ATTACHMENT REPORT

PRESENTED BY;BARNABAS LICHUNGU

ADM NO: AS- DME/31052/22

COURSE: DIPLOMA IN MEDICAL ENGINEERING

DEPARTMENT: MATHS & APPLIED SCIENCE

ATTACHMENT INDUSTRY: MEDICAL SUERINTENDET HOSPITAL

WEBUYE

SUBMITTED TO :THE KITALE NATIONAL POLYTECHNIC IN PARTIAL

FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF DIPLOMA
OF MEDICAL ENGINEERING

SUPERVISOR: MADAM MIRIAM MISIKO

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DECLARATION
I declare that this report is my original handwork compiled during and after the entire twelve
weeks period of attachment at Superintendent Webuye County hospital, under the department
of health science.

This work is a clear indication of my full participation and training in the attachment process
through the guidance of able biomedical engineer in charge with the technicians and
supervisors.

STUDENT NAME: LICHUNGU BARNABAS

Signature: Date:

SUPERVISOR NAME: MIRIAM MISIKO

Signature: Date:

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DEDICATION
Special dedication to my parents for contant inspirations and financial support. I dedicate this
work to the institution of Superintendent Webuye Hospital under the department of
biomedical engineering for providing me with good and recommended facilities and
equipment hence making the attachment successful

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ACKNOWLEGEMENT
Am grateful to God for his care and grace throughout the attachment period. I would like to
sincerely thank Kitale National Polytechnic institute for presenting such an opportunity for
industrial attachment to nature the skills of students in various fields. I pass my gratitude and
deep obligation for the technicians who guided me and gave me invaluable exposure to most
fields of medical engineering and I gained the skill.

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ABSTRACT
The report presents the tasks completed during my external attachment under the medical
engineering department which has been compiled successfully according to the
requirements. It addresses the main machines which I studied and did various experiments on
practical as part of learning and skill boosting. The report has images and diagrams which
illustrate on the theoretical aspect of notes.

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Table of Contents
DECLARATION......................................................................................................................................ii

DEDICATION.........................................................................................................................................iii

ACKNOWLEGEMENT.........................................................................................................................iv

ABSTRACT..............................................................................................................................................v

CHAPTER ONE.......................................................................................................................................1

INTRODUCTION....................................................................................................................................1

Outpatient department............................................................................................................................1

Renal........................................................................................................................................................1

OBJECTIVES...........................................................................................................................................2

HISTORY OF Superintendent Webuye................................................................................................2

CHAPTER TWO......................................................................................................................................4

2.1. ATTACHMENT ACTIVITIES.................................................................................................4

2.1.1. OXYGEN CYLINDER SET......................................................................................................4

Preparation..............................................................................................................................................4

Routine care.............................................................................................................................................4

2.1.2. Sphygmomanometer (BLOOD PRESSURE MACHINE).................................................................5

Operation.................................................................................................................................................5

Sphygmomanometer Uses.......................................................................................................................6

2.1.3 SUCTION MACHINE...............................................................................................................6

Routine care.............................................................................................................................................6

2.2. MATERNITY DEPARTMENT................................................................................................7

2.2.1. Infant incubator.........................................................................................................................7

Operation.................................................................................................................................................7

Routine care.............................................................................................................................................7

2.2.2. RADIANT WARMER...............................................................................................................8

Operation.................................................................................................................................................8

Routine care.............................................................................................................................................8

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OXYGEN CONCENTRATOR...............................................................................................................9

Operation.................................................................................................................................................9

Routine care.............................................................................................................................................9

2.2.3. PHOTOTHERAPY....................................................................................................................9

Operation.................................................................................................................................................9

Routine care...........................................................................................................................................10

2.3. THEATRE DEPARTMENT...................................................................................................10

2.3.1. Electro surgical Diathermy.......................................................................................................10

Operation...............................................................................................................................................10

Routine care...........................................................................................................................................11

2.3.2. Anesthesia machine.................................................................................................................11

The machine can be divided into three basic areas:..............................................................................11

Operation...............................................................................................................................................11

