session 4 -...

Session 4

COVID-19 Preparation for Biomedical Professionals

Patient Monitors & Pulse Oximetry

ECHO Etiquette

• Foundation of love and respect - respond kindly rather than react if you disagree

• It is everybody’s responsibility to keep ECHO a safe space

• Test your equipment ahead of time

• Mute your microphone when not speaking

• Bottom left corner of your screen

• Remember to unmute before speaking

• Introduce yourself before speaking

• Speak clearly, and stay close to your microphone

• IT issues? Send a message through chat/email.

• [email protected]

Agenda

Time Allotted Topic Presenter

30 minutes Didactic – Patient Monitors Dr. Masreshaw/Guna

15 minutes Preventive Maintenance on Patient Monitors Benedicto

10 minutes Discussion All

What’s so dangerous about COVID-19?The virus is stable for long periods of time on surfaces and in aerosols. According to

a study from experts at the National Institute of Health, the Center for Disease

Control, UCLA, and Princeton University the virus is detectable:

• In aerosols for up to 3 Hours

• On copper for up to 4 Hours

• On cardboard for up to 24 Hours

• On plastic and stainless steel for up to 3 Days

https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces

Session 1 Summary

PPEs needed include:

• Single use gloves

• Disposable or washable gowns

• Single use caps/hats

• Single use shoe covers

• N95 Respirators

• Eye goggles/face shields

High level disinfectants use products that include one of the following:

• 2% glutaraldehyde

• 6% hydrogen peroxide

• 0.2% peracetic acid

• 7% accelerated hydrogen peroxide

• 0.55% ortho-phthalaldehyde (OPA)

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/infection-prevention-and-control

Session 1 Summary

How do we keep our hospitals and equipment virus-free?

GLOVES AND PPEs DO NOT REPLACE HAND HYGEINE

1. EVERYONE should practice basic hygiene and social distancing.

2. In hospital settings, CLINICIANS and BIOMEDICAL PROFESSIONALS should

adopt the following, in addition to standard procedures:

• Increased frequency of basic hygiene like handwashing

• Increased use of personal protective equipment to protect against droplet and airborne infections, such as respirators and face masks

• Increased frequency of equipment disinfection

3. The virus can last up to three days on some surfaces, so be sure to use

proper disinfectants (as recommended by the CDC or WHO) and to

autoclave materials at high enough temperatures/for long enough.

Session 1 Summary

Resources

• For more information about the specifications for equipment/PPE needed to manage cases of COVID 19, see the WHO Operational Support & Logistics Disease Commodity Packages, COVID-19 v4, Updated March 6, 2020• https://reliefweb.int/sites/reliefweb.int/files/resources/WHO-2019-nCoV-

DCPv3-2020.4-eng.pdf

https://reliefweb.int/sites/reliefweb.int/files/resources/WHO-2019-nCoV-DCPv3-2020.4-eng.pdf

ObjectivesBy the end of this refresher module, the participants will recollect:

• How to perform preventive maintenance

• Basic troubleshooting and maintenance for patient monitors

• Proper disinfection of equipment between patients

Clinical attachment yields better experience for trainees to train other BMETs in the future.

Patient MonitorsINTRODUCTION

• Electrocardiography (ECG)(EKG)

• Heart rate (HR), pulse rate,

• Non/invasive blood pressure (NIBP,IBP)

• Oxygen saturation,

• Respiration, capnography (EtCO2 and InCO2)

• Temperature

Patient Monitors; medical devices that measure physiological parameters including:

Patient Monitor Specification

General

• 12.1″ color TFT display

• Suitable for adult, pediatric and neonatal patient

• Multiple parameters: ECG, NIBP, Pulse Rate/SpO2,

• Temperature, Respiration, CO2(Optional)

