1. Basics of Medical Equipment Lecture 3

2. I. Nebulizer
It is a device that delivers the same types of medication as metered-dose inhalers (MDIs), which are the familiar pocket-sized inhalers, but works differently. Nebulizers may be easier to use than MDIs, especially for children who aren’t old enough to properly use inhalers, or adults with severe asthma.
A nebulizer turns liquid medicine into a mist to help treat your asthma. They come in electric or battery-run versions. They also come in a larger size that’s meant to sit on a table and plug into a wall, and a smaller size you can carry with you. Both are made up of a base that holds an air compressor, a small container for liquid medicine, and a tube that connects the air compressor to the medicine container. Above the medicine container is a mouthpiece or mask you use to inhale the mist.

3. Types 1: Electrical 2: Manual

4. Most nebulizers are small, so they are easy to transport
Most nebulizers are small, so they are easy to transport. Also, most nebulizers work by using air compressors. A different kind, called an ultrasonic nebulizer, uses sound vibrations. This kind of nebulizer is quieter, but costs more

5. The basic steps to set up and use your nebulizer are as follows:
Wash your hands well.
Connect the hose to an air compressor.
Fill the medicine cup with your prescription. To avoid spills, close the medicine cup tightly and always hold the mouthpiece straight up and down.
Attach the hose and mouthpiece to the medicine cup.
Place the mouthpiece in your mouth. Keep your lips firm around the mouthpiece so that all of the medicine goes into your lungs.
Breathe through your mouth until all the medicine is used. This takes 10 to 15 minutes. If needed, use a nose clip so that you breathe only through your mouth. Small children usually do better if they wear a mask.
Turn off the machine when done.
Wash the medicine cup and mouthpiece with water and air dry until your next treatment.

6. 1 Immediate Care
1. Switch off the Nebulizer, stabilizer then the main switch and un-plug.
2. Disconnect Nebulizer port from the tubing’s (depending on the type).
3. Wash the Nebulizer pot in warm soapy water and rinse thoroughly with clean water after every use.
4. Reconnect the Nebulizer port to the tubing and blow air from the compressor unit through it for a few seconds.

7. 5. Decontaminate the patient’s mask, wash with soapy water and rinse with clean water
6. Leave the mask to dry
7. Disconnect the Nebulizer port from the tubing and allow it to dry completely.

8. 2 Routine Care
1. Once a week clean the Nebulizer port with disinfectant and rinse with clean water and dry.
2. Check the tubing regularly for cracks and kinking.
3. Cover with clean cloth or in their boxes when not in use.
Note:
1. Do not use a brush to clean the Nebulizer port as it may damage it.
2. Tubing should be replaced after every six months/whenever necessary.
3. Nebulizer port should be replaced after every four months/whenever necessary.

9. Suction Machine
Suction Machine is medical equipment that provides an efficient means of removing body fluids (e.g. blood, mucus, vomitus) from wounds, respiratory tract or body cavities.
Types:
1: Electrical
2: Manual

12. Preparation
1. Make sure the machine is clean, complete and in good working condition
2. Place the suction machine away from the wall and lock the casters.
3. Put some disinfectant in the collecting bottles.
4. Connect the tubing‟s appropriately.

13. Operation (electrical)
Plug into the socket and switch on the mains, stabilizer and machine.
2. Ensure the pilot lamp lights.
3. Connect the suction tube to the patient connector.
4. Fill the collecting bottles not more than 2/3 as the secretions will over flow to the motor causing damage.
5. When one bottle is 2/3 filled, shift to the other bottle

14. Immediate care
1. Suck in decontaminant, clean water before disconnecting.
2. Switch off the machine, stabilizer and main.
3. Unplug the cable from the socket.
4. Disconnect tubing, bottles and empty the content
5. Decontaminate the bottles and tubes.
6. Wash with soapy water, rinse with clean water and leave it to dry.

15. Routine care
1. Make sure that the equipment is clean and dry at all times.
2. Pack the tubing in the drum and sterilize.
3. Check the tubing for the damages or deterioration
Note:
1. Electrical suction machine is not recommended for infants because of the high pressure.
2. There is a pressure low suction machine for babies.

16. Preparation: (Manual type):
Same as electrical
Operation:
1. Put little water in the bottles.
2. Change the catheter after use and dispose off.
Note:
In case the equipment is to be used for babies:-
1. Put little water in the collecting bottle. This is because the disinfectant is harmful to babies in case of back flows.
2. The manual type is recommended for children and babies because of less pressure.

17. Syringe pumps
Syringe pumps use a series of sensors and a motor driven plunger head to infuse liquid at a precise rate
Applications
Infuse fluids, medication or nutrients into circulatory system
Administers fluids more reliably than humans
Improve patient safety by increasing consistency and accuracy
Assist in investigation of incidents by collecting data in memory

18. Preventive Maintenance
Replace IV tubing, cassette, and/or syringe
Clean machine and chassis of any solution residue
Verify software and menu settings are appropriate for clinical application
Examine controls and switches for proper function
Confirm lights, indicators, and displays are working
Verify flow stops when device is turned off
If device includes a feature that requires the IV set to be closed before it is disconnected (either automatically or manually), verify that this mechanism is operating properly

19. Check rollers and tubing to see if replacement is necessary
Run self-test, if equipped
Examine plug and line cord
Verify battery chargers and indicators are working
Check suggested replacement date for the battery to see if the date is passed or approaching
Calibrate machine as necessary
Check for unusual noise or vibration
Examine internal cables and connectors
Lubricate as required by syringe pump manufacturer

20. Ambulatory Infusion pump
Ambulatory infusion pumps are typically plastic handheld devices consisting of a disposable syringe or a disposable, collapsible bag reservoir; a mechanism for propelling the infusate; a flow control mechanism; and a means of displaying alarm conditions and/or user prompts. An IV set and tubing connect the pump to the patient.
Electronic models are powered by batteries; some include software to help prevent medication errors.

21. Principles of operation
Most ambulatory pumps are microprocessor controlled. Peristaltic pumps successively squeeze and release IV tubing, moving the fluid into the patient catheter. The speed of a stepper motor determines the cycling rate the peristaltic mechanism, thereby controlling the infusion flow. These pumps deliver at flow rates ranging from 0.01 to 999 mL/hr. Syringe-based pumps use a syringe as a drug reservoir, propelling the fluid by forcing the plunger into the syringe barrel. A lead-screw mechanism pushes a threaded block against the plunger. Syringe drivers use spring- or gas-powered mechanisms to provide a relatively constant force to the plunger, creating a constant pressure for fluid delivery.

22. Metering Syringe Pumps
For applications where a specific volume of fluid must be delivered, Syringe Pumps can be programmed to run in constant flow mode (for delivering a precise and constant rate) or dispense mode (to deliver an exact finite amount).
syringe pumps deliver steady, pulse-less feeds at precise flow rates down to the sub-microliter per minute. Metering applications, such as reactant feed, require the fluid to be pumped at extremely low flows. The flow rate accuracy of a low flow system is dependent upon the right setup for your application, and is highly susceptible to a number of factors.

23. Seal Cleaning andReplacement
The piston seal may be cleaned or replaced yearly. Maintenance may be more frequent, depending on the type of use and nature of the pumped fluids. If either the cylinder or seal has been scratched, it must be replaced to maintain flow rate specifications. Before cleaning or replacing any seals, run the pump at maximum flow rate until the cylinder is empty, then disconnect the power cord.