Routine care...........................................................................................................................................11

2.4. RADIOLOGY DEPARTMENT..............................................................................................12

2.4.1. X-ray machine..........................................................................................................................12

Operation...............................................................................................................................................12

Routine care...........................................................................................................................................12

Ultrasound machine...............................................................................................................................12

Operation...............................................................................................................................................12

Routine care...........................................................................................................................................13

2.5. INTENSIVE CARE UNIT.......................................................................................................13

2.5.1. Defibrillator..............................................................................................................................13

Operation...............................................................................................................................................13

Routine care...........................................................................................................................................13

2.5.2. ventilator..................................................................................................................................14

Other names that a ventilator is known by include:..............................................................................14

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Operation...............................................................................................................................................14

Routine care...........................................................................................................................................14

2.5.3. Nebulizer..................................................................................................................................15

Operations.............................................................................................................................................15

Routine care...........................................................................................................................................16

2.6. DENTAL DEPARTMENT......................................................................................................16

2.6.1. Dental chair..............................................................................................................................16

2.6.2. Compressor..............................................................................................................................16

CHAPTER THREE CHALLENGES...................................................................................................17

3.1 PROGRESS..............................................................................................................................17

3.2 CHALLENGES ENCOUNTERED........................................................................................17

3.3 SOLUTIONS TO THE CHALLENGES................................................................................17

3.4 RECOMMENDATION............................................................................................................17

REFERENCES.......................................................................................................................................18

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CHAPTER ONE

INTRODUCTION
It is a national training policy in Kenya that all students taking technical courses have to
undertake industrial work experience before final exams. Adhering to this policy and for the
sake of skills boosting. I proceeded for attachment to have more knowledge and also become
an impact to the organization I am working with.

Compiled below is the report for the industrial attachment that I fully participated at
Superintendent Webuye Hospital. Its content includes details and scientific explanations of
both activities done at the engineering workshops. It also covers the following aspects;

Outpatient department
Oxygen cylinder set
Sphygmanometer

New born unit

Infant incubator

Radiant warmer
Phototherapy
Bubble CPAP
Oxygen concentrator
Theatre room

Theatre table

Electrosurgical diathermy
Ana esthesia machine
Suction machine
Radiology
CT
scan x-
ray

ultrasound

Renal
dialysis machine

R.O plant
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OBJECTIVES
The purpose of industrial attachment workplace experience is to make sure is as per the job
requirement in industry which is achieved through several reasons and objectives as follows;

• Building confidence in students in technical operations and problem solving

by working with professionals in the workplace.
• Exposing students to industrial work culture by involving them in the real
work environment
• Exposing students to modern technology that may not be available at the
learning institution.
• Providing opportunities for students to apply their skills through formal instructions
in real work situations to acquire more practical knowledge in their profession.

HISTORY OF Superintendent Webuye

The promulgation of the Constitution of Kenya, 2010, introduced the devolved system of
Government which resulted to the formation of the 47 Counties across the Country,
Superintendent Webuye being among them.

Vision

To be regional Centre of excellence in hostilic health care development, medical research and
education.

Mission

To provide accessible, acceptable, affordable and sustainable quality curative, preventive,

promotive, rehabilitative and educational health care services to our clients.

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ORGANIZATIONAL STRUCTURE

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CHAPTER TWO

2.1. ATTACHMENT ACTIVITIES

2.1.1. OXYGEN CYLINDER SET

An oxygen cylinder set is a medical device that provides oxygen to patients who are unable
to inhale enough oxygen into their bodies on their own. It is used in hospitals, homes, and
during patient transfers between medical sites.

The set consists of a storage container, which supplies oxygen to a patient through a surgical
mask over the nasal cannula. The cylinder has a pressure gauge, flow regulator knob,
humidifier bottle, nasal cannula, surgical mask, adapter, and a cylinder. To operate an oxygen
cylinder, you need to turn the cylinder’s valve on with the help of a wrench. After the valve is
open, check the gauge to ensure that there is ample oxygen in the tank. Adjust the flow using
the flow regulator knob to the rate prescribed by the doctor. Attach tubing and nasal prongs as
required, and adjust the nasal prongs for a comfortable fit.