• Audible and visual alarms with adjustable alarm ranges

• Networkable with central monitoring system

• Preconfigurable patient settings


ECG

• ECG Input: 5- or 3-lead ECG cable

• ECG Lead: I, II, III, aVR, aVL, aVF, V

• Gain Choice: X1/4，X1/2，X1，X2，X4 and Auto

• Scanning Speed (mm/sec): 6.25, 12.5, 25, 50

• Heart Rate Range: 15-380BPM

• ECG Calibration: 1mV

• Frequency Response: 0.05-100Hz

• Heart Rate Accuracy: ±1%


NIBP

• Measurement Method: Automatic Oscillometric

• Patient Types: Adults/Paediatrics/Neonate

• Measurement Parameters: Systolic, Mean, Diastolic

• Measurement Range: 10-300mmHg

• Units of Measurement: mmHg/Kpa

• Accuracy: ±2mmHg

Pulse Rate/SpO2

• Display: Waveforms and Digits

• Measurement Range: 70-100%

• Resolution: 1%

• Pulse Rate Range: 30-240BPM

• Accuracy: ±2%

• Resolution: 1BPM



Temperature

• Measurement range: 25.0-45.0°C

• Display: T1, T2, ΔT

• Accuracy: ±0.1°C


Respiration

• Thoracic Impedance or Nasal Tube (Selectable)

• Measurement Range: 0-120BPM

• Accuracy: ±1BPM

• Resolution: 1BPM

CO2(Optional)

• Measurement Type: Main Stream or Side Stream

• Measurement Range: 0%-10.0%

• Accuracy: ±2mmHg

Power Requirements

• 100-250VAC, 50/60 Hz

Configuration

Standard

• ECG, HR, NIBP, SpO2, RESP, TEMP, Drug-concentration

• calculation, ST-segment detection, pace-maker analysis and

• arrhythmia analysis, build-in rechargeable battery

Optional

• ETCO2, build-in printer, 2-IBP (Dual invasive blood pressure),

• wall mount, monitor trolley

Patient MonitorsMAIN PARTS & THEIR FUNCTION

ECG

• ECG (electrocardiogram) is a recorded waveform of the electrical activity by the heart contraction/expand and displayed in EKG or ECG

• The electrical activity potential, in case of Heart muscle contraction/relaxation, occurs the flow of electricity spread to all over the body

• The flow of electricity, depending on the location of the body, causes potential difference, which can be recorded by the skin surface electrodes attached on the body

QRS Complex

Einthoven’s Triangle

Standard Electrode Placement

- White (red) (RA) The River at the center of a right collarbone near the shoulder.- Black (yellow) (LA) adjacent to the middle of the clavicle near the shoulder.- Red (green) (LL) to the lower front ribs.

ECG Color Code

IA

HPF1 st

orderAmp

LPF2nd

order

RL Driver

LA

RL

Out put Signal ECG

Display

RA

Patient

ECG Block Diagram:

Understanding The ECG Display

Current heart rateHeart rate alarm limit

Lead 2

Monitoring ECG

Prepare skin of Patient for Monitoring ECG

1. If the patient has hair at that where we stick electrode, you should remove it clean or scrub.

2. Cleaning the area with soap and water

3. Dry the area

4. Prepare the electrode: • Is it expired?

• Each electrode should be swapped out every 24 hours.

5. Connect the electrode to the patient

6. When you connect electrode stick from one side to other side opposite from side to in side

– By using electrodes, the resistance value of skin, during breathing, is represented by figures, with ECG

– EtCo2 can calculate the respiratory rate by driving out carbon dioxide generated

– Done during respiration, which is a little more precise way than the ECG

Respiration & Capnography

Respiration Circuit Electrical Model

Temperature

• It is displayed based on the temperature tale in accordance with EXACON's resistance

• After converting heat applied on the temp sensor to the value of the heat resistance

• Rectal TEMP sensor (insert to Rectum) is supplied as standard, & SKIN TEMP sensor is optional

Blood Pressure

• Invasive Blood Pressure: Blood Pressure measurement by inserting a catheter in the arteries

• Non-Invasive Blood Pressure : In general, swathe cuff the artery of upper limbs or lower limbs and apply pressure, once block the blood flow.

