TOPIC: PATIENT SAFETY BASED ON SUCTION AND ELECTROSURGICAL DIATHERMY MACHINES. PRESENTER: ALCARD FIDELIS BIOMEDICAL TECHNOLOGIST. ENGINEERING DEPARTMENT 21st July, 2016

1. Introduction 2. Suction machine  What is it  What does it do  How does it do  Types of sections  Safety precautions  Principle part and their respective roles  Equipment sop  PPM maintenance  Trouble shooting

3. Electrosurgical diathermy machine  What is it  What does do  How does it do  Types  Safety precaution  Principle part and their respective roles  Equipment sop  PPM maintenance  Trouble shooting

INTRODUCTION Patient safety training is essential for the operator of equipment and for the hospital maintenance staff so that the hospital may become nearly self – sufficient and able to keep its equipment in good working order. The maintenance of medical equipment is essential to ensure that it functions

correctly and efficiently and ultimately to ensure proper clinical management of the patient. The aims of this training are to ensure that equipment attain the standard performance characteristics set by the hospital, the manufacture’s specification and the clinical requirements.

SUCTION MACHINE What is it? The suction machine is the machine that achieve its function by using negative pressure. What are the types? Electrical suction machine Mechanical suction machine

CONT. What does it do? The equipment is mainly used for sucking body fluid from patients in hospitals. How does it do?

An electric suction machine has an electric driven pump which evacuates bottles(reservior)to which is attached a suction tube. The system incorparates a manometer and a mechanism to facilitate regulation of the vacuum by allowing air to be drawn in from the room.

FOOT OPERATED SECTION MACHINE Mechanical suction machine –is the simplest type of suction machine that is foot operated, the piston is pressed on by the foot and on the return stroke of the piston is operated by spring. Suction is created and a series of valves directs the flow as required.

SAFETY PRECAUTION Cover any cut or abrasions Always use gloves when operating or repairing a suction machine Make sure that the machine is disinfected Do not put any part in your mouth Wash your hands after using/repairing a suction machine Do not suck or blow into any part of the machine Handle all parts with care.

EQUIPMENTS Make sure that all bottles and tubes are securely fixed Make sure that fluid cut-off floater is clean and well functioning to protect liquid to the motor/pump Make sure the floats volume must be on pump side not patient side on collection bottle.

EQUIPMENT SOP Always follow the manufacturers instructions Wear protective gloves before you start to use the machine Plug the machine(if electric) to the wall electric socket Make sure that collection bottles/jar are securely fixed Make sure that all tubings are properly connected Switch on the electricity and turn the suction machine.

PPM Empty collection jar just before it is full to prevent overflow to the pump. Check the sealing washer for cracks Ensure that the bottle /jar cap is securely tightened Make sure the bottle/ jar is secured clamped in place properly Check the bottle if is not cracked

PPM Check the bottle and tubing for leakage Clean and disinfect the collection jar and tubes after every procedure Clean the equipment with tap water and detergent thoroughly everyday.use water cloth (deep in water and squeeze dry)Wipe dry the equipment.

TROUBLESHOOTING

VACUUM PLANT (WALL SUCTION) The medical vacuum plant system is the system designed to produce and maintain vacuum of not les than 400mmHg below the atmospheric pressure of 760mmHg(absolute temperature of approximately 360mmHg. Medical vacuum in a hospital supports suction equipment and evacuation procedures, supplied by vacuum pump systems exhausting to the atmosphere. Vacuum will fluctuate across the pipeline

PARTS OF VACUUM PLANT Vacuum pump Vacuum reservior- Exaust silencer assembly Isolating valve Bacterial filter Drainage trap Manual drain trap Tundish collector Sight level tube Vacuum mains service Non return valve Flexible pipe

ELECTROSURGICAL DIATHERMY What is it? Electrosurgical diathermy is a machine used for cutting and coagulation human skin during operation. What does it do? The diathermy is used as an alternative to scalpel. Diathermy can cut like a scalpel, but can also coagulate the blood in the small vessels so the surgical field is dry, meaning bloodless. It allows the surgeons to work faster as they do not have to hand tie off every vessel they cut. The patient recovers better as there is less blood loss and there is more repaid healing.

How does it do it? Diathermy accomplished electro surgery by converting high frequency electrical current into heat, caused by tissue resistance to the passage of electrical current. As current must pass through the body at least two electrical connections be made between the patient and the machine. The power needed is up to 400watts. If the waveform is damped it will coagulate blood and stop bleeding (coagulating setting). If the waveform is undamped the tissue is ablated leaving a void or cut or incision (cut setting). In all electro surgery procedures there is the smell of burning flesh and smoke.

Safety Precautions USERS AND MAINTENANCE PERSONNEL When oxygen is being administered to the patient avoid oxygen leakage to an atmosphere where fires can quickly ignite. Special care is required when doing neck or mouth surgery to avoid a flash fire. Make sure that the contacts between the patient and dispersive electrode are made properly to avoid tissue burns.

Equipment The equipment has generating unit which is solid state device that can produce 300 to 3000 kilo Hertz Most machines produce 25 – 200 watts The dispersive electrode can be a metal plate covered with a conductive gell or saline soaked cloths. However, many are now using single use of dispersive electrodes. Single use devices are often pre – gelled, conductive adhesive pads that include multiple connections to the machine. The multiple connections are used to allow the device to constantly check for a good contact between the patient and the dispersive electrode. Sparks are a common occurrence when diathermy is in use.

Principle parts and their respective roles NAMEFUNCTION Connecting leadsLink / connection between the machine and the switching hand piece Switching hand pieceFor cutting and coagulation switching Cutting blades /knivesFor cutting and coagulation Patient plateBase plate connection Foot switchDistant switching for cutting and coagulation pressed by foot.

Equipment SOP  Set the equipment at appropriate place.  Make all necessary connection (connecting leads, switching hand piece, foot switch, patient base plate, electrode and cutting blade).  Plug in the machine to power supply  Place the patient in contact with the base plate.  Select the operation mode.  Switch ON the machine

NOTE: “The dispersive electrode should always be placed on an area of the body that has good blood flow and not subject to high weight concentration. The side of the thing is a very common location, under the buttocks is not a good location as it generally is a high weight bearing point”.

PPM Maintenance: Keep the outside of the machine clean. Check the plate electrodes, the leads for any damage. Check instrument adjusting knobs for any loose, tighten if possible. Clean and sterilize the instrument electrodes after each surgical procedure. Store them in a cool dry place.

Troubleshooting ProblemCauseRemedy Burns of the skin on the patient plate contact Poor contact of the patient dispersive electrode Place the plate on an area of the body that has good blood flow and not subjected to high weight concentration Alarming sound from the machine No contact with the dispersive electrodes Ensure proper connection of all leads No cutting / coagulationDirty cutting / coagulation tips Clean and dry the tips