There are different types of oxygen cylinders available for different purposes. Medical
oxygen cylinders are made of steel or aluminum. When compared to steel oxygen cylinders,
aluminum oxygen cylinders are much lighter in weight. They can be easily transported as
they are light. Oxygen cylinders differ according to the materisphyal they are made of and
the amount of oxygen filled in liters.

Preparation
1. Identify the right cylinder
2. Make sure the oxygen cylinder set is clean, complete and working in a good condition
3. Fit the flowmeter to the cylinder by tightening the connecting nut using a spanner.
4. Connect the humidifier bottle to the flowmeter

Routine care
1. Check whether the oxygen cylinder set is in good condition.
2. Ensure that the oxygen cylinder is securely attached to a bed, trolley, or wall when
in use.
3. Store oxygen cylinders in a secure area that is well-ventilated, clean, and dry.
4. Modern lightweight oxygen cylinders can be damaged by sharp objects such
as securing screws. Therefore, ensure that the cylinder is not in contact with
sharp objects.
5. Clean your oxygen delivery equipment, including your nasal cannula or oxygen mask
and humidifier, regularly to protect yourself from illness and bacteria. As a general
rule of thumb, you should clean them at least once a week to prevent them from
getting clogged or contaminated with germs
6. Check tubing for cracks and deuteriations
7. If empty label and take to the store for refill
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2.1.2. Sphygmomanometer (BLOOD PRESSURE MACHINE)
A sphygmomanometer is a medical instrument used to measure blood pressure. It typically
consists of an inflatable rubber cuff that is wrapped around the upper arm and connected to a
column of mercury next to a graduated scale. The cuff is inflated to a pressure higher than the
systolic blood pressure, and then gradually released until the blood flow in the brachial artery
is no longer impeded. The pressure at which the first sound of blood flow is heard is recorded
as the systolic blood pressure, while the pressure at which the sound disappears is recorded as
the diastolic blood pressure

Operation
The steps to be followed are as follows :

The upper arm is tied with the inflatable cuff, keeping in mind that the cuff covers at least
80% area of the upper arm and its lower edge is above the antecubital fossa or the elbow pit
or the elbow bend.

Air is pumped into the bladder of the cuff to a pressure above the systolic and diastolic
pressure.

The stethoscope is then kept above the brachial artery on the arm.

The air is gradually released, and thus the pressure applied by the cuff also reduces. It is
released till the pressure drops to 180mm of Hg.

The stethoscope is used to listen to the first knocking sound while depressurising the cuff.
The pressure is also monitored when the sound is heard. This pressure is the systolic
pressure.

The pressure inside the cuff is then further dropped by releasing the air until no sound is
heard by the stethoscope. The pressure where no sound of blood flow is heard is recorded as
the diastolic pressure.

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Sphygmomanometer Uses
Sphygmomanometer has a variety of applications which are:

1. To measure the blood pressure of organisms.

2. To find out any abnormality in the blood pressure which can tell about any diseases.
3. To monitor the efficacy of drugs which alter the blood pressure of organisms.
4. As a first aid in ambulances, depending on the blood pressure different techniques
to help the aggrieved patient can be used.

2.1.3 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.

Routine care
1. Hand hygiene: Always wash your hands with soap and water or use an alcohol-
based hand sanitizer before and after using the suction machine.

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 2. Cleaning the canister: Empty the canister into the toilet and wash it with warm,
soapy water. Rinse it well and leave a little water in the bottom to prevent mucus
from sticking to the bottom.
3. Replacing tubing: Replace the tubing weekly to prevent contamination.
4. Checking outlet filter: Check the outlet filter monthly and replace it when it
looks dirty or at least once every two months.
5. Testing suction pressure: Check that the suction pressure is set correctly.
6. Charging batteries: Always ensure that your batteries are charged, as a dead
suction unit will be useless to you and your patient.

2.2. MATERNITY DEPARTMENT

2.2.1. Infant incubator
An infant incubator is a medical device that provides a controlled environment for premature
or sick newborns. It is used in neonatal intensive care units to ensure that babies needing
extra support have the best possible environment and continual monitoring.