• Gradually release air pressure of cuff. When the blood flow is resumed.• To measure artery occlusion pressure by vortex of blood

• The above method commonly used in hospitals is same to the mercury sphygmomanometer

(manual) methods

SpO2(Pulse Oximeter Saturation)

• The measurement of blood oxygen saturation concentration can be gotten by non-invasive blood way as like attaching SpO2 sensor on the finger or ear. And measures the percent of hemoglobin combined with oxygen in the blood

• By flashing alternately RED and IR(infrared light) of Oxygen saturation sensor, they permeate the finger capillary and the light of a specific area permeated has a constant absorption coefficient against the blood in the capillary, and is absorbed proportionally to the concentration of the blood.

• Permeated light is detected by an optical sensor on the other side and detected in the way of Voltage

HbO2

Hb

Wavelength (nm)

Ab

sorp

tio

n

660 800 940

RedInfra-red

Isobesticpoint

Pulse Oximeter

• Similar to SpO2 function in patient monitor.

• Stand alone unit.

Measuring SpO2• Pulse oximetry:

• noninvasive monitoring technique

• estimates the measurement of arterial oxygen saturation (SpO2) of hemoglobin.

• Oxygen saturation is an indicator of the percentage of hemoglobin saturated with oxygen at the time of the measurement.

• The device uses a light sensor containing two sources of light (red and infrared) that are absorbed by hemoglobin and transmitted through tissues to a photo detector

• The amount of light transmitted through the tissue is then converted to a digital value representing the percentage of hemoglobin saturated with oxygen

Position Input (SpO2 Sensor)

Patient MonitorsWORKING PRINCIPLES

Patient Monitor OverviewFront Panel Controls and Connectors: Key by Number:

Patient Monitor Overview

Rear Panel Component: Key By Number:

1. Air ventilation

2. Equipotential terminal

3. AC power connector

4. Speaker

5. Battery cover

6. Thermal Printer(option)

7. Handle

Patient Monitor Overview

1 . USB port

2. LAN connector

3.RS‐232 interface connector

1.Thermalprinter (option)

2 .Battery cover

Left Panel:Right Panel:

EtCO2• EtCO2 =End tidal CO2

• The MediCO2, Microstream CO2 module can be fitted onto MATRON.

• Provides the functions of measuring ETCO2, respiratory CO2, and respiration numbers using the small filterline based on a small lumen type filterline.

• In the Microstream CO2 type, the level is measured through the cannula (non-tubing type) attached to the nose or a sampling line equipped in the respiratory circuit (tubing type).

• Automatically changed during EtCO2 measurement.

• After ending the measurement, the device will display the calibrated impedance of chest.

• If MATRON senses proper respiratory movement, it displays EtCO2, FiCO2 and respiration rate after 3 seconds.

• In principle - CO2 absorbs infra-red radiation. A beam of infra-red light is passed across the gas sample to fall on a sensor. The presence of CO2 in the gas leads to a reduction in the amount of light falling on the sensor, which changes the voltage in a circuit

Connect the temperature sensor to the connection terminal of the measurement module.

Temp 1

Temp 2

Insert temp sensor to the anus.

Temperature

<- Wrapping the cuff too tight or too loose on the measuring site may cause errors in the value.

To change the setting of NIBP mode, push the Menu button once to select NIBP.

Connect the product with the gray hose as shown below..

By operating as detailed above, you can select each function of the NIBP mode. .

Non Invasive Blood Pressure

Connect the monitor interface cable to the press connection terminal of the measurement module.

Connecting of the converter interface cable.

The way of changing of IBP1,2 Mode is pushing Menu Button 1 time.

