present.

Troubleshooting Patient Monitors

 Check the Patient Cable for any visible damage, such as cracks or creases where the
wires may be damaged under the protective coating. Also be sure your leads are
compatible with the devise you are using.
 Check the date on the Electrodes you are using. They have a shelf life, and very often the
individual packages should be used within 7-10 days of opening. The gel has a use by
date also, as it can harden.
 Check the Blood Pressure Cuff & Hose for leakage. They are often wrapped up quickly
and stuffed next to the monitor which can kink the hose causing cracks, or small tears in
the cuff itself. A leaking cuff will give a false reading.
 Check the electrode clips to be sure they are attached firmly. A loose spring action will
not clamp itself tightly against the electrode.
 Check SpO2 Sensors to be sure they are fitting the patients’ finger correctly. Too loose,
or too tight will give an incorrect reading. The tip of the finger should be in contact with
the Sensor. Nail polish can be an interference to a correct reading, and cold fingers may
not give a reading at all.

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83
84
Appearance:

Front panel

1. Power switch: Press it to switch on/ off the monitor.

2. AC power indicator: When AC indicator is on, it means this device is using mains power
supply.

3. DC power indicator of built-in battery:When DC indicator is on, it means the battery is used;
when both of AC indicator and DC indicator are on, it means that this device is using mains
power supply and the battery is being recharged.
4. ECG lead selection: Click it to shift the ECG monitoring circulatory among Ⅰ, Ⅱ, and Ⅲ AVL,
AVF and V.
5. Alarm silence: Press this key to set or activate the system alarm. In the monitoring screen,
press “Alarm” to set the alarm timer. The time shows up on the upper left corner of the screen.
When the alarm timer is activated, the system begins to count down and alarm when the set time
has passed. There are four options of alarm silent time: 2 minutes, 5 minutes, 10 minutes and 20
minutes.

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  DO NOT silence the audible alarm or decrease its volume or patient safety could be
compromised.

6. Freeze: Press the key to freeze ECG waveform or the waveforms of ECG, SpO2 and RESP for
the S-T segment analysis according to the system setting.
7. NIBP: Press it to start or stop NIBP measuring.
8. Print: Click it to print out different waveforms under different system states.

9. DISP: Click it to shift the display modes. Press it to shift the main screen, list screen, viewing
screen and the seven leads on the same screen and return to the main screen from other screens.

10. Navigation Knob: It is the major operating key of the system, which can be used to select
functions or parameters. Press and release it to shift the screen and to confirm the function or
other operating tips.
11. Alarm indicator:

Indicator Color Alarm Level Alarm Event

Red flashing High priority alarm Exceeding the limits, pulse stop
or suffocation

Orange flashing Medium priority alarm Leads and probe off, VE RONT
and SVE RONT

Orange light Low priority alarm Low priority alarm

Green light Normal

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Left and Right Panel

Figure A the left panel :Figure B.the right panel

Different ports are located in different positions of the monitor for operating conveniences.
The built-in printer is at the left panel, shown in Figure A.
The cable and probe ports are at the right panel, shown in Figure B

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1. TEMP1, TEMP2: TEMP probe connector
2. NIBP: NIBP hose connector
3. SpO2: SpO2 probe connector
4. ECG/RESP: ECG cable connector
5. CO2:Cable connector of CO2 sensor module
6. : the
cover of
battery

compartment, open it to replace or insert the battery. The provided standard battery is a piece of
12V and 2.3Ah rechargeable battery. (The back-up rechargeable battery is optional, and the
detailed type of the battery you can see the surface of it.)
Note: Only the battery of same model with the standard battery can be used. Insert battery
properly, or else the improper insertion may damage the monitor. With type BF applied parts

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Rear Panel:

The following ports are at the rear panel of the monitor.