Incubators are designed to protect a baby and provide the optimal conditions for their
development. They are used in combination with other equipment and procedures to ensure
that babies needing extra support have the best possible environment and continual
monitoring.

The incubator is a rigid box-like enclosure that maintains stable conditions and a germ-free
environment for premature infants born before the thirty-seventh week of pregnancy. The
device may include a heater, a fan, a container for water to add humidity, a control valve
through which oxygen may be added, and access ports for nursing care.

Operation
1. Set the required temperature, humidity and oxygen concentration
2. Place the baby in an incubator and monitor its oxygen concentration, humidity
and temperature. Oxygen concentration is monitored using pulse oximeter.
3. Feeding, Taking weight measurement, administering treatment, changing position
and napkins should be done within the incubator

Routine care
1. Daily dump dusting of the incubator to leave it dry.
2. Replace hand inlet sleeves regularly and wash with soapy water, after that rinse
and leave it to dry.
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 3. When not in use, cover the incubator with clean cotton cloth.

2.2.2. RADIANT WARMER

Radiant Warmer is a body warming device to provide heat to the body. This device helps to
maintain the body temperature of the baby and limit the metabolism rate. Heat has a tendency
to flow in the heat gradient direction that is from high temperature to low temperature. The
heat loss in some newborn babies is rapid; hence body warmers provide artificial support to
keep the body temperature constant. In certain areas with very cold climates, babies are kept
on Radiant Warmer for a couple of hours immediately after birth to ensure the baby is
stabilized after birth.

Operation
1- connect the unit to the mains. switch it on.
2- Once connected to mains, heater output can be regulated by a knob on the front panel.
the output is displayed as % or bars or bulbs
3- select manual mode.
4- select heater output to 100% for sometime ( 20 minutes) to allow quick pre-warming of
the bassinet covered with lines.
5- select servo mode.
6- read the temperature on display.
7- select the desired set temperature of the baby as 36.5 degree C.
8- place the baby on the bassinet.
9- connect skin probe to the baby’s abdomen with sticking tape.
10- if the manual mode to be used, select the desired heater output.
11- In manual mode, record the baby’s axillary temperature at 30 minutes and then 2 hours.
12- respond to alarm immediately. identify the fault and rectify it.
13- ensure the baby’s head is covered with a cap and body with clothes unless indicated
to keep naked.
14- turn the baby frequently.
15- use of cling wrap.

Routine care
1. Radiant warmer must ideally be kept in a well ventilated air conditioned room
where the ambient temperature remains to study around 26 degree centigrade for
optimal operation of the infant warmer.
2. After switching off the unit, time should be given to allow the heater to cool down.
3. proper earthing of the unit must be ensured to prevent electrocution of the user.
4. ensure the power supply is continuous, Earthed, approved for hospital use
and complies with the voltage specific on the unit.

8
 5. ensure all service and maintenance is carried out by qualified personnel only.
6. The mattress and platform of the bed must be cleaned and covered.

OXYGEN CONCENTRATOR
An oxygen concentrator is a medical device that separates nitrogen from the air around you
so you can breathe up to 95% pure oxygen. You may need an oxygen concentrator if you
have a condition that affects your breathing.

Operation
The atmospheric air that most people breathe every day is about 20% oxygen. The rest is
nitrogen, along with tiny amounts of other gases. Oxygen concentrators take in atmospheric
air, remove the nitrogen and collect pure oxygen for you to breathe.

First, it sucks in the atmospheric air through an air filter and forces it through an air
compressor. The compressor pressurizes the air — think of it like blowing air into a balloon.
As the pressure increases, the air travels into special filters. Oxygen molecules are smaller
than nitrogen molecules, so the filters trap the nitrogen and let the oxygen pass through into a
collection tank. The oxygen then travels to an oxygen outlet and through your mask or nasal
cannula.