By using above way of changing, Selecting IBP1,2 Mode is available.

Invasive Blood Pressure

Blood Pressure

Absolute Sensor Gauge/ Differential sensor- Absolute, Vacuum, Sealed

Piezo-resistive Pressure Sensor

- Differential, Gauge

Fiber Optic Pressure Sensors

MEMS

MEMS pressure sensors have always provided easy interface to an MCU, reliability, and low cost. New manufacturing processes and designs have reduced their die sizes while enhancing their performance

Jul 1, 2000 By: Gordon Bitko, Randy Frank, Andrew

McNeil Sensors

http://www.sensorsmag.com/sensors/author/authorInfo.jsp?id=32512

http://www.sensorsmag.com/sensors/author/authorInfo.jsp?id=32514

Infusion set (Needle)Tube (hose)3 wayHolderTransducer (Membrane sensor, Dome, Diaphragm)

Blood Pressure Accessories

Patient MonitorsPREVENTIVE MAINTENANCE

Preventive Maintenance

Why is preventive maintenance important?

• Reduces the risk of injury (to patient, staff or visitors), and adverse impact on patient care

• Decreased equipment life-cycle costs

• Reduces operational difficulties

• Comply with codes, standards and regulations

Preventive MaintenanceThe PPM (planned preventive maintenance) procedure can be divided into the following tasks:

•Qualitative Task/Physical Inspection• Visible test and Cleaning

• Electrical Safety Test• Verify the electrical safety of the system

•Performance Verification Test• Verify that it performs as per its design parameters.

Cleaning

For cables, sensors, cuffs, and probes:

• Clean the outer surface of equipment using a soft cloth, dampened with a nonabrasive cleaner

Safety and Functionality Checks

For Batteries:

• If the monitor has not been used for long period more than two months, the battery should be charged before using.

• If the monitor kept install for more than two months the battery should be removed.

CAUTION: If the battery shows any signs of damage, leakage, or cracking, it must be replaced immediately.

CAUTION: Discarded batteries may explode during incineration. Recycle used batteries properly. Do not dispose of batteries in refuse containers.

Electrical Safety Test

SFC: Single Fault Condition / RM: Reverse Mains/Lines Voltage

Note: Earth leakage current is measured under various conditions of the AC mains and protective earth conductor. For each condition, the measured leakage current must not exceed that indicated in Table 3.

According to most standards, the safety testy should be done under the following settings:

Protective Earth Continuity This test checks the integrity of the power cord ground wire from the AC plug to the instrument chassis ground. The current used for this test is less than or equal to 4 Volts RMS, 50 to 60 Hz, and 25 Amperes.

Steps:• Connect the monitor AC mains plug to the analyzer

recommended by the analyzer operating instructions. • Connect the analyzer resistance input lead to the

equipotential terminal (ground lug) on the rear of the instrument.

• Verify that the analyzer indicates 100 mΩ or less.

*Device service should ALWAYS include electrical safetytesting and PVT testing.

Checklist for ESTDescription UOM Set values Measured values Limit/Tolerance

Main Voltage L-N Vac - 10%

Device Current A - -

Earth/Ground wire resistance Ω - <0.3Ω

Insulation test (optional) 500V/250VDC MΩ >2MΩ

Earth Leakage Current

1.Normal Condition uA <500 uA

2. Open Neutral uA <1000 uA

3. Open Neutral- Reversed Mains uA <1000 uA

4. Normal Condition- Reversed Mains uA <500 uA

Enclosure Leakage Current

1. Normal Condition uA <100 uA

2. Open Earth uA <500 uA

3. Open Neutral uA <500 uA

4. Open Neutral- Reversed Mains uA <500 uA

5.Normal Condition- Reversed Mains uA <100 uA

6.Open Earth- Reversed Mains uA <500 uA

Patient Leakage Current (AP)

