BC Biomedical NIBP-1010 Manuel d'utilisateur

 ExperimentaltaskswithintheenvironmentofanICUsimulatedsite Bc. Ondřej Čadek, Ing. Richard Grünes, Ph.D., Ing. Petr Kudrna, Ing.

spring changes its qualities over time, and so these instruments are less accurate on a long-term basis. This type of apparatus is depicted in Figur

ČSN EN 62353 Electrical medical devices Repetitive tests and post-repair tests of the electrical medical devices. The standard defines the essenti

• Accessories for measuring the applied part’s current ILLKO RM 2050 • Simulator FLUKE medSim 300B Measurementprocedure1) Carry out a detailed

To measure the apparatus’ insulation resistance, proceed in accordance with the user manual of REVEX 2051. Detailed measurement procedure can be fou

connection according to the user manual for medSim 300B. Turn the monitor on and set up the ECG measurement on at least two leads (e.g. II and V1),

9. The influence of user-adjustable parameters on the action of the patient simulator system METI ECS  The interactive, whole-body patient simulat

parameters change in one system, then all other parameters in a mutual bond change adequately, see the mutual interconnection in Fig. 9.2.

• Oropharyngeal oedema - the oedema size can be set up to various levels (medium severe to severe) and orotracheal intubation can thus be prevented

• Right atrial pressure • Pressure in the pulmonary artery • Cardiac output by means of thermodilution The system dynamically models the arteria

Basicparametersofthemodel Some initial patient configurations and scenarios have already been pre-programmed to the ECS:  Man, 33 years old,

CVP Central venous pressure mmHg Left Vol. The volume of the left lung ml Right Vol. The volume of the right lung ml Spont. VT Spontaneous ti

The efforts to replace mercury but to keep a similar design lead to the introduction of so called pseudo-mercury tonometers. These are electronic to

4) Simulate disconnecting the cable by taking one of the Einthoven leads off of the mannequin simulator and observe the influence on the ECG signal

 PACO2 = PAO2 = PaCO2 = PaO2 = pH = PvCO2 = PvO2 = ad 5b) Record the basic physiological parameters of the ECS simulator after an

• Intubation set • Ambu vac • Lung ventilator Veolar (Hamilton Medical, USA) ConclusionSummarize your findings and comment on the individual me

circulation within the artery above which the pressure sleeve (cuff) is placed. By gradual reduction of pressure in the sleeve (cuff), the circulati

becomes fully transitory again, and the Korotkov murmurs fade away. At this moment, we read the current pressure value, and it is the diastolic pres

pulse measurement will be verified in three particular simulated situations via the NIBP simulator. Measurementtasks1) Carry out measurement of

 For points 1), 2), and 3), the measurement procedure is the same. In mercury tonometer, do not forget to open the transport valve prior to the act

manual tonometers, and for digital tonometers, calculate percentual deviations of the measured values. For each group of tonometers (manual, digital

2. Principles and applications of electrocardiographs To understand the principle of functioning of the actual electrocardiograph, it is necessary t

Heartfunctions‐physiologyA healthy heart works as a pump, which makes the blood circulate in the body. Blood is brought from the organs by veins

precaution against the blood’s reflux from the ventricles to the atriums, but also as electrical insulation. In a healthy heart, the transmission of

Experimental tasks within the environment of an ICUsimulatedsiteBc. Ondřej Čadek, Ing. Richard Grünes, Ph.D., Ing. Petr K

 The action potential is accompanied by changes of tension on the membrane; see Fig. 2.4. These are caused by the flow of ions inside and outside o

 We distinguish between two essential types of action potentials: 1) Action potential with fast depolarization This is typical namely for the

 Fig. 2.5: Processes of action potentials in the individual parts of the heart [2.6]. Spreadingoftheactionpotential Action potential is spre

 Fig. 2.6: Absolute and relative refractory periods [2.6]. Variabilityofanatomicalandphysiologicalparameters Each individual has certain ch

Tab. 2.1: Typical values for sportsmen and non-sportsmen [2.2]. Non-sportsmen Sportsman at rest up at rest up Heart weight (g) 300 500 Blood v

The 12-lead system consists of: • Bipolar limb leads according to Einthoven (leads I, II, III) • Unipolar augmented leads - Goldberg’s leads (aVL,

 Fig. 2.9: Unipolar leads’ geometry according to Goldberg. Wilson’s chest leads The limb leads mentioned so far represent the heart’s electrica

Otherpossiblemodificationsoftheleads Besides the already described 12 conventional leads, some other leads may be used in certain situations

example, diodes connected in anti-parallel, Zener diodes connected in anti-series, or eventually voltage limiters consisting of two silicon transist

Filters Filtration is an inseparable part of signal processing. A filter is generally a circuit designed in such a way as to transmit signals of a

 Reviewed by: Ing. Jakub Ráfl Česká technika - publishing house of the Czech Technical University in Prague (ČVUT)

barrier is specified by the size of the isolation voltage uiso, the isolation capacity C, and the isolation resistance R. From the point of view of

continuously. Fig. 2.13 shows a schematic diagram of the circuit, which is used to discover badly connected electrodes on the patient’s body. Fig