Routine care
1. Change the filter at least once a year.
2. Change the cannula every month.
3. Run the portable oxygen concentrator (POC) for a minimum of 4 hours every
month 3.
4. Drain the batteries completely every month

2.2.3. PHOTOTHERAPY
Phototherapy is a medical treatment in which natural or artificial light is used to improve a
health condition. Treatment may involve ultraviolet (UV) fluorescent light bulbs, halogen
lights, sunlight, or light-emitting diodes (LEDs)

Light therapy can be used to treat skin conditions, mood disorders, sleep disorders,
some cancers, and jaundice in babies. Some treatments involve exposure to natural or
artificial light. Others combine light therapy with a drug that makes the light more
effective.

Operation
1. The skin or blood is exposed to an ultraviolet (UV) light for a set amount of time12.
2. A medication called psoralen may be used to make the skin more sensitive to the
light, in a procedure known as psoralen UVA (PUVA)1.
3. A photosensitiser agent may be injected into the blood and activated by a
specific light, in a procedure known as photodynamic therapy

9
Routine care

1. All patients who are candidates for phototherapy treatment must be evaluated
by a provider prior to treatment 3.
2. Appropriate eyewear for phototherapy will be provided for staff, patients, and
other individuals present during light treatment 3.
3. Signage indicating rooms have been cleaned or are requiring cleaning will be
placed on all entrances and exits to the rooms where light treatment is being used
3.
4. The phototherapy director will approve phototherapy for patients under 12 years
of age 3.
5. Patients under 12 years old receiving phototherapy will not be left alone in a
treatment room during time of treatment administration. Accompanying adults will
be requested to supervise patient’s behaviour during treatment. Only, if ordered,
parent or guardian should accompany child in the photo unit

2.3. THEATRE DEPARTMENT

2.3.1. Electro surgical Diathermy
Diathermy is the use of high frequency alternate polarity radio-wave electrical current to cut
or coagulate tissue during surgery. It allows for precise incisions to be made with limited
blood loss and is now used in nearly all surgical disciplines.

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 60-99oc, 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.

Operation
Diathermy can be used in both monopolar and bipolar configurations. In monopolar
diathermy, 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 1. 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
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Routine care
1. Keep the patient’s application site clean, dry, and shaved as excess hair is the
most common cause of electrosurgical burns 2.
2. Avoid placement near scars or implant sites, and consult a cardiologist when a
patient is wearing a pacemaker or pulse generator for interference with these
devices caused by electrosurgical equipment can cause malfunction 2.
3. Be familiar with the equipment, handle it properly, and use a smoke
evacuation system 2.
4. Keep everything dry and avoid flammable substances 2.
5. Take care of the electrode tips

2.3.2. Anesthesia machine

An anesthesia machine is a medical device used to administer anesthesia to patients during
surgery. It is a pneumatic device that supplies a mixture of oxygen, gas, and an anesthetic
agent to the patient, allowing the patient to remain unconscious during surgery but at the
same time breathe.

The machine can be divided into three basic areas:

(1) a high-pressure system,
(2) an intermediate pressure system,
(3) a low-pressure system.

The high-pressure system contains cylinders of compressed gases such as oxygen and nitrous
oxide. The intermediate pressure system reduces the pressure of the gases from the high-
pressure system and adds the anesthetic vapor. The low-pressure system delivers the gases to
the patient.

Operation
The machine has several components, including a ventilator, breathing circuit, scavenging
system, and safety mechanism. Ventilators are used for the patient to breathe during surgery.
They help maintain close to normal respiratory rates and normal blood chemistry for patients.
Breathing circuits deliver oxygen and anesthetic gases to patients and eliminate the CO2 they
release. Scavenging systems collect and then remove the expelled anesthetic gases

Routine care
1. Disconnect breathing hoses and bags from machine after use
2. Check connection of oxygen source to machine
3. Assess flutter (one-way valves) for moisture, if present remove domes and clean
with dry gauze Check connection of vaporizer to machine
4. Clean external portion of vaporizer with damp cloth or gauze.
5. Check window level and refill if below fill line
6. Check drain pin and tighten (if present and necessary)

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2.4. RADIOLOGY DEPARTMENT
2.4.1. X-ray machine
An X-ray machine is any machine that involves X-rays. It may consist of an X-ray generator
and an X-ray detector

Operation
An X-ray is a common imaging test that has been used for decades. It can help your doctor
view the inside of your body without having to make an incision. This can help them
diagnose, monitor, and treat many medical conditions.