Lead to earth leakage

1. Normal Condition uA <10CF/100BF/B uA

2. Open Earth uA <50CF/500BF/B uA

3. Open Neutral uA <50CF/500BF/B uA

4. Open Neutral- Reversed Mains uA <50CF/500BF/B uA

5. Normal Condition- Reversed Mains uA <10CF/100BF/B uA

6. Open Earth- Reversed Mains uA <50CF/500BF/B uA

Patient Auxiliary Current (AP)

Lead to Lead leakage

1. Normal Condition uA <10CF/100BF/B uA

2. Open Earth uA <50CF/500BF/B uA

3. Open Neutral uA <50CF/500BF/B uA

4. Open Neutral- Reversed Mains uA <50CF/500BF/B uA

5. Normal Condition- Reversed Mains uA <10CF/100BF/B uA

6. Open Earth- Reversed Mains uA <50CF/500BF/B uA

Mains on Applied Parts (AP)

Lead Isolation Leakage

1. Single Fault Condition-Normal uA <50CF/500BF/B uA

2. Single Fault Condition-Reverse uA <50CF/500BF/B uA

Electrical Safety Tests

220-240 V

How to Check Ground:

Performance Tests

• Tests need to be done anytime you service the device or perform maintenance• If the monitor does not pass this test, it should not be returned to the user.

Test Tools Needed

• Electrical Safety analyzer

• Patient simulatoro ECG/RESP

oNIBP

o IBP

• SpO2 simulator

• Multimeter

System Tests

• The monitor must be placed in the service menu. For a detailed explanation on how to access the service menu, refer to Service Menu and Factory Default Settings section in the manual

• Rotate the trim knob to select System Test in the service menu, and then press the trim knob.

Patient Simulator

Parameters should include:

• NIBP

• IBP

• RESP

• ECG

Patient Simulator: ECG

• ECG connection button type, to simulator ECG output.

SpO2 Simulator

• SpO2 simulator to simulated the SpO2 unit and verifying test.

LCD Test

To test the LCD display:

1. Select LCD Test in the system test.

2. The screen color will change over the following sequence every 2 seconds: Red, Green, Blue, White, Black

3. After testing the test, press trim knob twice to exit.

4. This test produces a Pass/Fail result.

5. When the color of the test screen changes in the order from Red, Green, Blue, White to Black, the LCD display is in a normal state.

Alarm Audible Test

1. Select Alarm Audible Test in the system test.

2. The level of the alarm tone will appear on the screen as the alarm tone sounds. Then, the level goes up gradually.

3. When the tone reaches the maximum level 8, it returns to the minimum level 1.

4. After finishing the test, press the trim knob to select Cancel The menu box will disappear

Pass/Fail Results1. Select Tone Audible Test in the system test.

2. Rotate the trim knob to select HR/PR Tone.

3. The HR/PR tone sounds intermittently as the level goes up gradually. When the tone reaches the maximum level 7, it returns to the minimum 1. When the tone returns to the minimum, the pitch will change automatically. There are three pitches – High, Med and Low.

4. Press Cancel to finish the test.

5. Rotate the trim knob to select Key Beep.

6. The key beep sounds intermittently as the level goes up gradually. When the tone reaches the maximum level 7, it returns to the minimum 1.

Battery Check

1. Connect the monitor to an AC power source using the proper power cord

2. Verify that the AC indicator is lit3. Charge the battery until the charging

status indicator is no longer flashing• This takes at least 12 hours

4. To check for a full charge, perform the procedure in “Battery Discharge”

Performance Test ReportDescription UOM Set values Measured values Limit/Tolerance Pass Fail N/A

1. Temperature Accuracy °C 37.1 ±0. 1 count ( ) ( ) ( )

°C 35.1 ± 0.1 count ( ) ( ) ( )

2. Heart Rate Accuracy (ECG) bpm 70 69 - 71 ( ) ( ) ( )

±1 count bpm 95 94 - 95 ( ) ( ) ( )

bpm 70 69 - 71 ( ) ( ) ( )