• Set the simulator to a normal sinus rhythm with a physiological frequency Measure the ECG signal’s amplitude, calculate the amplitude’s size prio

[2.2] Despopoulos, A., Silbernagl, S. Atlas fyziologie člověka, 6. vyd. Praha, Grada Publishing s. r. o., 2004. 448 s. ISBN 80-247-0630-X. (in Czech

3. Principles and applications of defibrillators Theoreticalintroduction Defibrillation is used to eliminate fibrillations (cardiac arrhythmias,

only, and to biphasic pulse (Fig. 3.2), when the direct current is lead past the heart muscle in one direction during the first stage of the pulse,

 The trapezoidal pulse is also marked as MTE or BTE (Monophasic/Biphasic Truncated Exponential pulse), Fig. 3.1 and Fig. 3.2. Damped shape of the

 Fig. 3.5: Equivalent electrical diagram of a final stage of a monophasic defibrillator with damp-shaped defibrillation pulse with delay. Position 1

ECG signal with additional ECG electrodes. Also the time interval of the R-R waves in the ECG signal is evaluated. In the fix-rate mode (bradycardia

R-R interval of spontaneous activity (TCL - Tachycardia Cycle Length), typically at 85 % of TCL. The distance of the subsequent stimulation impulses

Acknowledgements: This publication was supported by the European social fund within the framework of realizing the project „Modernisation of teachi

Measurementtasks Prior to the actual measurement, get familiar with the manipulation with and the components of the available defibrillators (suc

Ad task 1) Switch on the analyzer using the switch on the back side, see Fig. 3.7. Set up the analyzer to the required range according to the ener

 Fig. 3.8: Defibrillator analyzer - overall view with legend [3.6]. Read and record the applied discharge’s energy on the analyzer’s display - “E

discharge buttons into the analyzer. Read the time for charging the defibrillator on the analyzer’s display “Chg Time: xxx.x sec”. Compare the value

Ad task 5) Safety-technical check: on the basis of the operation manual [3.8, 3.9] for the defibrillator and the electro-revisional apparatus Medi

the operation (user) manual. Determine the type of the applied part the apparatus works with, the (electrical) insulation class and the MD classific

4. Principles and applications of pulse oxymeters Theoreticalintroduction Pulse oxymetry is a non-invasive optical method used for long-term mon

 There are more factors influencing the decrease of the radiation (light) intensity in a tissue. The thickness of the tissue the radiation (light)

bound to hemoglobin, we identify it as oxyhemoglobin (oxy-Hb) or deoxyhemoglobin (deoxy-Hb). The volume of oxygen transported in blood is thus direc

consists of the direct component DC (absorption of light via a tissue with fixed amount of venous and arterial blood), and of the alternating compon

Table of contents Introduction ...

 With (4.3) it is possible to calculate a theoretical conversion curve between the R ratio and oxygen saturation in arterial blood SaO2 (Fig. 4.4),

 Fig. 4.5: Schematic diagram of the edutool - a model of an analogous part of a pulse oxymeter with marked check points.

MeasurementprocedureAd task 1) ATTENTION: Supply the SpO2 simulator form a 12V source with the positive pole on the cover and the negative pole o

meaning: K1 - oscillator’s clock pulses, K2, K3 - managing impulses of the R/IR diodes, K4 - output signal of the input amplifier, K5, K6 - managin

suitable gain/amplification to display the curve within the full possible dynamic range. Connect the edutool to the oscilloscope by means of a coaxi

Check‐upquestionsregardingthegivenissue1) Why is pulse oxymetry called “pulse”? 2) What is the principle for sensing the plethysmographic cu

5. Principles and application of infusion pumps and linear infusion pumps  Infusion technology plays an important role in correct treatment of pat

the entire pump for new utilization, but the entire set is again replaced. In case of using the above mentioned pumps, the medium flows directly thr

systems are used in infusion pumps, as they are not so selective regarding the tubing materials used, and moreover, it is possible to use various si

 Concerning infusion dispensing, only the version using two stoppers and a supporting trail is used. This arrangement, together with the principle

Introduction  Dear students, dear readers, you are now holding a coursebook dealing with the problem of laboratory practical trainings in the cour

Linearsystemsofthemediumdrive The second version used for drawing the media using the peristaltic transfer of the liquid is represented by th

Linearinfusionpumps Linear infusion pumps are used for similar purpose as the infusion pumps - to administer drugs. As opposed to the infusion p

measurement accuracy. Another requirement stems from the standard ČSN EN 60601-1, which deals with electrical safety, both from the point of view of

 ČSN EN 60601-1, Part 1, General requirements for essential safety and necessary functioning This is a basic standard from an entire set of techn