The X-ray machine operates by generating a stream of electrons by heating up a cathode

(tungsten) filament. This stream of electrons is directed at high speed at a high voltage
Anode disc (usually tungsten). X-radiation is produced due to the electrons’ interaction with
the atomic particles of the Anode.

The procedure for an X-ray is standard. In most cases, you won’t need to take special steps
to prepare for them. Depending on the area that your doctor and radiologist are examining,
you may want to wear loose, comfortable clothing that you can easily move around in. They
may ask you to change into a hospital gown for the test. They may also ask you to remove
any jewelry or other metallic items from your body before your X-ray is taken. Always tell
your doctor or radiologist if you have metal implants from prior surgeries. These implants
can block X-rays from passing through your body and creating a clear image. In some cases,
you may need to take a contrast material or “contrast dye” before your X-ray. This is a
substance that will help improve the quality of the images. It may contain iodine or barium
compounds. Depending on the reason for the X-ray, the contrast dye may be given in
different ways

Routine care
1. Perform regular preventive maintenance
2. Use and manipulate equipment properly
3. Don’t overlook component care
4. Operate equipment within its technical specifications
5. Provide the optimum environment for your X-ray equipment
6. Use only approved cleaners and disinfectants on equipment exterior.

Ultrasound machine
An ultrasound machine is a medical device that uses high-frequency sound waves to create
images of the inside of the body. It is also known as sonography

Operation
Before the exam, you will change into a hospital gown. You will most likely be lying down
on a table with a section of your body exposed for the test.

An ultrasound technician, called a sonographer, will apply a special lubricating jelly to your
skin. This prevents friction so they can rub the ultrasound transducer on your skin. The

12
transducer has a similar appearance to a microphone. The jelly also helps transmit the sound
waves.

The transducer sends high-frequency sound waves through your body. The waves echo as
they hit a dense object, such as an organ or bone. Those echoes are then reflected back into a
computer. The sound waves are at too high of a pitch for the human ear to hear. They form a
picture that can be interpreted by the doctor.

Depending on the area being examined, you may need to change positions so the technician
can have better access.

After the procedure, the gel will be cleaned off of your skin. The whole procedure typically
lasts less than 30 minutes, depending on the area being examined. You will be free to go
about your normal activities after the procedure has finished.

Routine care
7. Use the Machine Properly Using the machine as instructed in the operator’s
manual will keep it in good condition. ...
8. Disinfect the Machine Frequently In a normal setting, it’s important to
disinfect certain parts of the machine. ...
9. Clean the Machine Daily As mentioned, keeping the transducer probe clean
and disinfected is important for preventing the spread of germs. ...
10. Pay Attention to the Probe

2.5. INTENSIVE CARE UNIT

2.5.1. Defibrillator
A defibrillator is a device that delivers an electric shock to the heart of someone who is in
cardiac arrest. The shock helps to restore the heart’s normal rhythm and can save the person’s
life. Defibrillators are used in emergency situations and are often found in public places such
as airports, shopping malls, and sports arenas. They are also used by medical professionals in
hospitals and ambulances.

Operation
1. Place the pads on the patient
2. Place the left paddle on the right side of the stemum and below the clavicle
3. Place the right paddle on the 5th intercostal space and midaxillary line, check the
skin paddle contact impedance.

Routine care
1. Check the defibrillator for any obvious signs of damage or use since you last
checked it.
2. Check to see if the items that are usually stored with it are still there such as a
safety razor, scissors, and a face shield for use during CPR.
3. Check the expiry date on the sticky pads. If they are out of date, replace them.
4. Regular checks will ensure that you are aware of when the electrode pads expire,
whether your defibrillator has been used or if it has a fault, for example, the battery
13
 is approaching the end of its life. Therefore, it’s important to have a routine in place
for checking your defibrillator.