3. Respiration Resp/min 20 19 - 21 ( ) ( ) ( )

±1 count Resp/min 40 39 - 41 ( ) ( ) ( )

Resp/min 20 19 - 21 ( ) ( ) ( )

4. SPO2 Accuracy %/bpm 85/80 ±1 count ( ) ( ) ( )

±1 count %/bpm 95/40 ±1 count ( ) ( ) ( )

%/bpm 98/80 ±1 count ( ) ( ) ( )

%/bpm 98/140 ±1 count ( ) ( ) ( )

5. NIBP Pressure relief test mmHg - <330 mmHg ( ) ( ) ( )

5A. Non-invasive Blood

Pressure Accuracy ±6%

mmHg 120/80

Adult

Low 112/75

High 128/85

( ) ( ) ( )

mmHg 70/40

Neo

Low 66/37

High 74/42

( ) ( ) ( )

mmHg 190/120

High

Low 179/113

High 201/127

( ) ( ) ( )

mmHg 80/40

Low

Low75/38

High 89/42

( ) ( ) ( )

6.IBP mmHg 0 0 ( ) ( ) ( )

mmHg 100 99-101 ( ) ( ) ( )

mmHg 200 199-201 ( ) ( ) ( )

mmHg 0 0 ( ) ( ) ( )

7. High Alarm/ Low Alarm - - ECG/RESP/SPO2/NIBP ( ) ( ) ( )

NIBP Test Modes

Manometer Mode:• Static manometer displays pressures

from -400 to +400 mmHg in 0.1 mmHg steps.

• Can be used for static calibration of NIBP monitors.

NiBP Test Configuration

For Dynamic simulation For Static Calibration

NIBP Analyzer

Leak Tests

72

Leak Test Measures leak rate of a NIBP monitor, cuff, and hose

Sim Cube Leak Test

• This mode is used for measuring leak rates in NIBP monitors, their cuff and their hoses.

• The Sim-Cube waits until it detects that cuff inflation is complete, then the leak test mode will simply display the cuff pressure.

• Once cuff inflation completion is detected (less then 8mmHg change in a 5 second window), the leak test mode will start its elapsed timer. When the elapsed timer reaches 15 seconds (to allow for initial pressure settling), the display will begin to cycle every 5 seconds, showing static pressure, indicated by P (in mmHg), leak rate, indicated by L (in mmHg per minute); and elapsed time (in Min:Sec).

• In many cases the monitor must be placed in a special test mode so that it will not release the cuff pressure.

73

Patient MonitorsTROUBLESHOOTING

Troubleshooting

What do I do if the battery doesn’t hold a charge?

1. Check the battery.• If battery is discharged, recharge battery.

• If problem persists after fully charged, replace the battery (P/N: M6010

2. If problem persists after you replace the battery, replace

SMPS (P/N: M2012)

What do I do if the monitor wont turn on?

1. Check the battery.

• If battery is defective, replace the battery (P/N: M6010).

2. Check AC Indicator.

• If the AC Indicator isn’t lit, replace SMPS (P/N: M2012)

Troubleshooting

Troubleshooting

What do I do if the display malfunctions?

1. Check the connection between main board and LCD.

2. Check Main board; if main board is defective, replace main board (P/N: P1031)

3. Check LCD; if LCD is defective, replace LCD (P/N: M4022).

Troubleshooting

If alarm message ‘Asystole’ appears, it can be caused by the defective main board. You should replace the ECG board.

What do I do if the ECG cable malfunctions?

1. Check ECG cable; if the problem persists after ECG cable is replaced, check ECG connector.

2. Check Main board; if Main board is defective, Replace Main Board.

Troubleshooting

What do I do if the NIBP accessories malfunction?

1.Ensure that the appropriate cuff and hose are used with the corresponding patient type.