• SEV LITOVEL 2P • POLYMED ID 20/50 • GOSSEN METRAWATT SECULIFE-IF + ACCESSORIES • ILLKO REVEX 2051 + ACCESSORIES • LUER syringe - 20 ml, 50 ml

2) Check the integrity of the supply cable While checking, focus namely of the cable terminations, in place where the cable enters the termination

(for SEV LITOVEL 2P and POLYMED ID 20/50) To measure the apparatus’ insulation resistance, proceed in accordance with the user manual of REVEX 205

 To check the bubble detector, turn the infusion bottle in such a way as to allow for a small amount of air (a bubble) to be sucked into the infusi

6. Using the patient simulator and breathing simulators in the area of ventilation technology Theoreticalintroduction Artificial lung ventilatio

application of the artificial lung ventilation, together with other risks, such as a greater infection risk, oxygen toxicity in its increased factio

national budget. And this part has been issued thanks to this support, namely by means of the authors’ fees being paid from the above mentioned proj

of the controlling panel [6.3]. The Hamilton ventilator supports the following ventilation modes: • (S)CMV – (Synchronized) Controlled Mechanical V

Spontaneous breathing ventilation mode (SPONT) This mode is designed for patients with spontaneous breathing activity and is used for its support

 Throughout the MMV, the ventilator always assesses the last 8 breaths and converts their volume to the expected minute volume. This automatic regu

 Spontaneous breathing may take place in the mode of continuous positive-pressure breathing or inspiratory assistance up to the positive pressure v

Measurementproceduread 1) Calculate the minute ventilation according to the relation (6.1): (6.1) and the alveolar ventilation according to the

 Fig. 6.2: Controlling panel of the ventilator. The individual parameters of artificial lung ventilation are set up on the controlling panel: • Ve

 Fig. 6.3: Setting up the I:E ratio. Example: Breathing frequency fCMV is 15 breaths per minute. That corresponds to the duration of the entire bre

 Fig. 6.4: Setting up the inspiration delay time. • Characteristics of flow during inspirium - the user may select among seven defined flow charac

 Fig. 6.5: Alarm control panel The Yes and No buttons are used for confirming the ventilator’s messages and actions. The Info button allows for d

 Fig. 6.6: Patient monitor. The displayed parameters are immediate measured or calculated values. A column scale is used to display the measured

1. Principles and applications of tonometers Theoreticalintroduction Measuring the blood pressure in a non-invasive way is a common routine in d

PEEP - positive end expiratory pressure or continuous positive pressure in the airways. Information on frequency: ftotal - total breathing frequen

Rinsp - inspiratory resistance; this resistance represents the dynamic resistance of the circuit, the endotracheal tube and the airways; this parame

What does the abbreviation PEEP stand for and what is its significance during ventilation: What does the symbol Ppeak mean and what is its si

Referencestousedandrecommendedinformationsources[6.1] Wesbter, J.G. ed. Encyclopedia of Medical Devices and Instrumentation. Wiley. [online]

7. Principles and application of electrosurgical apparatus Theoreticalintroduction Electrosurgery means application of radiofrequency (RF/VF) cu

Thecontentsandtheaimofthemeasurements High-frequency electrosurgery provides means for fine and accurate surgical interventions on vascula

for the individual measurements, the actual set-up of the analyzer and its connection to the oscilloscope [7.6]. Fig. 7.1: Front panel of the elect

Fig. 7.2: Rear panel of the electrosurgical apparatus CLINIC 170 W [7.5]. Legend: 1 - pneumatic trigger connector - connecting the foot switch 2

After that, connect the electrosurgical apparatus in the electrical power network and switch it on via the rocker-type switch on the rear side of th

 Activate the apparatus via the foot switch. Gradually read all the output performance values on the tester’s display and record them in the respec

Apparatusforbloodpressuremeasurements The basic concept of blood pressure measurements has remained the same from historical apparatus to the

function, namely with leakage currents and functional currents flowing from the high-frequency apparatus via undesirable paths through the patient o

• Digital apparatus for checking the medical electric apparatus MEDITEST 50 (ILLKO, s.r.o., Czech Rep.) • Oscilloscope and interconnecting BNC cab

 Tab. 7.3: Dependence of the working current size on the setting of the output performance and the load resistance size at section in monopolar mode

 Tab. 7.5: Dependence of the working current size on the setting of the output performance and the load resistance size at coagulation in monopolar

 Tab. 7.7: Dependence of the leakage current size on the setting of the ESU output performance in monopolar mode. Output power [-] Cut Mixed cut Coa

Conclusion Briefly comment on each point of the measurement. Evaluate the measured results and compare them with the data stated by the manufactur

4) Describe the functional principle of the electrosurgical apparatus’ analyzer RF 303. 5) Describe the significance of measuring the so called le

8. Principles and applications of the vital functions monitors Theoreticalintroduction Monitors of the patient’s vital functions play an importa

 Just like any medical device, also the patient monitors and their utilization are subject to valid legislation. STC (safety-technical check), whic

that the safety and health of the users or third persons are threatened or the usability period determined by the manufacturer or the importer has e