2.5.2. ventilator
A medical ventilator is a machine that helps your lungs work. It can be a lifesaving machine
if you have a condition that makes it hard for you to breathe properly or when you can’t
breathe on your own at all.

A ventilator helps to push air in and out of your lungs so your body can get the oxygen it
needs. You may wear a fitted mask to help get oxygen from the ventilator into your lungs.
Or, if your condition is more serious, a breathing tube may be inserted down your throat to
supply your lungs with oxygen.

A doctor or a respiratory therapist will control how much oxygen is pushed into your lungs by
the ventilator.

Other names that a ventilator is known by include:

respirator
breathing machine

mechanical ventilation

Operation
• Wear a mask and connect it to the oxygen delivery tube (oxygen flow rate
2-5L/min), fix the mask with the strap, and place it in a comfortable position.
• Turn on the BiPAP ventilator (S or S/T), adjust the inspiratory pressure (IPAP) to
8cmH2O, PEEP2cmH2O.
• Connect the ventilator tubing to the mask.
• Adjust the tension of the lace, so that the mask just does not leak air.
• Adjust the parameters to suit the pathophysiology of the patient:
• The respiratory rate is slightly lower than that of the patient, and the IPAP is
gradually increased from 8 or 10 cmH2O to 2 or 4 cmH2O until the patient’s
appropriate Pressure (tidal volume, respiratory ratio, loss of auxiliary respiratory
muscle activity, coordination of chest and abdomen).
• Adjust the oxygen inhalation flow or oxygen inhalation concentration (FiO2) until the
oxygen saturation (SPO2) reaches 90-95%.
• Monitor frequency rhythm, IPAP, Vt, PEEP and SPO2. After 20 minutes of
stabilization, blood gas analysis was performed. According to the results,
adjust various parameters.
• Strengthen oral care, remove secretions and vomit in time, and prevent suffocation.

Routine care
Here are some essential steps for routine care of a ventilator:

1. Review communications: Communication among care providers promotes optimal

outcomes. For mechanically ventilated patients, care providers may include primary
care physicians, pulmonary specialists, hospitalists, respiratory therapists, and
nurses. To make sure you’re aware of other team members’ communications about
14
 the patient, find out the goals of therapy for your patient when obtaining report.
Why is the patient on a ventilator? What is their do-not-resuscitate status?
2. Check ventilator settings and modes: When you enter the patient’s room, take vital
signs, check oxygen saturation, listen to breath sounds, and note changes from
previous findings. Also assess the patient’s pain and anxiety levels. Read the
patient’s order and obtain information about the ventilator. Compare current
ventilator settings with the settings prescribed in the order. Familiarize yourself
with ventilator alarms and the actions to take when an alarm sounds. Locate
suction equipment and review its use.
3. Oral hygiene: Oral hygiene is crucial to prevent ventilator-associated pneumonia
(VAP). Change canister, tubing, every 24 hours; coordinate with change in 24 hour
oral care kits. Oral care kits will be dated and timed. Change closed in-line suction
catheter every 72 hours. Change the heat, moisture exchange filter (HMEF) every
48 hours and prn
4. Tracheostomy care: If a tracheostomy tube is in place, it should be changed
regularly to remove mucus from airways. Maintain the equipment needed to clear
mucus and keep airways open.

2.5.3. Nebulizer
A nebulizer is a piece of medical equipment that a person with asthma or another respiratory
condition can use to administer medication directly and quickly to the lungs.

A nebulizer turns liquid medicine into a very fine mist that a person can inhale through a face
mask or mouthpiece. Taking medicine this way allows it to go straight into the lungs and the
respiratory system where it is needed.