(1) Monitor: External display port

(2) NET: Serial communication port which is used to network with central monitoring system
(3) : Equipotential grounding port
(4) Fuse 2T3. 15A: Fuse holders, fuse specification: T3. 15AL/250V Φ520mm.
(5) 100~240VAC: Power supply socket
(6) S/N: Serial Number

Advantages of patient monitor

1.Better access to healthcare

2.Improved quality of care

3.Peace of mind and daily assurance

4.Improved support, education and feedback

Disadvantage

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1.Cost is a barrier .There is a lack of reimbursement guidelines for PM services, which may deter
its incorporation into clinical practice.

Besides, doctors have to pay effort in order to engage patients and motivate them to use PM.

POSSIBLE FAULTS

1.Patient Cable visible damage, such as cracks or creases where the wires may be damaged
under the protective coating. ...

2. Electrodes expires

3 Blood Pressure Cuff & Hose for leakage.

Solutions

1.Check the Patient Cable for any visible damage, such as cracks or creases where the wires may
be damaged under the protective coating. Also be sure your leads are compatible with the devise
you are using.

2.Check the date on the Electrodes you are using. They have a shelf life, and very often the
individual packages should be used within 7-10 days of opening. The gel has a use by date also,
as it can harden.

3.Check the Blood Pressure Cuff & Hose for leakage. They are often wrapped up quickly and
stuffed next to the monitor which can kink the hose causing cracks, or small tears in the cuff
itself. A leaking cuff will give a false reading.

4.Check the electrode clips to be sure they are attached firmly. A loose spring action will not
clamp itself tightly against the electrode.

5.Check SpO2 Sensors to be sure they are fitting the patients’ finger correctly. Too loose, or too
tight will give an incorrect reading. The tip of the finger should be in contact with the Sensor.
Nail polish can be an interference to a correct reading, and cold fingers may not give a reading at
all.

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4.0 CONCLUSION

During my six [6] months SIWES program at the ONDO STATE Teaching
Hospital with various practical done and also having interacted with people already
working as a Biomedical engineer all this has helped and opened up my mind to better
understanding of Biomedical engineer in practical and it has also increased my
communication skills with others.

I have been able to know the wider applications of biomedical engineering in clinical
practices. Personally, I can say this program has helped me appreciate Biomedical
engineering the more, such that I can say the period of my Industrial Attachment is really
worth it.

4.1 RECOMMENDATION
Based on my experience during the course of my Industrial Attachment at ONDO STATE
TEAHING Hospital, I will like to make these recommendations:

RECOMMENDATIONS TO THE SCHOOL

The School could liaise with other organizations and establishments so that
finding relevant placements would be easy for every student.
The School should ensure that Supervisors coming from school to inspect IT students are
those that have experience in that Discipline.
The School should ensure that the supervisors pay visits without any prior notice to the
students, except those who are far away.
The School could organize excursions for 400L students in their first semester to see the
relevant places they could apply to for Industrial Training.

RECOMMENDATIONS TO BIOMEDICAL DEPARTMENT

The Department could also arrange for Departmental supervisors who will ensure that the
place students are having their SIWES is relevant to Biomedical technology.

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 The Department could also meet with hospitals and other health institutes and Pre-inform
them of Biomedical students coming to have their SIWES with them.
The Department may also design a Curriculum for SIWES and get it across to those
Organizations who are willing to accept Industrial Trainees, such that there won’t be any
misuse of Industrial Trainees.

REFERENCE

Maintenance and Repair of Laboratory, Diagnostic Imaging and HospitalEquipment, 1994.

World Health Organization ISBN-139789241544634
[email protected] 973.521.8769

What is an Oxygen Concentrator? How does it Work? medequip.co.in Retrieved on January

5th, 2018.

About Dental Chair retrieved from http://www.physiodent.com/service-repair.html on February

4th, 2020.

Wikipedia: Suction machine, Patient monitor, Diathermy machine.

Microscope Instrument by Brian J. Ford, Robert R. Shannon.
About Pedal bin retrieved from NEWS: The importance of clinical waste bins in healthcare
settings on Novemeber 14, 2017.

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