2.Check the connection between NIBP module and Patient monitor.

3.Check NIBP module. If NIBP module is defective, replace or repair NIBP module.

TroubleshootingWhat can cause inaccurate results in automated BP units?

• Incorrect cuff size

• Incorrect cuff application

• Arrhythmias, irregular heart rate

• Rapid change in pressure

• Patient movement (twitching, shivering)

• Placement of cuff is not at heart level

Troubleshooting

Blood Pressure Error Codes (Welch Allyn):

• C02 - Autozero failure; check for air obstruction, limit patient movement

• C03 - Inflation too rapid; check for kinked hose or air obstruction.

• C04 - Excessive inflation time; check for air leaks

• C05 - Excessive noise; check patient condition, cuff placement, and limit patient movement.

• C06 - Measurement outside device range, check patients condition.

• E10 - Cuff overpressure; check patients condition.

• E11 - Internal safety violation.

Troubleshooting

What can I do if the SpO2 module malfunctions?

A. Check SpO2 Sensor

If SpO2 Sensor isn’t on, Replace SpO2 Sensor.

B. Ensure that LED intensity increase when opening SpO2 Sensor.

If LED intensity doesn’t increase, Replace or repair SpO2

module

C. Test with Spo2 Simulator to verified if the probe or system fail

D. Check or replace the Main Board.

Typical Error Breakdown

System Processing

Sample Scenarios

If the user reports that the BP monitor is faulty:

What could cause this?

1. Monitor does not turn ON

2. Monitor turns on, but there is no response when START is pressed

3. Device starts the cycle but the cuff will not inflate

4. Cuff inflates but then does not deflate and the machine alarms

5. The monitor is frequently giving high NIBP readings

BMETs MUSOMA-TANZANIA

TITLE: MAINTENANCE OF PATIENT MONITOR IN MARA REGION

By the end of this presentation, the participants will be able to:

Understand all procedures taken during Preventive Maintenance (PM) on Patient monitors

Understand common problems associated with patient monitors

Understand how to minimize problems on patient monitors

Patient monitorIs the medical device which continuously measure, record, distribute and display combination of biometric values(vital signs) such as heart rate, SpO2, blood pressure, temperature, ECG and more.

Physical inspectionPhysical inspection involves checking of

all physical conditions of the unit like -

1. Unit housing or casing

2. ECG,SPO2 cables

3. Power cord

4. Battery

5. Sensor

6. Probe connectors

The following are procedures should be taken during planned preventive maintenance (PPM) of patient monitor:-

BP Cuff

SPO2 sensor

Temperature sensor ECG cable

Power cord

Physical inspection checklist

Electrical safety

Electrical safety is important in a patient monitor due to the hazards that can cause electric shock to a patient.

Electrical Safety Analyzer is used to check the electrical safety of Patient monitor.

Electrical safety checklist

Performance testPatient stimulator is used to

check the performance of patient monitor.

Heart rate ECG wave forms NiBP SpO2 Temperature IBP Respiratory rate

Performance test checklist

Alarm problemProblems with alarm caused by

-Improper Settings-Probe connection-Power supply

Hardware problemProblems with hardware caused by

-Breakage of cables, connectors and power cord.-Circuit problems-Display problems-Failure(breakage) of buttons(keypads)-Battery drain

Software problemProblems with software caused by

-Power fluctuation-Artifacts-New accessories

Software problem can cause information overload that make difficult to get an overview quickly.

Clinical User ErrorClinical users can cause errors by

-Poor handling-Misplacement of some accessories-Lack of enough knowledge/training

1. Proper handling and care2. Doing preventive maintenance on time by using test

equipment (Patient Monitor Simulator and Electrical Safety Analyzer)

3. Doing calibration4. Using UPS or voltage regulators to avoid power fluctuation5. Providing enough knowledge (training) to the users6. Ensure health centers have enough Biomedical

engineers/technicians.

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