Operations
1. To operate a nebulizer, you can follow these steps:
2. Wash your hands for at least 20 seconds with soap and water. Rinse your hands
and dry them off with a paper towel. Turn off the faucet using a paper towel
12345.
3. Prepare the medication by unscrewing the top of the nebulizer cup and putting
the prescribed medication into the nebulizer. Many types of respiratory
medications for nebulizer treatments come in pre-measured doses. If yours is not
pre-measured, measure out the exact amount prescribed for one dose. Secure
the top tightly to prevent the medication from spilling out.
4. Attach the mouthpiece to the nebulizer cup. Although different manufacturers may
have slightly different jet nebulizers, most mouthpieces will attach to the top of the
nebulizer cup. Most nebulizers have mouthpieces instead of face masks, since
masks can lead to facial deposits.
5. Connect the tubing to the nebulizer cup. On most types of nebulizers, the tubing
will connect on the bottom of the cup. Connect the other end of the tubing to an
air compressor used for nebulizers.
6. Turn on the air compressor and use the nebulizer. Put the mouthpiece into your
mouth, above your tongue, and keep your lips sealed tightly around it. Inhale
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 slowly and deeply through your mouth so that all the medicine goes into your
lungs. Exhale either through your mouth or nose. For adults, holding their nose
closed can help ensure that they inhale medicine through their mouth.
7. Clean and disinfect your nebulizer after each use to prevent germs from growing in
it 5.

Routine care
1. Wash your hands with soap and water or an alcohol-based sanitizer before
handling the nebulizer.
2. Disassemble the nebulizer into its individual parts, if possible.
3. Rinse the mouthpiece, mask, T-shaped connecting pieces, and medicine cup
with warm water for about 30 seconds to 1 minute.
4. Wash the parts with liquid dish soap and warm water. Do not use hot water or
put them in a dishwasher.
5. Rinse the parts thoroughly with warm water to remove any soap residue.
6. Shake off any excess water from the parts.
7. Air dry the parts on a clean towel or paper towel. Do not dry them with a cloth
or towel as this can introduce germs.
8. Reassemble the nebulizer once all parts are completely dry.

2.6. DENTAL DEPARTMENT

2.6.1. Dental chair
A dental chair is a specially designed medical device that is used to support a patient’s
whole body during dental procedures. It is similar to a recliner, but articulated, so that the
dentist can recline patients to virtually any position

2.6.2. Compressor
A dental air compressor is a basic necessity in any dental practice. It’s a machine that is used
to power the tools that are used in dentistry. They include, syringe, handpieces, delivery unit
and scalers among others.It’s designed to prevent patients from acquiring contaminated air
in the operation process.

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CHAPTER

THREE

CHALLENGES

3.1 PROGRESS
The industrial attachment was successful to me because I was able to learn more about
my course and got experience on how the hospital is run. I got skills on how to
operate some modern equipment, hence giving me hope.

3.2 CHALLENGES ENCOUNTERED

a) Inadequate staff members hence there were few engineers to help, making part of
my industrial attachment progress tiresome.
b) Congestion of trainees made learning difficult.
c) Inadequate tools for work.
d) Outdated technology on available machines
e) No provision of meals during the attachment period.

3.3 SOLUTIONS TO THE CHALLENGES

a) A good number of students on attachment was well trained to operate equipment
and became of good help to the facility.
b) Trainees were spread all over the hospital departments to reduce the numbers
that caused congestion.
c) The government supplied more equipment and tools to the hospital hence solving
the problem of inadequate tools.
d) The outdated technology in the faculty was taken away from the hospital and
replaced with new technology
e) Support from my parents helped to facilitate my meals

3.4 RECOMMENDATION
I recommend that the school to provide some of the small handy tools to the engineering
students so that we don’t depend on the workplace equipment that can be easily
acquired by an individual.

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REFERENCES
Yen GG (Oklahoma State University, School of Engineering, Stillwater, OK). Health
monitoring on vibration signatures. Final report. Arlington (VA): Air Force Office of
Scientific Research (US), Air Force Research Laboratory; 2002 Feb.

Russell ML, Goth-Goldstein R, Apte MG, Fisk WJ. Method for measuring the size
distribution of airborne Rhinovirus. Berkeley (CA): Lawrence Berkeley National Laboratory,
Environmental Energy Technologies Division; 2002 Jan. Report No.: LBNL49574. Contract
No.: DEAC0376SF00098. Sponsored by the Department of Energy.

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